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Late Effects of Treatment for Childhood Brain and Spinal Tumors
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Ralph Salloum, Katherine Baum, Melissa Gerstle, Helen Spoudeas, Susan R. Rose
Emerging treatments targeting central pathways of appetite regulation have not been evaluated in children with HyOb. Glucagon-like peptide analogs caused weight reduction with improved insulin secretion and improved satiety in adults with HyOb. Gastrointestinal upset might limit drug tolerability.151
Future and Novel Unexplored Indications of Retinoids
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
Retinoids, especially acitretin, lead to a significant reduction in the number of actinic keratoses (AKs) and prevent squamous cell carcinomas (SCCs) in solid-organ transplant recipients on long-term immunosuppression, but with drug tolerability being a limiting factor (27). The utility as a chemopreventive agent in high-risk, nontransplantation patients is not clear. A study has failed to demonstrate any significant decrease in the incidence of or clinically meaningful delay in new non-melanoma skin cancer (NMSC) development in patients with a history of multiple NMSCs (28). Similarly, another trial that assessed the chemopreventive effect of low-dose isotretinoin in patients with a history of basal cell carcinomas (BCCs) found no difference in the incidence or the time of onset for first new BCC (29). Retinoids have a role in preventing the development of SCCs in patients with xeroderma pigmentosa (XP) and in the treatment of multiple BCCs in the setting of XP (along with topical imiquimod) (29,30). Oral retinoids, such as etretinate/acitretin or isotretinoin, have been used (31).
Women’s health, cardiovascular risk and hypertension: the perspective still needs to improve
Published in Blood Pressure, 2023
Michel Burnier, Jana Brguljan, Engi Abd Elhady Algharably, Sverre E. Kjeldsen, Krzysztof Narkiewicz, Brent Egan, Suzanne Oparil, Reinhold Kreutz
As discussed by Delles and Currie [25], these new analyses reveal that the binary approach that is regularly used to assess the sex effects of interventions is probably insufficient, as it does not capture the male and female-specific conditions. Lastly, one should perhaps be more sensitive to the fact that there is sexual dimorphism in the pharmacology of antihypertensive drugs and the risk of developing drug-related adverse reactions [26]. A Polish survey conducted on 1000 treated hypertensive patients showed that the frequency of reported adverse drug-induced symptoms was significantly higher in females (54%) than in male patients (41%), even though females were taking significantly fewer drugs [27]. This study, like many others before, confirms the sex and gender-specific differences in drug tolerability and safety further emphasising the need for closer attention in the prescription of drugs (which often differs in women and men), and in the monitoring of adverse reactions during follow-up.
Antimalarial treatment in infants
Published in Expert Opinion on Pharmacotherapy, 2022
Laura C. Kalkman, Thomas Hanscheid, Sanjeev Krishna, Peter G. Kremsner, Martin P. Grobusch
Drug tolerability problems, such as nausea and vomiting, negatively impact adherence and increase treatment failure. Reduced malaria drug tolerability is observed in young children and infants. They generally seem more likely to vomit during a malaria episode and are at increased risk of vomiting after receiving ACT treatment. For example, a systematic review and pooled analysis including safety data of 5024 patients found that vomiting after A-L treatment occurred in 11% of infants as opposed to 4% of older patients [75]. More frequent occurrence of vomiting in infants compared to older children was reported for DHA-P and A-PYR as well [77,92]. When comparing frequencies of gastro-intestinal adverse events, most studies find A-L is best tolerated; closely followed by, or comparable to DHA-P, A-PYR, A-AQ, and A-SP [82,91,119–122]. A-MQ was reported to lead to increased rates of vomiting compared to other ACTs, although now that it is given in split dose (15 mg/kg followed by 10 mg/kg 12 hours later) and co-administered with artesunate, tolerability has improved [82,96,111,118,123]. Vomiting has led to increased rates of treatment failure in infants and children, at least in the case of A-MQ [97]. Notably, most trials determine efficacy as their primary outcome measure and are therefore not powered to compare ACT safety and tolerability in general, or across age groups.
Non-persistence to antiretroviral therapy among adults receiving HIV medical care in the United States
Published in AIDS Care, 2019
Margaret Nyaku, Linda Beer, Fengjue Shu
Estimates for non-persistence are lower than those found in previous work (Knobel et al., 2009; Oyugi et al., 2007; Spacek et al., 2006). For example, 43% of HIV patients in Barcelona, Spain followed from 1996 to 2007 self-reported >3 day treatment interruptions (Knobel et al., 2009). The Swiss HIV Cohort Study reported non-persistence (no ART for >24 hours in a 4 week period) among 5.8% of their population, slightly lower than our estimate (Glass et al., 2006). Because of differences in measurement and populations examined, adjudication between these varying estimates of non-persistence is difficult. Additionally, difference in the year of data collection could also account for the variation in estimates, as guidance regarding treatment interruptions and improvements in drug tolerability have changed over time.