scholarly journals New Treatment Options for Chronic Constipation: Mechanisms, Efficacy and Safety

2011 ◽  
Vol 25 (suppl b) ◽  
pp. 29B-35B ◽  
Author(s):  
Michael Camilleri
Keyword(s):  
Bile Acid ◽  
Serotonin Receptor ◽  
Treatment Options ◽  
Chloride Ion ◽  
New Drugs ◽  
Receptor Subtype ◽  
Efficacy And Safety ◽  
Guanylate Cyclase C ◽  
Patient Responsiveness ◽  
New Treatment

The present review has several objectives, the first of which is to review the pharmacology and selectivity of serotonergic agents to contrast the older serotonergic agents (which were withdrawn because of cardiac or vascular adverse effects) with the newer generation serotonin receptor subtype 4 agonists. Second, the chloride ion secretagogues that act through the guanylate cyclase C receptor are appraised and their pharmacology is compared with the approved medication, lubiprostone. Third, the efficacy and safety of the application of bile acid modulation to treat constipation are addressed. The long-term studies of surgically induced excess bile acid delivery to the colon are reviewed to ascertain the safety of this therapeutic approach. Finally, the new drugs for opiate-induced constipation are introduced. Assuming these drugs are approved, practitioners will have a choice; however, patient responsiveness will be based on trial and error. Nevertheless, the spectrum of mechanisms and demonstrated efficacy and safety augur well for satisfactory treatment outcomes.

scholarly journals New Treatment Options for Chronic Constipation: Mechanisms, Efficacy and Safety

2011 ◽  
Vol 25 (suppl b) ◽  
pp. 29B-35B ◽  
Author(s):  
Michael Camilleri
Keyword(s):  
Bile Acid ◽  
Serotonin Receptor ◽  
Treatment Options ◽  
Chloride Ion ◽  
New Drugs ◽  
Receptor Subtype ◽  
Efficacy And Safety ◽  
Guanylate Cyclase C ◽  
Patient Responsiveness ◽  
New Treatment

The present review has several objectives, the first of which is to review the pharmacology and selectivity of serotonergic agents to contrast the older serotonergic agents (which were withdrawn because of cardiac or vascular adverse effects) with the newer generation serotonin receptor subtype 4 agonists. Second, the chloride ion secretagogues that act through the guanylate cyclase C receptor are appraised and their pharmacology is compared with the approved medication, lubiprostone. Third, the efficacy and safety of the application of bile acid modulation to treat constipation are addressed. The long-term studies of surgically induced excess bile acid delivery to the colon are reviewed to ascertain the safety of this therapeutic approach. Finally, the new drugs for opiate-induced constipation are introduced. Assuming these drugs are approved, practitioners will have a choice; however, patient responsiveness will be based on trial and error. Nevertheless, the spectrum of mechanisms and demonstrated efficacy and safety augur well for satisfactory treatment outcomes.

scholarly journals Chronic Constipation: Current Treatment Options

2011 ◽  
Vol 25 (suppl b) ◽  
pp. 22B-28B ◽  
Author(s):  
Louis Wing Cheong Liu
Keyword(s):  
Chronic Constipation ◽  
Evaluation System ◽  
Serotonin Receptor ◽  
Treatment Options ◽  
Gastrointestinal Disorder ◽  
Treatment Modalities ◽  
Receptor Subtype ◽  
Bulking Agents ◽  
Quality Of Evidence

Chronic constipation is a common functional gastrointestinal disorder that affects patients of all ages. In 2007, a consensus group of 10 Canadian gastroenterologists developed a set of recommendations pertaining to the management of chronic constipation and constipation-dominant irritable bowel syndrome. Since then, tegaserod has been withdrawn from the Canadian market. A new, highly selective serotonin receptor subtype 4 agonist, prucalopride, has been examined in several large, randomized, placebo-controlled trials demonstrating its efficacy and safety in the management of patients with chronic constipation. Additional studies evaluating the use of stimulant laxatives, polyethylene glycol and probiotics in the management of chronic constipation have also been published. The present review summarizes the previous recommendations and new evidence supporting different treatment modalities – namely, diet and lifestyle, bulking agents, stool softeners, osmotic and stimulant laxatives, prucalopride and probiotics in the management of chronic constipation. A brief summary of lubiprostone and linaclotide is also presented. The quality of evidence is presented by adopting the Grading of Recommendations, Assessment, Development and Evaluation system. Finally, a management pyramid for patients with chronic constipation is proposed based on the quality of evidence, impact of each modality on constipation and on general health, and their availabilities in Canada.

scholarly journals Chronic Constipation: Current Treatment Options

2011 ◽  
Vol 25 (suppl b) ◽  
pp. 22B-28B ◽  
Author(s):  
Louis Wing Liu
Keyword(s):  
Chronic Constipation ◽  
Evaluation System ◽  
Serotonin Receptor ◽  
Treatment Options ◽  
Gastrointestinal Disorder ◽  
Treatment Modalities ◽  
Receptor Subtype ◽  
Bulking Agents ◽  
Quality Of Evidence

Chronic constipation is a common functional gastrointestinal disorder that affects patients of all ages. In 2007, a consensus group of 10 Canadian gastroenterologists developed a set of recommendations pertaining to the management of chronic constipation and constipationdominant irritable bowel syndrome. Since then, tegaserod has been withdrawn from the Canadian market. A new, highly selective serotonin receptor subtype 4 agonist, prucalopride, has been examined in several large, randomized, placebo-controlled trials demonstrating its efficacy and safety in the management of patients with chronic constipation. Additional studies evaluating the use of stimulant laxatives, polyethylene glycol and probiotics in the management of chronic constipation have also been published. The present review summarizes the previous recommendations and new evidence supporting different treatment modalities – namely, diet and lifestyle, bulking agents, stool softeners, osmotic and stimulant laxatives, prucalopride and probiotics in the management of chronic constipation. A brief summary of lubiprostone and linaclotide is also presented. The quality of evidence is presented by adopting the Grading of Recommendations, Assessment, Development and Evaluation system. Finally, a management pyramid for patients with chronic constipation is proposed based on the quality of evidence, impact of each modality on constipation and on general health, and their availabilities in Canada.

Management of Prostate Cancer with Systemic Therapy. A Prostate Cancer Unit Perspective

2020 ◽  
Vol 20 ◽  
Author(s):  
Fabio Campodonico ◽  
Marco Ennas ◽  
Silvia Zanardi ◽  
Ekaterini Zigoura ◽  
Arnoldo Piccardo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systemic Therapy ◽  
Treatment Options ◽  
New Drugs ◽  
Group Discussions ◽  
New Agents ◽  
Target Imaging ◽  
Multidisciplinary Group ◽  
Points Of View ◽  
New Treatment

: The scenario of systemic therapy for prostate cancer is rapidly evolving, with new drugs and new treatment options. To update the background knowledge of shared uro-oncologic practice, we reviewed current statements and landmarks in systemic therapy. A number of new agents are under investigation in non-metastatic and metastatic disease. Similarly, new target imaging technologies are under development to improve the detection rate of true non-metastatic and true metastatic patient. Five new drugs have shown to be effective on progression-free and overall survival in metastatìc prostate cancer. However, the optimal sequencing of these treatments requires further investigations. The tolerability and side effects of the new drugs are also crucial issues to be discussed, as well as their activity against the disease. The uro-oncologic team has to stay updated about new medical therapies in order to be confident in debating with other professionals involved in prostate cancer decision making. Different points of view and nuances should be shared during multidisciplinary group discussions to achieve a balanced decision in the disease management.

scholarly journals New Treatment Options against Carbapenem-ResistantAcinetobacter baumanniiInfections

2018 ◽  
Vol 63 (1) ◽  
Author(s):  
Burcu Isler ◽  
Yohei Doi ◽  
Robert A. Bonomo ◽  
David L. Paterson
Keyword(s):  
Treatment Options ◽  
Current Treatment ◽  
New Drugs ◽  
World Health ◽  
Content Type ◽  
Drug Candidates ◽  
Expected Benefits ◽  
New Treatment ◽  
Health Organization ◽  
Available Information

ABSTRACTCarbapenem-resistantAcinetobacter baumannii(CRAB) is a perilous nosocomial pathogen causing substantial morbidity and mortality. Current treatment options for CRAB are limited and suffer from pharmacokinetic limitations, such as high toxicity and low plasma levels. As a result, CRAB is declared as the top priority pathogen by the World Health Organization for the investment in new drugs. This urgent need for new therapies, in combination with faster FDA approval process, accelerated new drug development and placed several drug candidates in the pipeline. This article reviews available information about the new drugs and other therapeutic options focusing on agents in clinical or late-stage preclinical studies for the treatment of CRAB, and it evaluates their expected benefits and potential shortcomings.

scholarly journals Modern combined targeted and immunotherapy of metastatic skin melanoma

2020 ◽  
pp. 54-61
Author(s):  
S. A. Protsenko ◽  
E. N. Imyanitov ◽  
A. I. Semenova ◽  
D. Kh. Latipova ◽  
A. V. Novik ◽  
...  
Keyword(s):  
Treatment Options ◽  
Survival Rates ◽  
New Drugs ◽  
Phase Iii ◽  
Immune Checkpoints ◽  
Malignant Neoplasms ◽  
Skin Melanoma ◽  
Clinical Prognosis ◽  
New Treatment

Melanoma of the skin is one of the most aggressive malignant neoplasms. Metastatic skin melanoma has an extremely poor clinical prognosis with a high mortality rate, accounting for 80% of all deaths from skin malignancies. The approaches to the treatment of metastatic skin melanoma have been dynamically developing over the past decade. New drugs and their combinations are becoming more affordable. In connection with the advances in molecular genetics and the development of new targeted drugs, treatment outcomes have significantly improved: first of all, overall survival and the time to progression of the disease, which has set new challenges for continuing research in this area. The development of new treatment options for patients with inoperable and/or metastatic melanoma with a mutation in the BRAFV600 gene is still in high demand. Emerging data from clinical and preclinical studies suggest that synergies can be observed between inhibitors of immune checkpoints and inhibitors of BRAF and MEK. Despite the fact that inhibitors of the BRAF signaling pathway have a high frequency of objective responses, in most cases their duration is short. Inhibitors of immune checkpoints provide a longer lasting effect, but the response rate is relatively low. Combining the two types of therapy can improve survival rates over the long term. This review demonstrates the results of phase III randomized trials that have allowed to determine the current standards in the treatment of metastatic skin melanoma. We also demonstrated our own experience of using a triple combination of targeted therapy with BRAF/MEK inhibitors in combination with PD-1 inhibitors.

scholarly journals Clinical Management of COVID-19: A Review of Pharmacological Treatment Options

2021 ◽  
Vol 14 (6) ◽  
pp. 520
Author(s):  
Ashli M. Heustess ◽  
Melissa A. Allard ◽  
Dorothea K. Thompson ◽  
Pius S. Fasinu
Keyword(s):  
Clinical Experience ◽  
Clinical Management ◽  
Scientific Community ◽  
Treatment Options ◽  
Intravenous Immunoglobulins ◽  
New Drugs ◽  
Mixed Data ◽  
Efficacy And Safety ◽  
Long Term Effects ◽  
Pharmacological Agents

Since the outbreak and subsequent declaration of COVID-19 as a global pandemic in March 2020, concerted efforts have been applied by the scientific community to curtail the spread of the disease and find a cure. While vaccines constitute a vital part of the public health strategy to reduce the burden of COVID-19, the management of this disease will continue to rely heavily on pharmacotherapy. This study aims to provide an updated review of pharmacological agents that have been developed and/or repurposed for the treatment of COVID-19. To this end, a comprehensive literature search was conducted using the PubMed, Google Scholar, and LitCovid databases. Relevant clinical studies on drugs used in the management of COVID-19 were identified and evaluated in terms of evidence of efficacy and safety. To date, the FDA has approved three therapies for the treatment of COVID-19 Emergency Use Authorization: convalescent plasma, remdesivir, and casirivimab/imdevimab (REGN-COV2). Drugs such as lopinavir/ritonavir, umifenovir, favipiravir, anakinra, chloroquine, hydroxychloroquine, tocilizumab, interferons, tissue plasminogen activator, intravenous immunoglobulins, and nafamosat have been used off-label with mixed therapeutic results. Adjunctive administration of corticosteroids is also very common. The clinical experience with these approved and repurposed drugs is limited, and data on efficacy for the new indication are not strong. Overall, the response of the global scientific community to the COVID-19 pandemic has been impressive, as evident from the volume of scientific literature elucidating the molecular biology and pathophysiology of SARS-CoV-2 and the approval of three new drugs for clinical management. Reviewed studies have shown mixed data on efficacy and safety of the currently utilized drugs. The lack of standard treatment for COVID-19 has made it difficult to interpret results from most of the published studies due to the risk of attribution error. The long-term effects of drugs can only be assessed after several years of clinical experience; therefore, the efficacy and safety of current COVID-19 therapeutics should continue to be rigorously monitored as part of post-marketing studies.

scholarly journals The Future Perspectives of Drug Repurposing and Treatment for the Drug Resistant Breast Cancer: A Review

2021 ◽  
Author(s):  
Panneerselvam Theivendren ◽  
Selvaraj Kunjiappan ◽  
Yashoda Mariappa Hegde ◽  
Kaveena Ravi ◽  
Sivakumar Vellaichamy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Options ◽  
Survival Rates ◽  
Drug Repurposing ◽  
Current Treatment ◽  
New Drugs ◽  
Health Concern ◽  
Drug Resistant ◽  
The Future ◽  
New Treatment

Breast cancer is a major health concern as it is the second leading cause of death from cancer. There are several well-known risk factors that contribute to breast cancer. Despite the various treatment options available, complete cure is still difficult due to heterogenicity of BC subtypes. As a result, identifying BC subtypes is critical for determining the optimal treatment approach. Over the last several years, new drugs targeting particular therapeutic targets have resulted in significant advances in the treatment of breast cancer. Nonetheless, resistance to treatment is the “major” issue, and a significant increase in survival rates has been the main focus for researchers. The purpose of this review article is to provide a broad overview of the molecular basis of drug resistance in breast cancer, as well as a detailed assessment of current treatment options, potential new treatment methods for drug-resistant breast cancer and repurposed drugs used for treatment. The possibility of non-cancer drugs being studied for breast cancer in the future, as well as the obstacles and bottlenecks of drug repurposing, is also highlighted. Finally, we go through present problems and future prospects in drug-resistant breast cancer therapy.

scholarly journals Treatment of coronavirus disease 2019: a comprehensive review

2020 ◽  
Vol 3 (4) ◽  
pp. 228-242
Author(s):  
Damla Sosyal ◽  
Ozge Ozmen ◽  
Muhammed Yunus Bektay ◽  
Fikret Vehbi Izzettin
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Treatment Options ◽  
New Drugs ◽  
World Health ◽  
Comprehensive Review ◽  
New Type ◽  
Governmental Institutions ◽  
New Treatment ◽  
Health Organization

The new type of Coronavirus (SARS-CoV-2) is a highly contagious pathogen that causes severe acute respiratory syndrome and can be transmitted from human to human. COVID-19, which has been declared as a pandemic by the world health organization and is infected with more than 50 million people, is also responsible for the death of more than 1 million people. There is no sufficient data from randomized clinical trials that any potential treatment improves outcomes in COVID-19 patients. Chloroquine and hydroxychloroquine, antivirals such as favipiravir, lopinavir/ritonavir, immunomodulatory agents tocilizumab, siltuximab, and sarilumab, and anti-inflammatory drugs such as steroids are used for the treatment of COVID-19. Repurposing drugs can provide new treatment options faster than discovering new drugs due to the known safety profiles of existing drugs. On the other hand, there are new drug and vaccine trials for COVID-19. Many researchers, governmental or non-governmental institutions having clinical trials for COVID-19 drugs and vaccines. In this comprehensive review, we investigate the clinical features, management, and treatment of COVID-19 and possible adverse effects and important information related to drugs used for COVID-19. For future preparedness and readiness, new laws and legislations should be constituted. Besides, emergency teams and budgets should be prepared as well. .

scholarly journals New Treatment Options for Hyperkalemia in Patients with Chronic Kidney Disease

2020 ◽  
Vol 9 (8) ◽  
pp. 2337 ◽  
Author(s):  
Pasquale Esposito ◽  
Novella Evelina Conti ◽  
Valeria Falqui ◽  
Leda Cipriani ◽  
Daniela Picciotto ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Therapeutic Option ◽  
Treatment Options ◽  
New Drugs ◽  
Sodium Polystyrene Sulfonate ◽  
Sodium Zirconium ◽  
Life Threatening ◽  
New Treatment ◽  
Sodium Zirconium Cyclosilicate

Hyperkalemia may cause life-threatening cardiac and neuromuscular alterations, and it is associated with high mortality rates. Its treatment includes a multifaceted approach, guided by potassium levels and clinical presentation. In general, treatment of hyperkalemia may be directed towards stabilizing cell membrane potential, promoting transcellular potassium shift and lowering total K+ body content. The latter can be obtained by dialysis, or by increasing potassium elimination by urine or the gastrointestinal tract. Until recently, the only therapeutic option for increasing fecal K+ excretion was represented by the cation-exchanging resin sodium polystyrene sulfonate. However, despite its common use, the efficacy of this drug has been poorly studied in controlled studies, and concerns about its safety have been reported. Interestingly, new drugs, namely patiromer and sodium zirconium cyclosilicate, have been developed to treat hyperkalemia by increasing gastrointestinal potassium elimination. These medications have proved their efficacy and safety in large clinical trials, involving subjects at high risk of hyperkalemia, such as patients with heart failure and chronic kidney disease. In this review, we discuss the mechanisms of action and the updated data of patiromer and sodium zirconium cyclosilicate, considering that the availability of these new treatment options offers the possibility of improving the management of both acute and chronic hyperkalemia.

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