scholarly journals Clinical evaluation of the oral gonadotropin-releasing hormone-antagonist elagolix for the management of endometriosis-associated pain

2019 ◽  
Vol 9 (5) ◽  
pp. 497-515 ◽  
Author(s):  
Hugh S Taylor ◽  
Erica C Dun ◽  
Kristof Chwalisz
Keyword(s):  
Pelvic Pain ◽  
Treatment Options ◽  
Chronic Inflammatory Disease ◽  
Gonadotropin Releasing Hormone ◽  
The Novel ◽  
Releasing Hormone ◽  
The Us ◽  
Partial Suppression ◽  
Us Fda ◽  
Pain Symptoms

Endometriosis is an estrogen-dependent chronic inflammatory disease associated with pelvic pain symptoms that are often severe, mainly dysmenorrhea, nonmenstrual pelvic pain and dyspareunia. This condition is also associated with peripheral and central sensitization. The current medical treatment options for endometriosis-associated pain are limited. Recently, the US FDA approved the novel, oral, nonpeptide gonadotropin-releasing hormone antagonist elagolix for the management of moderate to severe endometriosis-associated pain. Elagolix produces dose-dependent estrogen suppression, from partial suppression at lower doses to nearly full suppression at higher doses. This review article summarizes the current understanding of the pathophysiology of endometriosis, with a focus on the role of estrogen and the mechanisms of pain symptoms, and reviews the clinical development of elagolix in women with endometriosis-associated pain.

Current and Future Medical Therapies for Adenomyosis

2020 ◽  
Vol 38 (02/03) ◽  
pp. 151-156
Author(s):  
Adela G. Cope ◽  
Alessandra J. Ainsworth ◽  
Elizabeth A. Stewart
Keyword(s):  
Quality Of Life ◽  
Pelvic Pain ◽  
Treatment Options ◽  
Gonadotropin Releasing Hormone ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Releasing Hormone ◽  
Line Therapy ◽  
Oral Agents

AbstractThere is no approved medical therapy for adenomyosis and limited evidence to guide treatments in part due to the complexity of nonhistologic diagnosis and the prevalence of concomitant gynecologic conditions. Most available evidence focuses on the treatment of heavy menstrual bleeding, painful menses, and pelvic pain. Data evaluating fertility outcomes, sexual function, and quality of life following treatment are lacking. Additionally, there is no disease-specific measure of quality of life for adenomyosis. The levonorgestrel-releasing intrauterine system appears to be the most effective first-line therapy based on efficacy compared with oral agents, maintenance of steady-state hormonal levels, and contraceptive benefit. In areas where it is marketed, the progestin dienogest appears superior to combined oral contraceptives. Long-acting gonadotropin-releasing hormone agonists are effective and should be considered second-line therapy but are limited by hypogonadal effects. Additional data regarding oral gonadotropin-releasing hormone antagonists are required. While aromatase inhibitors demonstrate improvement in heavy menstrual bleeding and pelvic pain, further research is needed to determine their role in the management of adenomyosis. Progesterone receptor modulators may have a role for this disease if released again to market with appropriate safety parameters. Finally, modulation of prolactin and/or oxytocin may provide novel nonsteroidal treatment options.

Brexpiprazole in the treatment of schizophrenia and agitation in Alzheimer’s disease

2020 ◽  
Vol 10 (4) ◽  
pp. 205-217 ◽  
Author(s):  
Lauren Stummer ◽  
Marija Markovic ◽  
Megan Maroney
Keyword(s):  
Daily Living ◽  
Partial Agonist ◽  
Treatment Options ◽  
Unmet Need ◽  
Adjunctive Treatment ◽  
Metabolic Disturbances ◽  
Major Depressive ◽  
The Us ◽  
Us Fda ◽  
The Eu

Schizophrenia is a disabling psychiatric disorder marked by progressive loss of functionality in activities of daily living with each relapse. Antipsychotics, the mainstay of therapy for schizophrenia, treat hallucinations and delusions but may have intolerable side effects, including metabolic disturbances and extrapyramidal symptoms. Brexpiprazole, a second-generation antipsychotic with dopamine partial agonist properties, was approved by the US FDA in 2015 for the treatment of schizophrenia and adjunctive treatment of major depressive disorder and by the EU in 2018 for adults with schizophrenia. Additionally, brexpiprazole has recently been studied for the treatment of agitation in Alzheimer’s dementia, an area of largely unmet need. Overall, well-tolerated brexpiprazole expands the armamentarium of treatment options available for these conditions.

Risankizumab in moderate-to-severe plaque psoriasis

Immunotherapy ◽  
2019 ◽  
Vol 11 (16) ◽  
pp. 1357-1370 ◽  
Author(s):  
Linda Serrano ◽  
Victoria Maloney ◽  
Kenneth B Gordon
Keyword(s):  
Biologic Therapy ◽  
Treatment Options ◽  
Rapid Onset ◽  
Chronic Inflammatory Disease ◽  
Current Treatment ◽  
Multiple Organ ◽  
Turn Of The Century ◽  
Severe Psoriasis ◽  
Organ Systems ◽  
Us Fda

Psoriasis is a chronic inflammatory disease affecting multiple organ systems affecting approximately 2% of the population worldwide. The etiology is multifactorial etiology with multiple co-morbidities complicating the disease. Therapeutic options for patients with moderate-to-severe psoriasis have made tremendous strides since the turn of the century and biologic agents are now generally considered to be safe, efficacious and common options for these patients. However, some patients remain recalcitrant to the current treatment options. Risankizumab is a newly US FDA-approved biologic therapy that inhibits IL-23p19 subunit, which is specific to IL-23. Risankizumab has proven rapid onset, safety and efficacy in moderate-to-severe psoriasis and is currently being studied in other diseases utilizing the IL-23 pathway.

scholarly journals Discovery of drugs that possess activity against feline leukemia virus

2012 ◽  
Vol 93 (4) ◽  
pp. 900-905 ◽  
Author(s):  
Willie M. Greggs ◽  
Christine L. Clouser ◽  
Steven E. Patterson ◽  
Louis M. Mansky
Keyword(s):  
Leukemia Virus ◽  
Treatment Options ◽  
Feline Leukemia Virus ◽  
Drug Classes ◽  
The Us ◽  
Us Fda ◽  
Hiv Drugs ◽  
Toxic Concentrations ◽  
Anti Hiv ◽  
Hiv 1

Feline leukemia virus (FeLV) is a gammaretrovirus that is a significant cause of neoplastic-related disorders affecting cats worldwide. Treatment options for FeLV are limited, associated with serious side effects, and can be cost-prohibitive. The development of drugs used to treat a related retrovirus, human immunodeficiency virus type 1 (HIV-1), has been rapid, leading to the approval of five drug classes. Although structural differences affect the susceptibility of gammaretroviruses to anti-HIV drugs, the similarities in mechanism of replication suggest that some anti-HIV-1 drugs may also inhibit FeLV. This study demonstrates the anti-FeLV activity of four drugs approved by the US FDA (Food and Drug Administration) at non-toxic concentrations. Of these, tenofovir and raltegravir are anti-HIV-1 drugs, while decitabine and gemcitabine are approved to treat myelodysplastic syndromes and pancreatic cancer, respectively, but also have anti-HIV-1 activity in cell culture. Our results indicate that these drugs may be useful for FeLV treatment and should be investigated for mechanism of action and suitability for veterinary use.

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