Abstract:
INTRODUCTION:Osteoarthritis is the most common cause of arthritis and one of the main causes of chronic pain. Although opioids are frequently employed for chronic pain treatment, their usage for osteoarthritis pain remains controversial due to the associated adverse effects. Most guidelines reserve their use for refractory pain in patients with hip and knee osteoarthritis. The situation is even more complex in Latin America, where the prevalence of insufficient pain treatment is high because of the limited availability and use of strong opioids. Areas covered: In this article we review the epidemiology of osteoarthritis, its socioeconomic burden, its impact as a chronic pain cause and the pharmacological treatment options, giving emphasis to the role of strong opioids, their safety and efficacy, especially in Latin American countries, where restrictions regulate their usage. Expert commentary: Usage of strong opioids is safe and effective in the short-term management of osteoarthritis with moderate to severe pain, when other pharmacological treatments are inadequate and surgery is contraindicated, provided their use adheres to existing guidelines. Educational programs for patients and physicians and further research on treating chronic pain with opioids should be implemented to reduce adverse effects and improve care quality.
journal_name
Expert Rev Clin Pharmacoljournal_title
Expert review of clinical pharmacologyauthors
Ruiz Iban MA,Benavides J,Forero JP,Bittelman S,Martinez R,Mite MA,Diaz Heredia J,Ulloa S,Lizárraga Ferrand MMdoi
10.1080/17512433.2018.1381556subject
Has Abstractpub_date
2018-01-01 00:00:00pages
47-59issue
1eissn
1751-2433issn
1751-2441journal_volume
11pub_type
杂志文章,评审abstract:INTRODUCTION:The Pharmacokinetics/pharmacodynamics (PK/PD) relationships with cytotoxics are usually based on a steepening concentration-effect relationship; the greater the drug amount, the greater the effect. The Maximum Tolerated Dose paradigm, finding the balance between efficacy, while keeping toxicities at their ...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2018.1477586
更新日期:2018-06-01 00:00:00
abstract::Chronic diarrhea remains a common condition that affects people infected with human immunodeficiency virus (HIV) despite the widespread use of potent antiretroviral therapy. It is important that providers control this condition, as the persistence of diarrhea affects the quality of life of patients and may contribute ...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/17512433.2015.1082424
更新日期:2015-01-01 00:00:00
abstract::Sugammadex, a modified γ-cyclodextrin, is the first selective relaxant binding agent. Sugammadex forms very tight complexes in a 1:1 ratio with steroidal neuromuscular blocking agents (rocuronium > vecuronium > pancuronium). This guest-host complex, which exists in equilibrium, is stable because of its very high assoc...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章
doi:10.1586/17512433.2.1.37
更新日期:2009-01-01 00:00:00
abstract::G-quadruplexes are non-Watson-Crick four-stranded nucleic acid structures. Recent evidence points toward their existence in vivo and their implication in various biological processes. Over the past two decades, small molecules have been developed to specifically and selectively target these structures in order to diss...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/17512433.2014.945909
更新日期:2014-09-01 00:00:00
abstract:INTRODUCTION:The incidence of kidney dysfunction increases with age and is highly prevalent among patients with hypertension. Since many therapeutic compounds are primarily eliminated through the kidneys, impaired renal function can have negative consequences on drug disposition, efficacy and safety. Therefore, regulat...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2017.1274651
更新日期:2017-03-01 00:00:00
abstract::Respiratory distress syndrome (RDS) is the leading cause of neonatal morbidity and mortality in premature infants. It is caused by surfactant deficiency and lung immaturity. Lucinactant is a synthetic surfactant containing sinapultide, a bioengineered peptide mimic of surfactant-associated protein B. A meta-analysis o...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/ecp.12.80
更新日期:2013-03-01 00:00:00
abstract:INTRODUCTION:Large-scale epidemiological studies on Greenlandic, Canadian and Alaskan Eskimos have examined the health benefits of omega-3 fatty acids consumed as part of the diet, and found statistically significant relative reduction in cardiovascular risk in people consuming omega-3 fatty acids. Areas covered: This ...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2017.1333902
更新日期:2017-08-01 00:00:00
abstract::Aripiprazole monohydrate (AM) and aripiprazole lauroxil (AL) are two different long-acting injectable formulations of aripiprazole. AM 400 mg administered once monthly demonstrated efficacy in an acute, double-blind, placebo-controlled, randomized clinical trial, as well as in a double-blind, placebo-controlled, rando...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/17512433.2016.1121809
更新日期:2016-01-01 00:00:00
abstract::Globally, it is possible that less than half of all patients are treated in compliance with guidelines and more than half of all patients fail to take their medicines as prescribed or dispensed. Such inappropriate use is wasteful of resources and causes patient harm in terms of lack of satisfactory outcome, serious ad...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/ecp.11.14
更新日期:2011-05-01 00:00:00
abstract::The QT interval from the ECG cannot be measured precisely. The relationship of the QT interval to the RR interval within individuals across time and different RR values, and across individuals eludes complete understanding. Intrinsic beat-to-beat variability in QT interval corrected for heart rate (QTc interval) is no...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章
doi:10.1586/17512433.1.6.815
更新日期:2008-11-01 00:00:00
abstract:INTRODUCTION:Induction chemotherapy based on anthracyclines and cytarabine (Ara-C) combination remains the standard of care for acute myeloid leukemia (AML) patients who are considered candidate for intensive and curative approaches. However, the toxicity of this regimen is high, with disappointing clinical outcomes am...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章
doi:10.1080/17512433.2019.1573668
更新日期:2019-03-01 00:00:00
abstract:INTRODUCTION:Acute bacterial skin and skin structure infections (ABSSSI) are among the most frequent infectious diseases. Recently, several new antibiotics with activity against MRSA have been approved. Tedizolid, a second-generation oxazolidinone approved for ABSSSI offers theoretical advantages over first-generation ...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2020.1774362
更新日期:2020-06-01 00:00:00
abstract::The aim of this article was to assess the efficacy and safety of apremilast in treatment of psoriatic arthritis (PsA) with meta-analysis method. We included four randomized clinical trials identified from MEDLINE, EMBASE, Cochrane Library, "ISRCTN Register" and "ClinicalTrials.gov" which compared apremilast with place...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,meta分析,评审
doi:10.1586/17512433.2016.1159130
更新日期:2016-06-01 00:00:00
abstract::After the introduction of anti-tumor necrosis factor (anti-TNF) agents, the clinical outcome of patients with Inflammatory Bowel Disease (IBD) has improved significantly. However, use of anti-TNF therapy is complicated by loss of response. In order to maintain remission, adequate serum levels are required. Hence, ther...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/17512433.2016.1133288
更新日期:2016-01-01 00:00:00
abstract::Research on the specific effects of sex and gender on pharmacokinetics and pharmacodynamics, as well as safety profile tolerability and drug efficacy, of medications remain meager because female animals and women have only recently been included in the pharmacological domain. To date, the influence of sex and gender o...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/17512433.2014.922866
更新日期:2014-07-01 00:00:00
abstract::Schizophrenia is a major mental illness with a lifetime prevalence of about 1%. Antipsychotic drugs, with a primary mechanism of action that involves dopamine receptor blockade, are the mainstay in the treatment of the disorder. However, despite optimum antipsychotic treatment, few patients return to pre-morbid levels...
journal_title:Expert review of clinical pharmacology
pub_type: 社论
doi:10.1586/17512433.2016.1095086
更新日期:2016-01-01 00:00:00
abstract:INTRODUCTION:Allogeneic hematopoietic cell transplants (allo-HCT) recipients are at the high-risk of reactivation of cytomegalovirus (CMV), and reactivation is associated with significant morbidity and mortality. Although available anti-CMV therapies may be effective for the prevention of CMV, they are plagued by unacc...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2018.1500897
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:To estimate the prevalence of polypharmacy (≥5 drugs) among adults and to analyze related factors. METHODS:Cross-sectional study with 1,159 interviewees distributed across 104 cities and 253 primary healthcare services delivered through the Brazilian Unified Health System. Polypharmacy-related factors were ...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章
doi:10.1080/17512433.2020.1836958
更新日期:2020-12-01 00:00:00
abstract::Over the last two decades, research developments have revolutionized our understanding of the pathogenesis of psoriasis and of the contribution of several cytokines in the manifestation of the disease. The key role of TNF-α in the pathogenesis of psoriasis has been extensively studied and its therapeutic action, initi...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/ecp.11.28
更新日期:2011-07-01 00:00:00
abstract::The thermo transient receptor potential (TRP) ion channels, a recently discovered family of ion channels activated by temperature, are expressed in primary sensory nerve terminals, where they provide information regarding thermal changes in the environment. Six thermo-TRPs have been characterized to date: TRPV1-4, whi...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章
doi:10.1586/ecp.10.41
更新日期:2010-09-01 00:00:00
abstract::Introduction: The clinical use of tacrolimus is characterized by many side effects which include neurotoxicity. In contrast, tacrolimus has also shown to have neuroregenerative properties. On a molecular level, the mechanisms of action could provide us more insight into understanding the neurobiological effects. The a...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2019.1675507
更新日期:2019-11-01 00:00:00
abstract::Introduction: Dementia is the 7th leading cause of death that imposes a significant financial and service burden on the global population. Presently, only symptomatic care exists for cognitive loss, such as Alzheimer's disease.Areas covered: Given the advancing age of the global population, it becomes imperative to de...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2020.1698288
更新日期:2020-01-01 00:00:00
abstract::Magnetic nanoparticles (MNPs) represent a promising nanomaterial for the targeted therapy and imaging of malignant brain tumors. Conjugation of peptides or antibodies to the surface of MNPs allows direct targeting of the tumor cell surface and potential disruption of active signaling pathways present in tumor cells. D...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/ecp.12.1
更新日期:2012-03-01 00:00:00
abstract::Migraine is a common neurological syndrome that affects approximately 10-20% of the population. The pathophysiology of migraine is unclear. 5-hydroxytriptamine is a key mediator in the pathogenesis of migraine and thus 5-HT1-receptor agonists are the principal drugs for acute migraine therapy. There are three classes ...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/ecp.13.14
更新日期:2013-05-01 00:00:00
abstract::Treatment of age-related macular degeneration (AMD) has changed dramatically over the last decade. It has evolved from primarily destructive therapies (laser-based treatment strategies) to nondestructive therapies (intravitreal pharmacotherapies that target angiogenesis). Intermittent intravitreal ranibizumab, an inhi...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章
doi:10.1586/ecp.10.6
更新日期:2010-03-01 00:00:00
abstract::RNAi is a powerful gene silencing process that holds great promise in cancer therapy by the use of siRNA. The aim of this review is to give an outline on different approaches to deliver siRNA and to describe the advantages and disadvantages of these systems. The prospects for siRNA are to be substantially better than ...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/ecp.12.33
更新日期:2012-07-01 00:00:00
abstract::Inflammation plays a critical role in host defense, maintaining cellular and tissue integrity following chemical, physical and biological insults. Inflammation presents in a variety of acute and chronic disease states and can contribute to disease resolution or progression depending upon the type, magnitude and durati...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1586/ecp.11.66
更新日期:2012-01-01 00:00:00
abstract::The unprecedented levels of political, technical and financial support for improved malaria control, and particularly for changes in the malaria treatment policy, have heralded a renewed appreciation of the role of pharmacovigilance, its relationship with other areas of public health and the development of novel appro...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章
doi:10.1586/ecp.10.37
更新日期:2010-07-01 00:00:00
abstract:INTRODUCTION:Checkpoint inhibitor immunotherapy has revolutionized the treatment of many advanced stage cancers. Preexisting immunity is necessary for a response to these agents, which are most effective in inflamed tumors since they principally act by reinforcing preexisting antitumor T-cell responses. An important go...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2018.1518713
更新日期:2018-10-01 00:00:00
abstract:INTRODUCTION:The broad use of immunotherapy is revolutionizing the treatment paradigms of many solid tumors. Although chemotherapy remains the treatment backbone for advanced gastric cancer, improvements in its molecular characterization and progresses in understanding its underpinning biology have supported clinical d...
journal_title:Expert review of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1080/17512433.2017.1313113
更新日期:2017-06-01 00:00:00