- MeSH
- antagonisté serotoninu terapeutické užití MeSH
- antipsychotika * terapeutické užití MeSH
- lidé MeSH
- receptory serotoninové MeSH
- schizofrenie * farmakoterapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- úvodníky MeSH
Introduction: Depressive symptoms may occur in any phase of schizophrenia and can have far-reaching consequences.Areas covered: The author focuses on recent reviews and meta-analyses dealing with the prevalence, importance, etiopathogenesis, and pharmacotherapy of comorbid depression and schizophrenia. Depressive symptoms in acute episodes may improve in parallel with psychosis due to antipsychotic treatment. Therefore, the first step is to evaluate the current antipsychotic treatment of psychotic symptoms and consider changing the dosage. A second step is switching antipsychotic medications, since there are indications that some medications are slightly more effective in reducing depressive symptoms than others. For persistent depressive episodes, additional therapeutic interventions are indicated. Most guidelines recommend the administration of antidepressants as an add-on treatment with a limited evidence level. Immunotherapeutic strategies could be successful, at least in some schizophrenia patients.Expert opinion: In the near future, precision psychiatry should enable clinicians to recognize specific biotypes with unique biosignatures that will guide accurate and prompt clinical management for individual patients.
- MeSH
- antidepresiva aplikace a dávkování terapeutické užití MeSH
- antiflogistika aplikace a dávkování terapeutické užití MeSH
- antipsychotika aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- deprese komplikace farmakoterapie MeSH
- lidé MeSH
- schizofrenie komplikace farmakoterapie MeSH
- toxické psychózy prevence a kontrola MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
INTRODUCTION: Approximately one third of patients with epilepsy fail to respond to existing medications. Levetiracetam is an effective antiepileptic drug (AED) postulated to act by binding to synaptic vesicle protein 2A. Brivaracetam is a novel high affinity SV2A ligand with approximately 20-fold higher affinity for SV2A protein than levetiracetam. It is at an advanced stage of clinical development for treatment of epilepsy. AREAS COVERED: This article reviews animal data, pharmacokinetics, and phase 1-3 data of Brivaracetam treatment of epilepsy. Brivaracetam has broad-spectrum anticonvulsant activity in animal models. EXPERT OPINION: Phase 1 studies indicated that single oral doses of 5-800 mg and repeated oral doses of up to 600 mg were well tolerated and showed favorable pharmacokinetic profile. Phase 2 studies indicated good safety and tolerability of brivaracetam in the dose range of 5-150 mg/day and provided proof of concept for efficacy in treating refractory partial onset seizures. Efficacy and safety have been evaluated in 4 phase 3 studies with dose range of 5-200 mg which have demonstrated efficacy in the range of 100-200 mg/day dose and, in most studies, also with 50 mg/day dose, and good safety and tolerability profile across 5-200 mg doses in adjunctive treatment of refractory partial onset seizures.
- MeSH
- antikonvulziva farmakologie terapeutické užití MeSH
- epilepsie farmakoterapie MeSH
- klinické zkoušky jako téma MeSH
- lidé MeSH
- pyrrolidinony farmakologie terapeutické užití MeSH
- záchvaty farmakoterapie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
INTRODUCTION: Vitiligo is a skin disorder characterized by a progressive depigmentation, which is caused by the loss of melanocytes at the cutaneous level. A shift of the immune system with a prevalence of T helper (Th)1/Th17 response instead of a Tregs/Th2 one and may be part of etiology of 10 vitiligo. AREAS COVERED: This review describes the major points of vitiligo onset and shows the cutting-edge results in the field of low-dose medicine in the treatment of dermatologic diseases and, in particular. in vitiligo. In this review on advances in vitiligo pharmacotherapy, the most pertinent recent publications are reported. Electronic databases such as PubMed were searched for terms 'low-dose medicine' or 'low dose and vitiligo' or 'low dose and psoriasis.' EXPERT OPINION: The availability of a systemic treatment for vitiligo, based on the oral administration of low-dose activated signaling molecules represents an opportunity for the dermatologists to overcome some specific pitfalls of currently available therapeutic protocols.
- MeSH
- cytokiny metabolismus terapeutické užití MeSH
- keratinocyty fyziologie MeSH
- lidé MeSH
- melaniny metabolismus MeSH
- melanocyty fyziologie MeSH
- oxidační stres MeSH
- signální transdukce MeSH
- vitiligo farmakoterapie imunologie patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
INTRODUCTION: Antineutrophil cytoplasmic antibodies-associated vasculitis (AAV) is a group of autoimmune diseases characterized by the necrotizing inflammation of small vessels and associated with the antineutrophil cytoplasmic antibodies. Treatment of AAV can be divided into the induction phase aimed at achieving remission of the disease and the maintenance phase aimed at prevention of relapses. Long-term outcome of AAV dramatically improved with the introduction of cyclophosphamide. Recent clinical studies resulted in the reduction of the cumulative dose of cyclophosphamide and introduction of new treatment options, namely B-cell-depleting antibody rituximab, into both induction and maintenance treatment. This paper aims to evaluate the current role of the conventional induction and maintenance treatment in view of the gradually increasing use of rituximab. AREAS COVERED: This paper provides an overview of the main clinical studies in induction and maintenance treatment of adult patients with AAV, treatment of relapses of AAV and shortly comments also on the treatment of refractory AAV, treatment of different subgroups of AAV (based on the age, renal function, clinical presentation and type of autoantibody), long-term outcome of patients with AAV, adverse events of treatment and treatment of end-stage renal disease in AAV. EXPERT OPINION: Our analysis demonstrates that although the introduction of rituximab modified the approach to both the induction and maintenance treatment of AAV, more conventional induction and maintenance treatment with standard immunosuppressive drugs still retains its importance as we need more data on long-term efficacy and safety of biologic treatment, and also its cost-effectiveness still remains an open issue.
- MeSH
- ANCA-asociované vaskulitidy farmakoterapie imunologie patofyziologie MeSH
- B-lymfocyty imunologie MeSH
- chronické selhání ledvin terapie MeSH
- glukokortikoidy terapeutické užití MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- randomizované kontrolované studie jako téma MeSH
- recidiva MeSH
- rituximab terapeutické užití MeSH
- transplantace ledvin MeSH
- udržovací chemoterapie MeSH
- výměna plazmy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
CNS research has become unprofitable, and several pharmaceutical companies have reduced financial support for developing new CNS drugs. Until the situation can be changed, it is our duty to optimize the usage of the currently available psychoactive drugs. Several tools for optimizing pharmacotherapy are available, such as therapeutic drug monitoring and genotyping and phenotyping CYP enzymes. Further medical treatment and healthcare provision for patients with severe mental disorders should be improved. Knowledge of psychopharmacotherapy influences the choices of medication and outcomes; therefore, future psychiatrists should have a greater knowledge of pharmacodynamics, pharmacokinetics and pharmacogenetics.
- MeSH
- duševní poruchy farmakoterapie MeSH
- farmaceutický průmysl MeSH
- farmakogenetika MeSH
- genotyp MeSH
- individualizovaná medicína MeSH
- lidé MeSH
- monitorování léčiv MeSH
- psychotropní léky farmakokinetika farmakologie terapeutické užití MeSH
- systém (enzymů) cytochromů P-450 genetika MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- úvodníky MeSH
A short overview of new drugs approved for the treatment of obesity (lorcaserin, phentermine/topiramate combination) as well as those with a perspective for approval as antiobesity drugs (cetilistat, naltrexone/bupropion combination, liraglutide) is presented. All these drugs produce significant weight loss accompanied by reductions in cardiometabolic health risks. Although the adverse events were rather rare and tended to decrease with the duration of treatment with most of these medications, the drug-specific safety concerns should be seriously considered. In order to ensure an appropriate, efficient and safe implementation of novel antiobesity drugs into the comprehensive treatment of obesity, it will be necessary to establish a network of physicians and other health-care providers well educated in obesity management.
- MeSH
- benzazepiny terapeutické užití MeSH
- benzoxaziny terapeutické užití MeSH
- bupropion terapeutické užití MeSH
- fentermin terapeutické užití MeSH
- fixní kombinace léků MeSH
- fruktosa analogy a deriváty terapeutické užití MeSH
- glukagonu podobný peptid 1 analogy a deriváty terapeutické užití MeSH
- hmotnostní úbytek účinky léků MeSH
- látky proti obezitě terapeutické užití MeSH
- lidé MeSH
- naltrexon terapeutické užití MeSH
- obezita farmakoterapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
- úvodníky MeSH
INTRODUCTION: Multiple sclerosis (MS) is an autoimmune neurodegenerative disease of the central nervous system involving inflammation, chronic demyelination and axonal loss. MS affects more than 2 million people worldwide. AREAS COVERED: This article aims to summarize the findings from two pivotal 2-year, randomized, double-blind, placebo-controlled, Phase III studies of BG-12 (dimethyl fumarate) for relapsing-remitting MS (RRMS): DEFINE (Determination of the Efficacy and Safety of Oral Fumarate in RRMS) and CONFIRM (Comparator and an Oral Fumarate in RRMS). Results from both studies demonstrated that BG-12 provides clinical and radiological efficacy over 2 years across a range of outcomes. These results were apparent as early as 12 weeks and sustained over the course of both studies. BG-12 was found to have an acceptable safety profile, with a similar overall incidence of adverse events across all treatment groups. EXPERT OPINION: The combination of robust efficacy, ease of administration and established safety profile is unique to a new therapy in MS. Findings from the pivotal Phase III studies support BG-12 as a potential initial oral treatment for patients with RRMS or as an alternative to other currently available therapies.
INTRODUCTION: In the search for new antiepileptic drugs (AEDs), AMPA-type receptor antagonists have a novel target and the potential to improve seizure control in patients with refractory seizures. This article reviews preclinical and clinical data for 2-(2-oxo-1-phenyl-5-pyridin-2-yl-1,2-dihydropyridin-3-yl)benzonitrile, perampanel , a new chemical entity developed for the treatment of partial-onset seizures. AREAS COVERED: Perampanel is a selective, non-competitive AMPA receptor antagonist. The preclinical profile of perampanel and its clinical development are reviewed. EXPERT OPINION: Unlike many traditional AEDs, perampanel demonstrated efficacy in a broad spectrum of preclinical seizure models. Phase I and II clinical studies suggested perampanel had a favorable safety and tolerability profile and demonstrated proof of concept for its mechanism of action in patients with treatment-resistant partial-onset seizures. Three Phase III studies have additionally demonstrated that adjunctive perampanel 4 - 12 mg/day is well-tolerated and significantly improves seizure control in these patients. Median reductions in seizure frequency were 23.3% (4 mg), 26.3 - 30.8% (8 mg) and 17.6 - 34.5% (12 mg) versus 9.7 - 21.0% for placebo. Responder rates were 28.5% (4 mg), 33.3 - 37.6% (8 mg) and 33.9 - 36.1% (12 mg) versus 14.7 - 26.4% for placebo. Perampanel may offer an alternative treatment option in the management of patients with refractory partial-onset seizures.
- MeSH
- AMPA receptory antagonisté a inhibitory MeSH
- antikonvulziva škodlivé účinky farmakologie terapeutické užití MeSH
- cílená molekulární terapie MeSH
- epilepsie parciální farmakoterapie MeSH
- klinické zkoušky jako téma MeSH
- lidé MeSH
- preklinické hodnocení léčiv MeSH
- pyridony škodlivé účinky farmakologie terapeutické užití MeSH
- výsledek terapie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
AIM: The aim of this surveillance study was to assess the tolerability of, and response to, treatment with escitalopram in 525 psychiatric out-patient clinics in the Czech Republic. METHODS: Clinical response was evaluated using the Zung Depression Rating Scale (ZDRS) and the Clinical Impressions--Improvement (CGI-I) scale. The change from baseline in the ZDRS, Clinical Impressions--Severity of Illness (CGI-S) and CGI-I scores were analysed for each visit (baseline, weeks 1-2, 4, 8 and 26). RESULTS: There were 2664 patients included, with 2126 patients (79.8%) completing the 6-month treatment. During the course of the study, the patients showed an improvement in their severity of depression, with a response rate (CGI-I < or = 2) of 86.7% and a remission rate (CGI-S < or = 2) of 80.6% for patients completing 6 months of treatment. The most frequent adverse events were nausea (5.5%), headache (2.1%) and sweating (2.0%). Discontinuation due to adverse events occurred in 170 patients (6.4%) and 3.7% of patients withdrew from the study because of non-response and/or worsening of psychopathology. There were no significant differences between baseline and final visit in mean body mass index for men or women. CONCLUSION: In this large surveillance study, escitalopram was well tolerated by a heterogeneous group of patients, whose depressive symptoms responded to < or = 6 months of treatment.
- MeSH
- antidepresiva druhé generace škodlivé účinky terapeutické užití MeSH
- citalopram škodlivé účinky terapeutické užití MeSH
- deprese diagnóza farmakoterapie psychologie MeSH
- dítě MeSH
- dospělí MeSH
- financování organizované MeSH
- index tělesné hmotnosti MeSH
- léková rezistence MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- pacienti ambulantní MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stupeň závažnosti nemoci MeSH
- výsledek terapie MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
