Clinical therapeutics
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Clinical therapeutics · Apr 2011
Randomized Controlled Trial Multicenter StudyEffects of varenicline in adult smokers: a multinational, 24-week, randomized, double-blind, placebo-controlled study.
Prevalence rates of smoking are rising in developing countries. Previous trials evaluating the efficacy and tolerability of the smoking-cessation medication varenicline have used largely participants of Caucasian origin. ⋯ Based on these data, varenicline was apparently efficacious and generally well tolerated as a smoking-cessation aid in smokers from selected sites in Latin America, Africa, and the Middle East. ClinicalTrials.gov identifier: NCT00594204.
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Clinical therapeutics · Apr 2011
Review Comparative StudyEmerging antiplatelet therapies in percutaneous coronary intervention: a focus on prasugrel.
Prasugrel is the most recent addition to the available thienopyridine antiplatelet agents used to prevent ischemic events in patients with acute coronary syndrome undergoing percutaneous coronary intervention. ⋯ Prasugrel's clinical benefits were counterbalanced by an increase in bleeding risk compared with conventional thienopyridine treatment with clopidogrel. Current practice guidelines incorporated prasugrel as a treatment option, but at this time do not recommend that prasugrel be selected over clopidogrel in any patient subgroup. Further study is required to determine optimal dosing and proper patient selection with prasugrel treatment.
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Clinical therapeutics · Apr 2011
ReviewCardiovascular implications of antihyperglycemic therapies for type 2 diabetes.
Several risk factors for cardiovascular disease (CVD), including insulin resistance/hyperinsulinemia, hyperglycemia, overweight/obesity, dyslipidemia, and hypertension, are often present in varying combinations in patients with type 2 diabetes mellitus (DM). Patients with a clustering of these risk factors, termed the metabolic syndrome, are at greater risk for CVD than are patients with only a single risk factor. Although glycemic control is the central feature of type 2 DM management, patients require an individualized approach to therapy that takes their other CVD risk factors into account. ⋯ A wide variety of agents were available to aid glycemic control in patients with type 2 DM. These agents had variable effects on known CV risk factors that might be present in this patient population, including excess body weight, elevated BP, and increased serum lipids. Some of the newer agents improved glycemic control while also having potentially favorable effects on these CV risk factors. The impact of various agents on known CV risk factors should be considered when selecting a therapeutic regimen.
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Clinical therapeutics · Apr 2011
ReviewEvaluating treatment algorithms for the management of patients with type 2 diabetes mellitus: a perspective on the definition of treatment success.
Traditional treatment of type 2 diabetes mellitus (T2DM) has focused on correcting hyperglycemia. However, T2DM is often accompanied by other conditions and risk factors, including hypertension, overweight/obesity, and dyslipidemia, that affect morbidity and mortality. A broader view toward treating the array of physiologic derangements may provide significant long-term outcomes benefits. ⋯ Physicians should evaluate the array of treatment options available for patients with T2DM. An aggressive regimen including metformin, a thiazolidinedione, and a GLP-1 receptor agonist may improve insulin sensitivity and enhance β-cell function. Addressing the pathophysiologic defects associated with T2DM, as well as the various associated cardiovascular risk factors, with combination therapy may slow the natural progression of the disease and development of its associated complications.
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Clinical therapeutics · Apr 2011
Comparative StudyPalonosetron versus other 5-HT(3) receptor antagonists for prevention of chemotherapy-induced nausea and vomiting in patients with cancer on chemotherapy in a hospital outpatient setting.
Despite favorable evidence from clinical trials for single-dose palonosetron versus other commercially available 5-HT(3)-receptor antagonists for the prophylaxis of chemotherapy-induced nausea and vomiting (CINV), clinical comparative data are scarce from hospital outpatient settings, where these antiemetic agents are used in patients diagnosed with cancer who are receiving chemotherapy (CTH). ⋯ In this study, patients with cancer who were treated with CTH and on antiemetic prophylaxis using palonosetron were found to have significantly lower CINV event rates than those receiving other 5-HT(3) receptor antagonists.