Expert opinion on pharmacotherapy
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Expert Opin Pharmacother · Aug 2008
ReviewNeoadjuvant chemotherapy preceding cystectomy for bladder cancer.
Occult micrometastasis at the time of radical cystectomy leads predominantly to distant failures in patients with locally advanced, muscle-invasive transitional cell carcinoma of the bladder. ⋯ Neoadjuvant chemotherapy is a standard for the therapy of locally advanced bladder cancer, and the neoadjuvant paradigm may assist in accelerating novel agent development.
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Expert Opin Pharmacother · Aug 2008
Randomized Controlled TrialEffects of extended-release tramadol on pain-related sleep parameters in patients with osteoarthritis.
To examine the effects of extended release tramadol (tramadol ER) on reducing pain-related sleep disturbances (PRSDs) in patients (20-80 years) with moderate to moderately severe pain with radiographically confirmed osteoarthritis (OA) of the knee or hip. ⋯ In this post hoc analysis, a reduction in pain was associated with a significant reduction in PRSDs due to OA.
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Heparin-induced thrombocytopenia (HIT) is a serious, life-threatening complication which occurs in 1-3% of patients receiving heparin. Patients with untreated HIT have an up to 50% risk of developing life- and limb-threatening thromboembolic complications. Treatment is based upon clinical suspicion, stopping heparin therapy and initiation of anticoagulation with a rapidly acting alternative non-heparin anticoagulant, such as argatroban-a hepatically excreted direct thrombin inhibitor which is effective in the treatment of HIT. ⋯ Argatroban is a safe and effective treatment for HIT. In patients taking other hepatically cleared medications, lower initial doses may have to be used to avoid over-anticoagulation.
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Expert Opin Pharmacother · Aug 2008
ReviewAzacitidine and the beginnings of therapeutic epigenetic modulation.
Although originally developed as a cytarabine analog more than 40 years ago, azacitidine has been the subject of renewed interest in the era of cancer epigenetics. ⋯ The use of azacitidine has changed the approach to the treatment of MDS and has resulted in improved outcomes for patients.
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Expert Opin Pharmacother · Jul 2008
ReviewAn alternative topical treatment of osteoarthritis of the knee with cutaneous diclofenac solution.
Osteoarthritis (OA) is the most common chronic degenerative disease, which is characterised by the destruction of the articular cartilage and subchondral bone. The current treatment of OA is based primarily on the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics. There are disadvantages to routinely using NSAIDs in OA. Topical NSAIDs represent a potentially important advance in this regard as they may be significantly safer than oral NSAIDs. Cutaneous diclofenac solution (Pennsaid) was developed for the treatment of symptomatic OA of the knee and contains diclofenac sodium as an active ingredient and dimethyl sulfoxide (DMSO), a penetration enhancer. ⋯ The clinical studies showed that applying the topical diclofenac solution (Pennsaid) to a painful knee with primary OA could provide symptom relief equivalent to oral diclofenac with minimal systemic side effects; however, studies are needed that compare the effectiveness of Pennsaid with different topical forms of diclofenac.