Expert opinion on pharmacotherapy
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Statins have been shown to reduce morbidity and mortality in patients with and without coronary heart disease, and in patients with elevated and normal or average cholesterol levels. Economic evaluations of these mortality trials have demonstrated statins to be cost-effective. As these trials were placebo comparisons, their results are now of limited use in guiding the drug therapy selection process. ⋯ These trials suggest that statins with greater efficacy in reducing low-density lipoprotein cholesterol, would be preferred over less effective statins. So far, economic analyses of these comparative studies have not been published. These economic studies are needed to support formulary and drug therapy selection decisions regarding statins.
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Expert Opin Pharmacother · Jun 2006
ReviewIn search of pharmacoeconomic evaluations for fibromyalgia treatments: a review.
Fibromyalgia is characterised by chronic widespread pain of unknown aetiology and affects approximately 2% of the population. It can cause significant patient disability, sizeable economic costs, complex management decisions and controversy for healthcare providers. In lieu of uniformly approved treatments for fibromyalgia, patients may try multiple pharmacological and non-pharmacological therapies with questionable efficacy. ⋯ Due to inconclusive results, further study is needed on fibromyalgia treatment cost-effectiveness. These analyses could provide useful information for policy and evidence-based practice guidelines toward optimal disease management. Medical professionals should be a driving force in understanding the clinical and economic challenges of fibromyalgia.
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Expert Opin Pharmacother · Apr 2006
ReviewGenital herpes: antiviral therapy for symptom relief and prevention of transmission.
The episodic and daily suppressive treatment of genital herpes is safe and effective with the currently available antiviral agents: acyclovir, valacyclovir and famciclovir. Clinical strategies for the comprehensive management of genital herpes simplex virus infections are recommended. Data from recent clinical trials demonstrating the efficacy of shorter duration of therapy for recurrences and the use of antivirals for the prevention of transmission are reviewed in this article. The factors influencing the choice of therapy, such as cost, ease of dosing and acyclovir resistance are also discussed.
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Expert Opin Pharmacother · Apr 2006
ReviewAdvances in the treatment for haematological malignancies.
Despite the progress made in the last decade in the treatment of haematological malignancies, most of the patients still have a dismal prognosis. However, the improved knowledge of tumour biology opened the possibility to develop new 'intelligent' therapeutic strategies, the so-named targeted therapies. ⋯ Finally, the authors focus on the application of imatinib mesylate in chronic myeloid leukaemia as the paradigm of molecular treatment. Although these novel therapies are beginning to fulfil their promise, continued research efforts are needed to determine the optimal role of these strategies in haemato-oncology.
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Expert Opin Pharmacother · Apr 2006
ReviewThe management of behavioural and psychiatric symptoms in delirium.
Delirium is a common and usually reversible syndrome occurring during a period of physical illness. It is most common in children and the elderly. ⋯ If behavioural and environmental interventions are ineffective, psychotropic medication may be needed. This paper reviews the drugs commonly used in the management of behavioural and psychiatric symptoms in delirium, and suggests the need for further trials.