Expert opinion on pharmacotherapy
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Expert Opin Pharmacother · Mar 2005
Randomized Controlled Trial Multicenter StudyThe therapeutic potential of vasopressin in cardiopulmonary resuscitation.
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Expert Opin Pharmacother · Feb 2005
ReviewCurrent pharmacological options in the treatment of croup.
Croup is one of the most common respiratory illnesses seen in the acute paediatric setting. It can be a cause of acute stridor and/or respiratory distress in young children. Research has shown that therapy aimed at reducing symptoms and inflammation can reduce complications such as the need for intubation, hospitalisation and improve quality of life for parents and children. ⋯ Wet nebulised adrenaline (racaemic or l-adrenaline) is also an effective treatment for more severe cases of croup. Recent studies have shown that mist/humidified air provides no additional symptom improvement, nor does it alter the overall cause of the disease process. Currently, there is insufficient randomised controlled trial evidence to support the role of heliox in the short-term treatment of croup.
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Expert Opin Pharmacother · Jan 2005
ReviewMesalazine for diverticular disease of the colon--a new role for an old drug.
Colonic diverticulosis is among the most common diseases of developed countries. Its prevalence is approximately 5 - 10% of the population by age 50, and 30, 50 and 66% of those > 50, > 70 and > 85years of age, respectively. ⋯ Indeed, mesalazine (with or without antibiotics) showed significant superiority in improving the severity of symptoms, bowel habits, and in preventing symptomatic recurrence of diverticulitis over antibiotics alone. More-over, in light of some preliminary results, it is probable that the association of mesalazine with probiotics may in the future be the first-choice treatment for mild-to-moderate uncomplicated attacks of acute diverticulitis.
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Expert Opin Pharmacother · Sep 2004
ReviewCost-effectiveness of TNF-alpha-blocking agents in the treatment of rheumatoid arthritis.
The current literature covering cost-effectiveness and cost-utility analyses of biological treatments in patients with rheumatoid arthritis (RA) are reviewed in order to discuss options and limitations for future application of these highly priced drugs in routine clinical practice. The cost-effectiveness and cost-utility ratios of the studies analysed are converted into the corresponding Euros of the publication year. Etanercept treatment achieved a cost-effectiveness ratio of 44,300 Euros (2002)/ACR 20 (20% response according to American College of Rheumatology criteria) and 43,100 Euros (2002)/ACR 70WR (ACR 70 weighted response) compared with sulfasalazine and methotrexate, respectively, in methotrexate-naive RA. ⋯ No substantial differences of cost-utilities of infliximab and etanercept were found. The administration of these drugs as third-line therapy is regarded cost-effective compared to other well-accepted therapies with comparable cost-utility ratios of < 50,000 Euros/QALY gained. Still, data on economic outcomes of RA trials are sparse and further cost-effectiveness and cost-utility evaluations are needed.
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Expert Opin Pharmacother · Sep 2004
ReviewValganciclovir: oral prevention and treatment of cytomegalovirus in the immunocompromised host.
Herpes virus infections, particularly those caused by cytomegalovirus (CMV), lead to significant and, sometimes severe, clinical problems for the immunocompromised host. As effective agents have become available, several treatment and prevention strategies have evolved over the past decade, first in intra-venous form and more recently, as oral preparations. Valganciclovir, the valine ester of ganciclovir, is an orally administered, potent, antiviral agent active against all herpes viruses. ⋯ Clinical trials evaluating the safety and efficacy of valganciclovir for the treatment of new AIDS-associated CMV retinitis showed equivalency to intravenous ganciclovir and prevented progression of quiescent disease. In solid organ recipients, once-daily valganciclovir has been proven equivalent to oral ganciclovir for the prevention of CMV infection. The high bioavailability and convenient dosing formulation make valganciclovir an attractive option for these indications.