Journal•ISSN: 1474-0338
Expert Opinion on Drug Safety
Informa
About: Expert Opinion on Drug Safety is an academic journal published by Informa. The journal publishes majorly in the area(s): Medicine & Adverse effect. It has an ISSN identifier of 1474-0338. Over the lifetime, 2305 publications have been published receiving 56747 citations.
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TL;DR: It is shown that well-designed interprofessional intervention studies that focus on enrolling high-risk older patients with polypharmacy have shown that they can be effective in reducing aspects of unnecessary prescribing with mixed results on distal health outcomes.
Abstract: Introduction: Polypharmacy, defined as the use of multiple drugs or more than are medically necessary, is a growing concern for older adults. MEDLINE and EMBASE databases were searched from January 1, 1986 to June 30, 2013) to identify relevant articles in people aged > 65 years. Areas covered: We present information about: i) prevalence of polypharmacy and unnecessary medication use; ii) negative consequences of polypharmacy; and iii) interventions to improve polypharmacy. Expert opinion: International research shows that polypharmacy is common in older adults with the highest number of drugs taken by those residing in nursing homes. Nearly 50% of older adults take one or more medications that are not medically necessary. Research has clearly established a strong relationship between polypharmacy and negative clinical consequences. Moreover, well-designed interprofessional (often including clinical pharmacist) intervention studies that focus on enrolling high-risk older patients with polypharmacy have sh...
1,279 citations
TL;DR: This article analyzes English-language literature and provides an update on the most recent literature regarding side effects of systemic glucocorticoid treatment and suggests the risk/benefit ratio of glucoc Corticoid therapy can be improved by proper use.
Abstract: Introduction: Glucocorticoids represent the standard therapy for reducing inflammation and immune activation in various diseases. However, as with any potent medication, they are not without side effects. Glucocorticoid-associated side effects may involve most major organ systems. Musculoskeletal, gastrointestinal, cardiovascular, endocrine, neuropsychiatric, dermatologic, ocular, and immunologic side effects are all possible.Areas Covered: This article analyzes English-language literature and provides an update on the most recent literature regarding side effects of systemic glucocorticoid treatment.Expert Opinion: The risk/benefit ratio of glucocorticoid therapy can be improved by proper use. Careful monitoring and using appropriate preventive strategies can potentially minimize side effects.
404 citations
TL;DR: This review addresses the toxicities associated with paclitaxel treatment and describes existing and future strategies of pac litaxel administration directed at limiting these toxicities.
Abstract: Better known as Taxol (Bristol-Myers Squibb), paclitaxel is the first member of the taxane family to be used in cancer chemotherapy. The taxanes exert their cytotoxic effect by arresting mitosis through microtubule stabilization, resulting in cellular apoptosis. The use of paclitaxel as a chemotherapeutic agent has become a broadly accepted option in the treatment of patients with ovarian, breast and non-small cell lung cancers, malignant brain tumors, and a variety of other solid tumors. However, significant toxicities, such as myelosuppression and peripheral neuropathy, limit the effectiveness of paclitaxel-based treatment regimens. This review addresses the toxicities associated with paclitaxel treatment and describes existing and future strategies of paclitaxel administration directed at limiting these toxicities.
356 citations
TL;DR: An updated systematic review and meta-analysis of all placebo-controlled randomized clinical trials on the effect of testosterone supplementation (TS) on CV-related problems indicates that TS is not related to any increase in CV risk, even when composite or single adverse events were considered.
Abstract: Introduction: Recent reports have significantly halted the enthusiasm regarding androgen-boosting; suggesting that testosterone supplementation (TS) increases cardiovascular (CV) events.Areas covered: In order to overcome some of the limitations of the current evidence, the authors performed an updated systematic review and meta-analysis of all placebo-controlled randomized clinical trials (RCTs) on the effect of TS on CV-related problems. Out of 2747 retrieved articles, 75 were analyzed, including 3016 and 2448 patients in TS and placebo groups, respectively, and a mean duration of 34 weeks. Our analyses, performed on the largest number of studies collected so far, indicate that TS is not related to any increase in CV risk, even when composite or single adverse events were considered. In RCTs performed in subjects with metabolic derangements a protective effect of TS on CV risk was observed.Expert opinion: The present systematic review and meta-analysis does not support a causal role between TS and adver...
264 citations
TL;DR: The issue of ‘confounding by multimorbidity’ has been underestimated and should be better accounted for in future studies, and researchers should develop more clinically relevant definitions of polypharmacy, including measures of inappropriate or problematic polyPharmacy.
Abstract: Introduction: Polypharmacy, the use of multiple medications by one individual, is increasingly common among older adults. Caring for the growing number of older people with complex drug regimens an ...
263 citations