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New perspectives on management of idiopathic pulmonary fibrosis
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive parenchymal lung disease characterized by a median survival of 3–5 years following diagnosis. The diagnosis is based on clinical, radiological and histopathological evaluation. Therefore, a multidisciplinary team is needed to reach the correct diagnosis. For a long time, supportive care and lung transplantation in selected cases, have been considered the only possible treatments for IPF. In the last decade many studies have investigated IPF pathogenesis, leading to an improved knowledge of the mechanisms underlying the disease and to the approval of two ne...
Source: Therapeutic Advances in Chronic Disease - February 26, 2016 Category: Internal Medicine Authors: Puglisi, S., Torrisi, S. E., Vindigni, V., Giuliano, R., Palmucci, S., Mule, M., Vancheri, C. Tags: Reviews Source Type: research

The GLP-1 agonist, liraglutide, as a pharmacotherapy for obesity
This article briefly reviews the history of pharmacotherapy for obesity before focusing on the clinical trial evidence for the use of the GLP-1 agonist liraglutide as a weight loss agent and comparing its efficacy with other emerging drug therapies for obesity. (Source: Therapeutic Advances in Chronic Disease)
Source: Therapeutic Advances in Chronic Disease - February 26, 2016 Category: Internal Medicine Authors: Crane, J., McGowan, B. Tags: Reviews Source Type: research

A review of the medical treatment of primary sclerosing cholangitis in the 21st century
Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease that progresses to end-stage liver disease and cirrhosis. Recurrent biliary inflammation is thought to lead to dysplasia, and as such PSC confers a high risk of cholangiocarcinoma. PSC accounts for 10% of all UK liver transplants, although transplantation does not guarantee a cure with 20% recurrence in the graft. At present there are no effective medical treatment options for PSC, and trials of novel therapeutic agents are limited by the time taken to reach clinically significant endpoints with no well defined early surrogate markers for disease o...
Source: Therapeutic Advances in Chronic Disease - January 5, 2016 Category: Internal Medicine Authors: Goode, E. C., Rushbrook, S. M. Tags: Reviews Source Type: research

Ocular itch associated with allergic conjunctivitis: latest evidence and clinical management
This article presents the evolution of ocular allergy treatments, from vasoconstrictors, to antihistamines and mast-cell stabilizers, to the dual-acting agents, as well as corticosteroid and immunomodulatory options. Future targets for allergy treatment are also discussed. (Source: Therapeutic Advances in Chronic Disease)
Source: Therapeutic Advances in Chronic Disease - January 5, 2016 Category: Internal Medicine Authors: Ackerman, S., Smith, L. M., Gomes, P. J. Tags: Reviews Source Type: research

Eosinophilic airway inflammation: role in asthma and chronic obstructive pulmonary disease
The chronic lung diseases, asthma and chronic obstructive pulmonary disease (COPD), are common affecting over 500 million people worldwide and causing substantial morbidity and mortality. Asthma is typically associated with Th2-mediated eosinophilic airway inflammation, in contrast to neutrophilic inflammation observed commonly in COPD. However, there is increasing evidence that the eosinophil might play an important role in 10–40% of patients with COPD. Consistently in both asthma and COPD a sputum eosinophilia is associated with a good response to corticosteroid therapy and tailored strategies aimed to normalize sp...
Source: Therapeutic Advances in Chronic Disease - January 5, 2016 Category: Internal Medicine Authors: George, L., Brightling, C. E. Tags: Reviews Source Type: research

Ponesimod, a selective S1P1 receptor modulator: a potential treatment for multiple sclerosis and other immune-mediated diseases
The first oral treatment for relapsing multiple sclerosis, the nonselective sphingosine-1-phosphate receptor (S1PR) modulator fingolimod, led to identification of a pivotal role of sphingosine-1-phosphate and one of its five known receptors, S1P1R, in regulation of lymphocyte trafficking in multiple sclerosis. Modulation of S1P3R, initially thought to cause some of fingolimod’s side effects, prompted the search for novel compounds with high selectivity for S1P1R. Ponesimod is an orally active, selective S1P1R modulator that causes dose-dependent sequestration of lymphocytes in lymphoid organs. In contrast to the long...
Source: Therapeutic Advances in Chronic Disease - January 5, 2016 Category: Internal Medicine Authors: DAmbrosio, D., Freedman, M. S., Prinz, J. Tags: Reviews Source Type: research

Lixisenatide in type 2 diabetes: latest evidence and clinical usefulness
Type 2 diabetes (T2D) is a highly prevalent disorder that affects millions of people worldwide. The hallmark of T2D is hyperglycemia and, while many treatment modalities exist, achieving and maintaining glycemic control can be challenging. Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) are an appealing treatment option as they improve glycemic control, reduce weight, and limit the risk of hypoglycemia. Lixisenatide is a once-daily GLP-1 RA that has been evaluated in the GetGoal clinical trial program and has demonstrated efficacy and tolerability across a spectrum of patients. The feature that most distinguishes l...
Source: Therapeutic Advances in Chronic Disease - January 5, 2016 Category: Internal Medicine Authors: Anderson, S. L., Trujillo, J. M. Tags: Reviews Source Type: research

The diagnosis and treatment of chronic migraine: the case for daily scheduled opioid treatment in chronic headache
(Source: Therapeutic Advances in Chronic Disease)
Source: Therapeutic Advances in Chronic Disease - October 13, 2015 Category: Internal Medicine Authors: Derakhshan, I. Tags: Letter to the Editor Source Type: research

Insulin degludec and insulin aspart: novel insulins for the management of diabetes mellitus
Patients with type 2 diabetes mellitus require insulin as disease progresses to attain or maintain glycaemic targets. Basal insulin is commonly prescribed initially, alone or with one or more rapid-acting prandial insulin doses, to limit mealtime glucose excursions (a basal–bolus regimen). Both patients and physicians must balance the advantages of improved glycaemic control with the risk of hypoglycaemia and increasing regimen complexity. The rapid-acting insulin analogues (insulin aspart, insulin lispro and insulin glulisine) all have similar pharmacokinetic and pharmacodynamic characteristics and clinical efficacy...
Source: Therapeutic Advances in Chronic Disease - October 13, 2015 Category: Internal Medicine Authors: Atkin, S., Javed, Z., Fulcher, G. Tags: Reviews Source Type: research

Cardiovascular disease and type 1 diabetes: prevalence, prediction and management in an ageing population
Cardiovascular disease (CVD) is a major cause of mortality in type 1 diabetes mellitus (T1D). However, evidence of its risks and management is often extrapolated from studies in type 2 diabetic (T2D) patients or the general population. This approach is unsatisfactory given that the underlying pathology, demographics and natural history of the disease differ between T1D and T2D. Furthermore, with a rising life expectancy, a greater number of T1D patients are exposed to the cardiovascular (CV) risk factors associated with an ageing population. The aim of this review is to examine the existing literature around CVD in T1D. We...
Source: Therapeutic Advances in Chronic Disease - October 13, 2015 Category: Internal Medicine Authors: Lee, S. I., Patel, M., Jones, C. M., Narendran, P. Tags: Reviews Source Type: research

The effect of angiotensin II receptor blockers on hyperuricemia
In conclusion, losartan is the only ARB that has consistently demonstrated a significant reduction in serum uric acid levels, although the significance of impacting clinical outcomes remains unknown. Losartan appears to be a safe and efficacious agent to lower serum uric acid levels in patients with hyperuricemia. (Source: Therapeutic Advances in Chronic Disease)
Source: Therapeutic Advances in Chronic Disease - October 13, 2015 Category: Internal Medicine Authors: Wolff, M. L., Cruz, J. L., Vanderman, A. J., Brown, J. N. Tags: Reviews Source Type: research

Pharmacological treatment of spondyloarthritis: exploring the effectiveness of nonsteroidal anti-inflammatory drugs, traditional disease-modifying antirheumatic drugs and biological therapies
Spondyloarthritis represents a heterogeneous group of articular inflammatory diseases that share common genetic, clinical and radiological features. The therapy target of spondyloarthritis relies mainly in improving patients’ quality of life, controlling articular inflammation, preventing the structural joints damage and preserving the functional abilities, autonomy and social participation of patients. Among these, traditional disease-modifying antirheumatic drugs have been demonstrated to be effective in the management of peripheral arthritis; moreover, in the last decade, biological therapies have improved the app...
Source: Therapeutic Advances in Chronic Disease - October 13, 2015 Category: Internal Medicine Authors: Caso, F., Costa, L., Del Puente, A., Di Minno, M. N. D., Lupoli, G., Scarpa, R., Peluso, R. Tags: Reviews Source Type: research

Strategies for treating chronic HCV infection in patients with cirrhosis: latest evidence and clinical outcomes
This article provides a review on the most up to date data on the use of DAA’s in patients with advanced fibrosis and cirrhosis. We are at a point where HCV could be truly eradicated, but to do so will require ensuring there are effective and safe treatments for those with advanced fibrosis and cirrhosis. (Source: Therapeutic Advances in Chronic Disease)
Source: Therapeutic Advances in Chronic Disease - October 13, 2015 Category: Internal Medicine Authors: Wilder, J. M., Muir, A. J. Tags: Reviews Source Type: research

Chronic spontaneous urticaria: latest developments in aetiology, diagnosis and therapy
Chronic urticaria is a debilitating disease characterized by itching and hives with or without angioedema lasting for more than 6 weeks. The disease carries a significant emotional and economic burden for the patient and often results in an odyssey between doctors of different specialities. Patients suffering from chronic urticaria are considered more difficult to satisfy, treat and to have a bigger emotional burden than the average patient in dermatology, paediatric and general practice settings. A joint initiative under the Dermatology section of the European Academy of Allergy and Clinical immunology (EAACI), the Global...
Source: Therapeutic Advances in Chronic Disease - October 13, 2015 Category: Internal Medicine Authors: Vestergaard, C., Deleuran, M. Tags: Reviews Source Type: research

Impact of air quality on lung health: myth or reality?
The respiratory system is a primary target of the harmful effects of key air pollutants of health concern. Several air pollutants have been implicated including particulate matter (PM), ozone (O3), nitrogen dioxide (NO2) polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs). It is well known that episodes of exposure to high concentrations of outdoor air pollutants can cause acute respiratory exacerbations. However, there is now increasing evidence suggesting that significant exposure to outdoor air pollutants may be also associated with development of lung cancer and with incident cases of chronic ...
Source: Therapeutic Advances in Chronic Disease - August 25, 2015 Category: Internal Medicine Authors: Marino, E., Caruso, M., Campagna, D., Polosa, R. Tags: Reviews Source Type: research