Therapeutic Advances in Chronic Disease This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Obstructive sleep apnoea syndrome and its management
Obstructive sleep apnoea (OSA) is a common disorder characterized by repetitive episodes of nocturnal breathing cessation due to upper airway collapse. OSA causes severe symptoms, such as excessive daytime somnolence, and is associated with a significant cardiovascular morbidity and mortality. Different treatment options are now available for an effective management of this disease. After more than three decades from its first use, continuous positive airway pressure (CPAP) is still recognized as the gold standard treatment. Nasal CPAP (nCPAP) is highly effective in controlling symptoms, improving quality of life and reduc...
Source: Therapeutic Advances in Chronic Disease - August 25, 2015 Category: Internal Medicine Authors: Spicuzza, L., Caruso, D., Di Maria, G. Tags: Reviews Source Type: research

Medical treatment update on pulmonary arterial hypertension
Pulmonary arterial hypertension is a chronic, progressive disease of the pulmonary vasculature resulting in poor outcomes if left untreated. The management of group 1 pulmonary arterial hypertension has included the use of prostanoids, phosphodiesterase-5 inhibitors, and endothelin receptor antagonists targeting the prostacyclin, endothelin-1, and nitric oxide pathways. Three new medications have been approved by the US Food and Drug Administration over the past couple of years. Macitentan is the newest endothelin receptor antagonist, riociguat is a soluble guanylate cyclase stimulator, and treprostinil diolamine is the fi...
Source: Therapeutic Advances in Chronic Disease - August 25, 2015 Category: Internal Medicine Authors: Enderby, C. Y., Burger, C. Tags: Reviews Source Type: research

Managing hyperphosphatemia in patients with chronic kidney disease on dialysis with ferric citrate: latest evidence and clinical usefulness
Ferric citrate is a novel phosphate binder that allows the simultaneous treatment of hyperphosphatemia and iron deficiency in patients being treated for end-stage renal disease with hemodialysis (HD). Multiple clinical trials in HD patients have uniformly and consistently demonstrated the efficacy of the drug in controlling hyperphosphatemia with a good safety profile, leading the US Food and Drug Administration in 2014 to approve its use for that indication. A concurrent beneficial effect, while using ferric citrate as a phosphate binder, is its salutary effect in HD patients with iron deficiency being treated with an ery...
Source: Therapeutic Advances in Chronic Disease - August 25, 2015 Category: Internal Medicine Authors: Yagil, Y., Fadem, S. Z., Kant, K. S., Bhatt, U., Sika, M., Lewis, J. B., Negoi, D., for the Collaborative Study Group Tags: Reviews Source Type: research

Statin use in prediabetic patients: rationale and results to date
Prediabetes increases the risk for new-onset diabetes mellitus in patients receiving statins and this risk is dose- and time- dependent. Explanations for the conversion of a predisposed individual to diabetes are ambiguous including reductions in ubiquinone and adiponectin levels. However, the risk of new-onset diabetes mellitus is far outweighed by the statin-induced considerable decrease in cardiovascular events. Thus, prediabetic patients at high cardiovascular risk should not be denied high-dose statin therapy due to the small increase in the risk of developing diabetes since statins, especially at higher doses, cause ...
Source: Therapeutic Advances in Chronic Disease - August 25, 2015 Category: Internal Medicine Authors: Kei, A., Rizos, E. C., Elisaf, M. Tags: Reviews Source Type: research

Perspective on the role of Ozurdex (dexamethasone intravitreal implant) in the management of diabetic macular oedema
Diabetic macular oedema (DMO) is the most common cause of visual loss in the working age population. Intravitreal therapy has superseded macular laser as the first-line treatment for the management of centre-involving DMO in most patients. As well as the proven efficacy of intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents, phase II and III clinical trials of Ozurdex intravitreal dexamethasone implants for DMO have also demonstrated a mean increase in visual acuity and corresponding mean reduction in central macular thickness, particularly in pseudophakic eyes. Because of the risk of visual loss from c...
Source: Therapeutic Advances in Chronic Disease - August 25, 2015 Category: Internal Medicine Authors: Mehta, H., Gillies, M., Fraser-Bell, S. Tags: Reviews Source Type: research

Vedolizumab: an {alpha}4{beta}7 integrin antagonist for ulcerative colitis and Crohn's disease
Ulcerative colitis (UC) and Crohn’s disease (CD) are chronic, relapsing inflammatory bowel diseases associated with significant morbidity. Conventional therapies for these diseases include corticosteroids, aminosalicylates, immunomodulators, and monoclonal antibodies. Over the years tumor necrosis factor (TNF)-α antagonists alone or in combination with other therapies have emerged as the cornerstone of treatment for induction and maintenance of remission of moderate to severe UC and CD. Unfortunately, some patients with moderate to severe UC and CD are unable to attain or maintain remission with TNF-α ant...
Source: Therapeutic Advances in Chronic Disease - August 25, 2015 Category: Internal Medicine Authors: Cherry, L. N., Yunker, N. S., Lambert, E. R., Vaughan, D., Lowe, D. K. Tags: Reviews Source Type: research

P2Y12 antagonists in non-ST-segment elevation acute coronary syndromes: latest evidence and optimal use
Dual antiplatelet therapy (DAPT), which includes the combination of aspirin and a P2Y12 platelet receptor inhibitor, is a well-established antiplatelet regimen in the treatment of patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Three P2Y12 inhibitor options (clopidogrel, prasugrel and ticagrelor) are currently available, all having different efficacy and safety profiles along with contrasting contraindications, special warnings and precautions for use. This review compares and contrasts the unique P2Y12 antagonists in the NSTE-ACS setting, covering the latest evidence and their optimal use. (Sour...
Source: Therapeutic Advances in Chronic Disease - June 8, 2015 Category: Internal Medicine Authors: Norgard, N. B., DiNicolantonio, J. J. Tags: Reviews Source Type: research

Psoriatic arthritis: latest treatments and their place in therapy
Psoriatic arthritis (PsA) is a heterogeneous chronic inflammatory disease that may affect peripheral and axial joints, entheses, skin and nails, and other organs. Treatment with nonsteroidal anti-inflammatory drugs, steroid and disease-modifying antirheumatic drugs had been the backbone of traditional management of PsA for many years. However, improvement in our understanding of immunopathogenesis of PsA has led to new immunomodulatory therapies. Introduction of novel agents has raised the bar for treatment and helped drive research into additional therapeutic options. (Source: Therapeutic Advances in Chronic Disease)
Source: Therapeutic Advances in Chronic Disease - June 8, 2015 Category: Internal Medicine Authors: Kang, E. J., Kavanaugh, A. Tags: Reviews Source Type: research

Atypical femoral fractures and bisphosphonate use: current evidence and clinical implications
Osteoporosis is a disease characterized by a low bone volume and deterioration of the bone quality, which increases the risk of low-energy fractures. Bisphosphonate (BP) treatment increases the bone mass and reduces the risk of fractures in patients with osteoporosis by suppressing bone resorption. In spite of its clinical benefits, the long-term use of BPs has been linked to the occurrence of atypical femoral fractures (AFFs). Although the evidence had been controversial regarding the association between the occurrence of AFFs and BP use, more recent studies with radiographic adjudication have indicated the significant as...
Source: Therapeutic Advances in Chronic Disease - June 8, 2015 Category: Internal Medicine Authors: Saita, Y., Ishijima, M., Kaneko, K. Tags: Reviews Source Type: research

Bedaquiline for the treatment of multidrug-resistant tuberculosis: great promise or disappointment?
This report examines the available data on this novel drug for the treatment of MDR-TB. PubMed searches, last updated 18 February 2015, using the terms bedaquiline, TMC 207 and R207910 identified pertinent English citations. Citation reference lists were reviewed to identify other relevant reports. Pertinent MDR-TB treatment reports on the US Food and Drug Administration, Centers for Disease Control and Prevention (CDC), World Health Organization (WHO) and Cochrane websites were also evaluated. Bedaquiline is an adenosine triphosphate (ATP) synthase inhibitor specific for MTB and some nontuberculous mycobacteria. The early...
Source: Therapeutic Advances in Chronic Disease - June 8, 2015 Category: Internal Medicine Authors: Field, S. K. Tags: Reviews Source Type: research

Potential for specific dihydropyridine calcium channel blockers to have a positive impact on cognitive function in humans: a systematic review
Conclusion: At present there is limited evidence to suggest that nitrendipine may be associated with reduction in incident dementia. This association comes from a single trial and needs to be replicated. Furthermore, there is no high-quality evidence for any of the other potential candidate CCBs. (Source: Therapeutic Advances in Chronic Disease)
Source: Therapeutic Advances in Chronic Disease - June 8, 2015 Category: Internal Medicine Authors: Peters, J., Booth, A., Peters, R. Tags: Original Research Source Type: research

Optimizing the use of anti-tumor necrosis factor in the management of patients with Crohn's disease
Since the approval of the first anti-tumor necrosis factor (anti-TNF) therapy in late 1998, the treatment for Crohn’s disease (CD) has been revolutionized. Anti-TNF therapy has been consistently shown in numerous clinical trials to be effective for patients with more aggressive perianal, internal penetrating, and fistulizing CD. However, the loss of clinical remission is frequent and only one-third of patients remain in clinical remission at 1 year. The pharmacokinetics of anti-TNF is highly variable among patients and could be influenced by many factors including serum albumin, gender, body weight, systemic inflamma...
Source: Therapeutic Advances in Chronic Disease - May 1, 2015 Category: Internal Medicine Authors: Nguyen, D. L., Flores, S., Sassi, K., Bechtold, M. L., Nguyen, E. T., Parekh, N. K. Tags: Reviews Source Type: research

Optimizing the use of thiopurines in inflammatory bowel disease
Immunomodulator drugs, of which thiopurines can be considered the backbone, are widely used in the treatment of inflammatory bowel disease. They have been shown to be highly effective and safe; however, a significant proportion of patients are deemed to have a poor response or suffer adverse reactions. Knowing how to monitor and optimize thiopurine therapy in these scenarios is crucial to effective management. We discuss the metabolism of thiopurines, the use of enzyme/metabolite testing to guide treatment, as well as strategies to circumvent toxicity and side effects, such as allopurinol coprescription. The indications, u...
Source: Therapeutic Advances in Chronic Disease - May 1, 2015 Category: Internal Medicine Authors: Goel, R. M., Blaker, P., Mentzer, A., Fong, S. C. M., Marinaki, A. M., Sanderson, J. D. Tags: Reviews Source Type: research

Management of cirrhotic ascites
The most common complication to chronic liver failure is ascites. The formation of ascites in the cirrhotic patient is caused by a complex chain of pathophysiological events involving portal hypertension and progressive vascular dysfunction. Since ascites formation represents a hallmark in the natural history of chronic liver failure it predicts a poor outcome with a 50% mortality rate within 3 years. Patients with ascites are at high risk of developing complications such as spontaneous bacterial peritonitis, hyponatremia and progressive renal impairment. Adequate management of cirrhotic ascites and its complications bette...
Source: Therapeutic Advances in Chronic Disease - May 1, 2015 Category: Internal Medicine Authors: Pedersen, J. S., Bendtsen, F., Moller, S. Tags: Reviews Source Type: research

The diagnosis and treatment of chronic migraine
This article discusses the current state of management of chronic migraine. (Source: Therapeutic Advances in Chronic Disease)
Source: Therapeutic Advances in Chronic Disease - May 1, 2015 Category: Internal Medicine Authors: Weatherall, M. W. Tags: Reviews Source Type: research