4- Thursday Pharmacotherapy News – 8th July

1 – Treatment of Patients with Serious Infections Due to Carbapenem-resistant Acinetobacter baumannii: How Viable are the Current Options?

• This review critically appraises the published microbiologic and clinical data on the treatment of patients with carbapenem-resistant Acinetobacter baumannii infections.
• Despite being recognized as an urgent threat pathogen by the CDC and WHO, optimal treatment of patients with serious CRAB infections remains ill-defined.
• No treatment regimen has been found to reduce mortality, which exceeds 40% across most studies, or substantially improve clinical response.
• While some newer agents, such as eravacycline and cefiderocol, have demonstrated in vitro activity, clinical efficacy has not been fully established.
• New agents with clinically relevant activity against CRAB isolates and favorable toxicity profiles are sorely needed.

Source: ACCP

2 – Hospitalizations for opioid-related overdose and timing of concurrent opioid and benzodiazepine use: A nested case-control study

• Concurrent opioid and benzodiazepine (BZD) use is a prevalent high-risk prescribing behavior that increases the risk of opioid overdose.
• However, there is limited evidence on the relationship between timing of concurrent use and risk of opioid overdose.
• This article aims to evaluate the likelihood of opioid-related overdose across levels of duration, recency, and daily dose of concurrent use.
• Patients with an opioid-related overdose were more likely to be prescribed concurrent opioid and BZD across all levels of duration, timing, and daily dose.
• Future policies and quality measures should be pursued to prevent concurrent use unless medically necessary.

Source: ACCP

3 – The association between urate-lowering therapies and treatment-related adverse events, liver damage, and major adverse cardiovascular events (MACE): A network meta-analysis of randomized trials

• Hyperuricemia is a common disease that may lead to gout, renal damage, and cardiovascular events.
• Oral medication is the main treatment for hyperuricemia patients when lifestyle intervention fails.
• An evaluation of the safety of various urate-lowering therapies (ULTs) is integral to clinical decision-making.
• They constructed a network meta-analysis (NMA) to evaluate the safety of oral ULTs.
• Through NMA, they provide some evidence for the safety of ULTs.
• They found no statistically significant differences in their effects on treatment-related adverse events and MACE.
• However, Topiroxostat likely increases the risk of liver damage.

Source: ACCP

4- Effectiveness of Sacubitril/Valsartan Versus Aldosterone Antagonists in Heart Failure with reduced Ejection Fraction: A Retrospective Cohort Study

• Sacubitril/valsartan (SAC/VAL) and aldosterone antagonists (ARAs) are each recommended therapy for heart failure with reduced ejection fraction (HFrEF), but little is known about their comparative effectiveness for preventing HF-related and all-cause hospitalizations in patients previously hospitalized for HFrEF.
• Compared with ARAs, SAC/VAL was associated with lower risk of HF-related and all-cause hospitalizations.
• This data suggest that, when added sequentially, SAC/VAL should be the preferred initial agent over ARAs.

Source: ACCP

5 – Cytoprotective effects of erythropoietin: What about the lung?

• Erythropoietin (Epo) is a pleiotropic cytokine, essential for erythropoiesis.
• Epo and its receptor (Epo-R) are produced by several tissues and it is now admitted that Epo displays other physiological functions than red blood cell synthesis.
• Indeed, Epo provides cytoprotective effects, which consist in prevention or fight against pathological processes.
• This perspective article reviews the various protective effects of Epo in several organs and tries to give a proof of concept about its effects in the lung.
• The tissue-protective effects of Epo could be a promising approach to limit the symptoms of acute and chronic lung diseases.

Source: ScienceDirect

6 – Amyloid-β: A double agent in Alzheimer’s disease?

• Amyloid-β (Aβ) accumulation is one of the cardinal pathological hallmarks of Alzheimer’s disease and plays an important role in its pathogenesis.
• Although the neurotoxic effects of Aβ has been extensively studied, recent studies have revealed that it may also have protective effects.
• Here, they review novel findings that have shifted our understanding of the role of Aβ in the pathogenesis of Alzheimer’s disease.
• An in-depth and comprehensive understanding of Aβ will provide us with a broader perspective on the treatment of Alzheimer’s disease.

Source: ScienceDirect

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