Current Drug Therapy - Volume 20, Issue 6, 2025

Prostate cancer (PCa) ranks the second most diagnosed cancers among men globally and the sixth leading cause of cancer-related deaths. Advanced prostate cancer can be defined as the recurrence after definitive therapies (radical prostatectomy or external beam radiotherapy) and de novo metastasis (metastasis without prior treatment). Advanced PCa can be categorized as metastatic hormone sensitive prostate cancer (mHSPC), non-metastatic castration resistant prostate cancer (nmCRPC), and metastatic castration resistant prostate cancer (mCRPC). Management of advanced PCa often involves castration to reduce testosterone levels, which can be achieved by gonadotropin releasing hormone antagonists such as degarelix and relugolix. Degarelix is injectable while relugolix is an orally administered form of GnRH antagonist. This review aims to explore the latest pharmacological aspects of these drugs to inform treatment decisions for advanced PCa.

Remimazolam, a novel ultra-short-acting benzodiazepine, has emerged as a promising agent in the field of anaesthesia and sedation. This comprehensive review examines the pharmacological properties, clinical applications, and safety profile of remimazolam. Its unique pharmacokinetic profile, characterised by rapid onset and offset of action, organ-independent metabolism, and availability of a specific reversal agent, offers potential advantages over traditional sedatives. Clinical studies have demonstrated its efficacy in procedural sedation, particularly in gastrointestinal endoscopy and bronchoscopy, as well as in the induction and maintenance of general anaesthesia. Emerging evidence also suggests its potential utility in intensive care sedation. Remimazolam has shown a favourable safety profile, with studies indicating comparable or improved hemodynamic stability and potentially reduced respiratory depression compared to propofol. The availability of flumazenil as a reversal agent enhances its safety profile. However, as with any relatively new medication, ongoing research is needed to fully characterise its long-term safety and optimal use in various clinical scenarios. This review synthesises current knowledge on remimazolam, providing insights into its potential to optimise sedation and anaesthesia practices across diverse patient populations and clinical settings, while highlighting areas for future research.

The family Delesseriaceae possesses enormous bioactive medicinal and pharmacological constituents that have calculable positive effects on various diseases in humans. The Delesseriaceae family contains approximately 25 different marine species that are found throughout coastal areas. This review aims to integrate global scientific literature, including seaweed studies in Mandapam, to provide a comprehensive understanding of Deleserriaceae species, encompassing taxonomy, ecology, and potential applications. Nitophyllum species contain bioactive components, especially polysaccharides and proteins. Deleseriaceae, a seaweed recognized for its nutritional richness, presents a potential resource for various therapeutic applications. However, it's important to note that the specific activities mentioned, such as insulin sensitization, lipid peroxidation inhibition, antimicrobial effects, and antioxidant properties, might not be well-documented or established in Deleserriaceae species such as Nitophyllum marginale, Nitophyllum punctatum, Nitophyllum hommersandii venvorstia spectabilis, Martensia indica, Taenioma perpusilium, and Martensia fragilis. Further research is required to ascertain the exact bioactive compounds and potential health benefits associated with this seaweed species.

Glycosaminoglycans (GAGs), natural components of the extracellular matrix, exert significant influence over cellular function and regulate the microenvironment surrounding cells. This characteristic makes them promising targets for therapeutic intervention across a spectrum of diseases. In the realm of medical research, there has been a longstanding quest for precise and targeted drug delivery methods to mitigate adverse effects and enhance the efficacy of treatments for conditions, such as wounds, cancer, and organ disorders. However, implementing a systemic delivery approach, particularly for protein-based therapeutics, poses challenges. Addressing this challenge requires the development of biocompatible materials capable of efficiently encapsulating and releasing therapeutic proteins. GAGs emerge as promising candidates possessing these desirable attributes, given their bio-derived nature and ability to modulate biological responses. Within the realm of GAGs, various linear polysaccharides exhibit diverse functionalities and payloads. Notably, hyaluronic acid (HA) and chondroitin sulfate (CS) have been utilized as polysaccharide-based biomaterials for drug delivery, particularly in the treatment of rheumatoid arthritis. Modified HA and CS can self-assemble into micelles or micellar nanoparticles (NPs), enabling precise and controlled drug delivery. This paper explores a range of NP formulations derived from HA and CS, including drug conjugates, polymers, small molecules, polyelectrolyte nanocomplexes (PECs), metals, and nanogels. The versatility of these NP formulations extends to various therapeutic applications, including cancer chemotherapy, gene therapy, photothermal therapy (PTT), photodynamic therapy (PDT), sonodynamic therapy (SDT), and immunotherapy. By harnessing the unique properties of HA and CS, these NP-based systems offer promising avenues for advancing therapeutic interventions in diverse clinical settings.

Cosmetics may have “pharmaceutical therapeutic benefits” but not always “biological therapeutic rewards.,” Products for skin care that combine cosmetics and pharmaceuticals are known as Cosmeceuticals. Cosmeceuticals are applied topically like cosmetics, but they also contain substances that affect the biological functions of the skin. Cosmetics make people seem better, but they do so by giving their skin the nutrition it needs to stay healthy. Cosmeceutical skincare has specific ingredients to correct particular skin concerns or conditions. For example, they have high percentages of salicylic acid and niacinamide to correct oily to acne-prone skin. A skincare expert has access to pharmaceutical-grade items that can be utilized to customize each client's at-home or face regimen. This study aims to provide an up-to-date analysis of cutting-edge natural bio-actives that not only improve skin health but also shield it from a range of dangerous agents, such as UV radiation and free radicals.

Atopic Dermatitis (AD) is a chronic, inflammatory, and widespread skin disease with heterogeneous manifestations having a significant influence on the lives of youngsters and adults. Atopic Dermatitis prevalence is higher in African-American children compared with European American children, and the interaction between various factors such as genetics, skin barrier dysfunction, and immune abnormalities mainly causes it. Despite various available treatment options for atopic dermatitis, they often fall short in addressing the root cause, prompting patients to seek more effective and enduring solutions. To combat these shortcomings, researchers are focusing on the development of targeted therapy. The development of targeted treatment options involves the utilization of a range of biological agents designed to pinpoint specific components and regulators of inflammatory pathways associated with allergic and inflammatory conditions. Phytochemicals, viz. alkaloids, phenols, carotenoids, and organo-sulphurs, have been utilized in traditional medicine for centuries, which contribute to increased efficacy while minimizing adverse events. The objective of this review is to give information about the epidemiology, pathophysiology, and evolving landscape of targeted therapy for atopic dermatitis, encompassing both biologics and phytochemicals.

Milk thistle seeds contain silymarin, a powerful hepatoprotective compound known to shield liver cells from toxins, increase glutathione levels, and promote cell regeneration. Silybin, one of the key components of silymarin, is highly valued by herbalists due to its minimal side effects. Silymarin is ubiquitously distributed across diverse geographic regions, encompassing Europe, Africa, Asia, Australia, North and South America, India, and China. Silymarin comprises an array of compounds, specifically silydianin, isosilybin A, isosilybin B, silybin A, and silydianin flavonoids. Its pharmacological applications are multifaceted, including antidiabetic, hepatoprotective, hypocholesterolemic, antihypertensive, anti-inflammatory, anticancer, and antioxidant properties. Milk thistle seeds additionally exhibit anti-spasmodic, neuroprotective, antiviral, immunomodulant, and cardioprotective characteristics. They can even enhance milk secretion and help treat uterine disorders. Such an in-depth inquiry is poised to facilitate the meticulous assessment by researchers of its efficacy in therapeutic applications. Additionally, silymarin exhibits changes in cellular transporter, P-glycoprotein, as well as estrogenic and nuclear receptors. It also impedes apoptosis and follicular development during in vitro fertilization, making it a promising option in complementary medicine. This documented evidence is useful in safeguarding vital organs against an array of maladies, encompassing cancer, in vitro fertilization, hepatotoxicity, nephrotoxicity, viral hepatitis challenges, neurotoxicity, depressive disorders, and pulmonary and prostate disorders. This scholarly article undertakes a comprehensive exploration of the pharmacognostic, morphological, ethnobotanical, and pharmacological importance of Silybum marianum.

Significant progress has been made in the field of gastroretentive drug delivery systems using natural polysaccharides. These improvements aim to improve the effectiveness and absorption of different medicinal agents. Pectin has received substantial attention in recent years due to its distinctive structural characteristics, abundant availability, biocompatibility, lack of toxicity, and wide range of applications. The global utilization of pectin in drug delivery systems has expanded significantly. Pectin is used to achieve flotation and mucoadhesive properties, which enhance gastric residence length and improve therapeutic effectiveness. The article aims to comprehensively examine the information on several pectin-based formulations for medication delivery that are designed to remain in the stomach for an extended period of time. Furthermore, this article emphasizes the diverse physicochemical and biological properties of pectin and modified pectin, as well as their prospective uses in numerous fields. This publication also presents the significant advantages, challenges, potential future developments, and patents on pectin-based gastroretentive drug delivery systems.

The purpose of this study is to evaluate hyaluronic acid (HA), sometimes referred to as hyaluronan or hyaluronate, as well as its derivatives and how they are used in cosmetic formulations. N-acetylglucosamine and D-glucuronic acid are the two disaccharides that make up HA, a glycosaminoglycan that was first isolated from the vitreous humor of the eye and then found in other tissues and fluids, including the synovial fluid and articular cartilage. It is found in all vertebrates, including humans, and has a variety of roles in biological processes, such as wound healing, inflammation, cell differentiation, and embryological development. With its moisturizing and anti-aging properties, HA offers numerous advantages over other chemicals used in skin regeneration. The biological activity and skin penetration of HA are influenced by its molecular weight. The current study outlines the key elements of hyaluronic acid's usage in cosmetology, given its broad range of uses and applications in ophthalmology, arthrology, pneumology, rhinology, aesthetic medicine, cancer, nutrition, and cosmetics. There is a discussion of the biological impact of HA at the skin's level as well as any possible negative consequences. From the brand portfolios of the most well-known manufacturers, a few readily available cosmetic items containing HA have been discovered, and their composition has been assessed.

In recent years there has been increased interest in exploring the therapeutic efficacy of cannabis for the management of chronic pain among adult patients. However, the use of cannabis for chronic pain is still a matter of debate and uncertainty. This opinion paper carried out a short overview of the literature with the aim of evaluating data on efficacy and safety of cannabis-based medicines, to fill the existing gaps in understanding the role of cannabis in therapy and to identify the critical issues associated with their use. The analysis of existing literature has clearly highlighted the potential benefits of cannabis-based preparations for the management of chronic pain. However, several criticalities have been identified. These include the lack of standardization of preparations and the insufficient clinical evidence to establish cannabis as the therapy of choice for chronic pain. As a result, although the potential benefits of cannabis preparations for the management of chronic pain are clear, further research is needed to address existing limitations and establish a solid scientific basis, especially through real-world data collection.

Alzheimer's disease (AD) is a neurological condition associated with a decrease in levels of acetylcholine and diminished cholinergic functions. This may be caused by the degeneration of cholinergic neurons in the brain, leading to cognitive deficits. Due to the difficulty and invasiveness of collecting cerebrospinal fluid (CSF) required for assessing conventional biomarkers, researchers are currently exploring less intrusive, less expensive, and more straightforward methods for diagnosing AD. Additionally, conventional interventions such as cholinesterase inhibitors like rivastigmine, donepezil, and galantamine are US FDA-approved drugs that are still effective for managing AD. The goal of this therapy is to increase acetylcholine levels in the brain by inhibiting the enzymes that degrade acetylcholine. Therefore, this therapeutic approach is useful for treating mild-to-moderate AD. However, only symptomatic treatment is currently available, and it can lead to serious adverse effects from conventional therapy. Thus, novel therapies for AD are needed in a growing global population. This manuscript provides information on various biomarkers with possible pathogenesis mechanisms, novel treatment strategies such as microalgae, HupA, cannabinoids, and the beneficial effects of coenzyme Q10, bacterial probiotics, omega-3 fatty acids, vitamin B12, and D3 in memory impairment for managing AD. Non-pharmacological treatments such as music therapy, Electroacupuncture (EA), or manual acupuncture (MA) also play an important role in enhancing the effectiveness of conventional pharmacological treatments for AD.