Current Pharmaceutical Design - Volume 29, Issue 25, 2023

The treatment options for hepatitis C have undergone noteworthy advancements since direct-acting antivirals (DAAs) were introduced. The selection of a DAA therapy depends on the patient’s genotype, treatment history, concomitant comorbidities, and concurrent medications. Pharmacists have a pivotal role in providing clarification and recommendations in selecting appropriate, individualized DAAs for patients. This commentary aims to (1) provide an overview of DAAs on the market for hepatitis C, and (2) describe the implication for the care of patients with hepatitis C in a community pharmacy. Community pharmacists can establish a workflow to recommend appropriate DAA therapy, identify drug interactions, and improve medication adherence and compliance with lab appointments.

Curcumin is a polyphenol compound widely investigated for its potential health benefits. Clinical evidence from randomized controlled trials shows substantial positive effects in healthy individuals but contrasting results for patients with cardio-metabolic disorders. There is growing evidence that the gut microbiota may play a role in curcumin transformation and absorption of more bioactive compounds, suggesting that the baseline health status (or other unmeasured variables) may explain the observed variability of the results.

Human health is significantly threatened by infectious diseases caused by viral infection. Over the years, there have been numerous virus epidemics worldwide, causing millions of deaths. Traditional antiviral medications have many problems, including poor solubility and antiviral resistance. Additionally, because different drug delivery methods have different biological barriers to overcome, the drug’s bioavailability will be significantly affected. Therefore, it is essential that researchers create more effective antiviral drugs. To serve as a guide for the future development of nanosized antiviral drugs with stronger and more precise therapeutic effects, research has been performed on nanotechnology in the field of antiviral therapy. This review summarizes the recent developments in antiviral nanopharmaceuticals with different delivery routes. Research on 7 typical viruses, including COVID-19, has been included in this review. After being loaded into nanoparticles, antiviral drugs can be delivered through several drug modes of delivery, overcoming biological barriers. Moreover, some nanoparticles themselves have the ability to combat infections, so they can be used in conjunction with antiviral medication. The use of nanoparticle medications through various routes of administration can result in their unique benefits. They can be capable of overcoming its limitations as well as retaining the advantages of this method of delivery. This will motivate researchers to conducted a new investigation on nanoparticle medicines from the standpoint of the route of administration in order to increase the practicability of antiviral medications.

Background: Patients with heart failure with preserved ejection fraction (HFpEF) have large individual differences, unclear risk stratification, and imperfect treatment plans. Risk prediction models are helpful for the dynamic assessment of patients' prognostic risk and early intensive therapy of high-risk patients. The purpose of this study is to systematically summarize the existing risk prediction models and novel prognostic factors for HFpEF, to provide a reference for the construction of convenient and efficient HFpEF risk prediction models. Methods: Studies on risk prediction models and prognostic factors for HFpEF were systematically searched in relevant databases including PubMed and Embase. The retrieval time was from inception to February 1, 2023. The Quality in Prognosis Studies (QUIPS) tool was used to assess the risk of bias in included studies. The predictive value of risk prediction models for end outcomes was evaluated by sensitivity, specificity, the area under the curve, C-statistic, C-index, etc. In the literature screening process, potential novel prognostic factors with high value were explored. Results: A total of 21 eligible HFpEF risk prediction models and 22 relevant studies were included. Except for 2 studies with a high risk of bias and 2 studies with a moderate risk of bias, other studies that proposed risk prediction models had a low risk of bias overall. Potential novel prognostic factors for HFpEF were classified and described in terms of demographic characteristics (age, sex, and race), lifestyle (physical activity, body mass index, weight change, and smoking history), laboratory tests (biomarkers), physical inspection (blood pressure, electrocardiogram, imaging examination), and comorbidities. Conclusion: It is of great significance to explore the potential novel prognostic factors of HFpEF and build a more convenient and efficient risk prediction model for improving the overall prognosis of patients. This review can provide a substantial reference for further research.

Objective: The study aimed to evaluate the clinical efficacy of the Huo Xue Hua Yu method combined with aspirin in the treatment of patients with acute cerebral infarction (ACI). Methods: By searching electronic databases, such as the Chinese Biomedical Literature Database (CBM), the China National Knowledge Infrastructure Database (CNKI), the China Science and Technology Journal Database, Wanfang, PubMed, Embase, and the Cochrane Library, all randomized controlled trials (RCTs) published before 14 July, 2022, and published in Chinese or English languages were selected. Statistical analysis was performed using Review Manager 5.4 calculation software to calculate the odds ratio (OR), mean difference (MD), 95% confidence interval (CI), and p values. Results: 13 articles that included 1,243 patients were identified; in 646 of them, the Huo Xue Hua Yu method combined with aspirin has been administered, while 597 have only been administered aspirin therapy. The combined treatment significantly improved clinical efficacy (OR: 4.41, 95% CI: 2.90 to 5.84, p < 0.001, I² = 0), as assessed by the National Institutes of Health Stroke Scale score (MD = -4.18, 95% CI: -5.69 to -2.67, p < 0.001, I² = 94%), Barthel score (MD = -2.23, 95% CI: -2.66 to -1.81, p < 0.001, I² = 82%), the China Stroke Scale score (MD = 6.74, 95% CI: -3.49 to 16.96, P = 0.20, I² = 99%), packed cell volume (MD = -8.45, 95% CI: -8.81 to -8.09, p < 0.001, I² = 98%), fibrinogen levels (MD = -0.93, 95% CI: -1.23 to -0.63, p < 0.001, I² = 78%) and plasma viscosity (MD = -0.51, 95% CI: -0.72 to -0.30, p < 0.001, I² = 62%). Conclusion: The combination of the Huo Xue Hua Yu method and aspirin represents a beneficial adjunctive therapy for ACI.

Introduction: Critical issues in the therapeutic management of cervical cancer (CC) include therapy resistance and treatment failure. The development of therapy resistance is a multifaceted, progressive process, including genetic and epigenetic abnormalities. The present study aimed to identify genes that may contribute to therapy resistance in CC. Materials and Methods: We have created an extensive list of the genes in cancer that are therapy-resistant using a text-mining approach. The list was compared with the TCGA-CESC dataset to identify the differentially expressed therapy resistance genes (DETRGs) in CC. We used online resources (UALCAN, DNMIVD, cBio- Portal, HCMDB, OncoDB, ShinyGO, HPA, KM Plotter, TIMER, and DGIdb) to determine the potential association between methylation and expression of therapy resistance genes with the prognosis and clinical outcomes in CC. Results: The systematic analysis identified 71 out of 91 DETRGs showed aberrant DNA methylation. The overlapping analysis identified 25 genes to show an inverse correlation between methylation and expression. Further, differential expression or methylation could be helpful in CC staging, HPV association, prediction of metastasis and prognosis. The study identified seven driver genes in CC. The PPIN identifies ten hub genes (HGs) associated with CC staging, cancer hallmarks, and prognosis to affect long-term survival. Conclusion: Our thorough investigation uncovered several novel genes and pathways that might contribute to therapy resistance in CC. The genes identified in our study may serve as a biomarker, prognostic indicator, and therapeutic target in CC.