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Additional Treatment Options (additional + treatment_option)
Selected AbstractsCertolizumab pegol: a new option for rheumatoid arthritisFUTURE PRESCRIBER, Issue 4 2009MSc Rheumatology SpR, Margaret HY Ma MBBS Rheumatoid arthritis (RA) presents a significant burden to healthcare in the UK. New biological therapies have advanced treatment but at a high cost to the NHS. Certolizumab pegol is a new TNF inhibitor, providing an additional treatment option for RA. In this article Dr Ma and Dr Choy consider the efficacy of certolizumab pegol, and where it may fit into the RA armoury. Copyright © 2009 John Wiley & Sons, Ltd. [source] Single-Agent Pamidronate for Palliative Therapy of Canine Appendicular Osteosarcoma Bone PainJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 3 2007Timothy M. Fan DVM Background:Canine appendicular osteosarcoma (OSA) causes focal bone destruction, leading to chronic pain and reduced quality-of-life scores. Drugs that inhibit pathologic osteolysis might provide additional treatment options for managing cancer-induced bone pain. Aminobisphosphonates induce osteoclast apoptosis, thereby reducing pain associated with malignant osteolysis in human patients with cancer. Hypothesis:Treatment of dogs with pamidronate administered intravenously will alleviate bone pain and reduce pathologic bone turnover associated with appendicular OSA in dogs. Animals:Forty-three dogs with naturally occurring appendicular OSA administered pamidronate intravenously. Methods:Prospective study. Therapeutic responses in dogs treated with pamidronate administered intravenously and nonsteroidal anti-inflammatory drugs (NSAID) were evaluated by using a numerical cumulative pain index score (CPIS), and by quantifying urine N-telopeptide (NTx) excretion and relative primary tumor bone mineral density (rBMD) assessed with dual energy x-ray absorptiometry. In addition, variables, including pamidronate dose, skeletal mass, baseline and change for CPIS, urine NTx and rBMD during treatment, and baseline tumor volume and radiographic pattern were compared between dogs clinically responsive and nonresponsive to pamidronate therapy. Results:Twelve of 43 dogs (28%) had pain alleviation for > 4 months, lasting a median of 231 days. Changes in CPIS and rBMD during treatment were statistically different between responders and nonresponders (P= .046 and .03, respectively). Conclusions and Clinical Importance: Substantiated by reductions in CPIS and increases in rBMD, single-agent pamidronate administered intravenously with NSAID therapy relieves pain and diminishes pathologic bone turnover associated with appendicular OSA in a subset of dogs. [source] Review article: the role of serotonergic agents in the treatment of patients with primary chronic constipationALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11-12 2005B. D. CASH Summary Chronic constipation is a highly prevalent disorder that is associated with significant direct and indirect costs and has substantial impact on patient quality of life. It is more common among women and non-white populations and is evenly distributed across adult age groups. Constipation is a heterogeneous disorder associated with multiple symptoms and aetiologies. Recent research has increased our understanding of the pathogenesis of this disorder and the central role of the neurotransmitter serotonin in mediating gastrointestinal motility, secretion and sensation. Abnormal serotonin signalling and reuptake appear to play central roles in the symptoms of a subset of patients with chronic constipation. This observation provides a rationale for the use of targeted serotonergic agents for the treatment of chronic constipation. As the role of serotonin in gastrointestinal function is further elucidated and additional candidate drugs are developed, it is likely that serotonergic agents will afford additional treatment options for patients with chronic constipation. This article provides a concise review of the evidence supporting a role for serotonin in the pathogenesis of chronic constipation and a summary of the currently available evidence supporting the use of serotonergic agents for this disorder. [source] Lipid treatment strategies for metabolic syndrome in established cardiovascular disease: a consensus guidelinePRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 2 2006M Davis MB BS General Practitioner Abstract In this paper we present an evidence-based guideline for the management of metabolic syndrome in patients with established cardiovascular disease. We initially discuss the relationship between the various components of metabolic syndrome and dyslipidaemia, the evidence base for treatment of both LDL and HDL cholesterol and the specific issue of extremely high rates of cardiovascular disease in the Indo-Asian community in the UK. Although several national and international guidelines provide treatment strategies for prevention of cardiovascular disease, none provide separate guidance on the prevention and management of coronary heart disease in the context of metabolic syndrome. In this document we emphasise that although statins will remain the mainstay of therapy, there remain a range of additional treatment options to further improve the lipid profile. These include the cholesterol absorption inhibitor, ezetimibe, fibrates and nicotinic acid derivatives. We present an algorithm to guide health professionals treating patients with cardiovascular disease and metabolic syndrome from lifestyle modification through to pharmacotherapy. We hope this will provide a practical, accessible tool for managing the increased cardiovascular risk in patients with metabolic syndrome and established cardiovascular disease. Copyright © 2006 John Wiley & Sons, Ltd. [source] Management Strategies for Stage-D Patients with Acute Heart FailureCLINICAL CARDIOLOGY, Issue 7 2008David Feldman M.D., Ph.D. Abstract Heart Failure (HF) accounted for 3.4 million ambulatory visits in 2000. Current guidelines from the American Heart Association/American College of Cardiology, the Heart Failure Society of America, and the International Society for Heart & Lung Transplantation recommend aggressive pharmacologic interventions for patients with HF. This may include a combination of diuretics, Angiotensin Converting Enzyme inhibitors, ,-blockers, angiotensin receptor blockers, aldosterone antagonists, and digoxin. Nitrates and hydralazine are also indicated as part of standard therapy in addition to ,-blockers and Angiotensin Converting Enzyme inhibitors, especially but not exclusively, for African Americans with left ventricular (LV) systolic dysfunction. For those with acute decompensated HF, additional treatment options include recombinant human B-type natriuretic peptide, and in the future possible newer agents not yet approved for use in the U.S., such as Levosimendan. Medical devices for use in patients with advanced HF include LV assist devices, cardiac resynchronization therapy, and implantable cardioverter defibrillators. For refractory patients, heart transplantation, the gold-standard surgical intervention for the treatment of refractory HF, may be considered. Newer surgical options such as surgical ventricular restoration may be considered in select patients. Copyright © 2007 Wiley Periodicals, Inc. [source] | ||||||||||