Pharmacokinetic considerations surrounding triple therapy for uncontrolled asthma

Matera, Maria Gabriella; Rinaldi, Barbara; Belardo, Carmela; Calzetta, Luigino; Cazzola, Mario

doi:10.1080/17425255.2023.2230130

Cited by 1 publication

(2 citation statements)

References 93 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite evaluation of drug posology selection, there is variation among individuals in drug response as a result of many different parameters associated with different factors including genomic [16][17][18][19][20], immunological [20,21], pharmacological [22,23] and toxicological variations [24,25], as well as interactions with drugs, dietary substances, etc. Similarly, there are also differences among individuals in drug response as a result of many other limitations such as underlying disease pathological complications, variations in organ functioning, idiosyncratic reactions, accessibility to effective drug posology due to high cost and other variations [22][23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

“…A major advancement in optimizing drug protocols with increasing therapeutic successes in many diseases has been the introduction of drug combination therapies [13,22,[41][42][43][44][45]. This approach is in most cases almost exclusively based on academic initiatives and is not generally regulated by the drug regulatory authorities, nor does it usually involve the manufacturers of each of the drugs in the combination.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Drug Selection and Posology, Optimal Therapies and Risk/Benefit Assessment in Medicine: The Paradigm of Iron-Chelating Drugs

Kontoghiorghes

2023

IJMS

View full text Add to dashboard Cite

The design of clinical protocols and the selection of drugs with appropriate posology are critical parameters for therapeutic outcomes. Optimal therapeutic protocols could ideally be designed in all diseases including for millions of patients affected by excess iron deposition (EID) toxicity based on personalised medicine parameters, as well as many variations and limitations. EID is an adverse prognostic factor for all diseases and especially for millions of chronically red-blood-cell-transfused patients. Differences in iron chelation therapy posology cause disappointing results in neurodegenerative diseases at low doses, but lifesaving outcomes in thalassemia major (TM) when using higher doses. In particular, the transformation of TM from a fatal to a chronic disease has been achieved using effective doses of oral deferiprone (L1), which improved compliance and cleared excess toxic iron from the heart associated with increased mortality in TM. Furthermore, effective L1 and L1/deferoxamine combination posology resulted in the complete elimination of EID and the maintenance of normal iron store levels in TM. The selection of effective chelation protocols has been monitored by MRI T2* diagnosis for EID levels in different organs. Millions of other iron-loaded patients with sickle cell anemia, myelodysplasia and haemopoietic stem cell transplantation, or non-iron-loaded categories with EID in different organs could also benefit from such chelation therapy advances. Drawbacks of chelation therapy include drug toxicity in some patients and also the wide use of suboptimal chelation protocols, resulting in ineffective therapies. Drug metabolic effects, and interactions with other metals, drugs and dietary molecules also affected iron chelation therapy. Drug selection and the identification of effective or optimal dose protocols are essential for positive therapeutic outcomes in the use of chelating drugs in TM and other iron-loaded and non-iron-loaded conditions, as well as general iron toxicity.

show abstract