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Alemtuzumab: A Place in Ther.py for.Tr.atment of Multiple Scler.sis

Inter.ational Jour.al of Clinical Medicine 2013年第10期4卷 459-471页

作者： Teya M. Tietje douglas r. allington Michael P. r.vey Skaggs School of Phar.acy University of Montana Missoula USA Skaggs School of Phar.acy University of Montana Missoula USA Phar.acy Depar.ment Community Medical Center Mis-soula USA.

Alemtuzumab is a humanized mononclonal antibody known to cause r.pid depletion of B-and T-cell lymphocytes. Subsequent r.pletion of these lymphocytes leads to changes in adaptive immunity. Alemtuzumab is appr.ved by the United States Food and Dr.g Administr.tion (FDA) for.the tr.atment of B-cell lymphocytic leukemia but has been investigated off-label in r.cent year. for.tr.atment of autoimmune diseases, including multiple scler.sis (MS). In MS tr.atment, alemtuzumab is administer.d as pulsed ther.py, given once daily initially for.5 consecutive days and then for.3 consecutive days at 12-month inter.als. Alemtuzumab has r.cently been compar.d to inter.er.n beta 1-a in one phase II and two phase III tr.als in patients with r.lapsing-r.mitting MS. r.sults fr.m the studies show alemtuzumab compar.d to inter.er.n beta 1-a is associated with a gr.ater.r.duction in the r.sk of sustained accumulation of disability and is mor. effective in r.ducing disease r.lapse r.tes. The tr.atment of MS continues to be a healthcar. challenge due to the modest clinical benefit and adver.e effect pr.files of available disease modifying tr.atment options. Available data suggest alemtuzumab may offer.better.efficacy outcomes compar.d to tr.ditional disease modifying ther.pies in patients with MS. However. the agent has not been compar.d to other.new disease modifying medications that have been r.cently intr.duced.

关键词： Alemtuzumab Multiple Scler.sis Monoclonal Antibody Lymphocyte Depletion

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Asthma in pr.gnancy

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Wor.d Jour.al of Phar.acology 2014年第4期3卷 56-71页

作者： Hayley K Blackbur. douglas r.allington Kendr. A Pr.cacci Michael P r.vey Depar.ment of Phar.acy Pr.ctice University of Montana Skaggs School of Pharmacy Missoula MT 59812 United States Depar.ment of Phar.acy Community Medical Center Missoula MT 59804 United States Depar.ment of Phar.acy Grant Creek Family Practice Missoula MT 59804 United States

Asthma affects appr.ximately 8% of women dur.ng pr.gnancy. Pr.gnancy r.sults in a var.able cour.e for.asthma contr.l, likely contr.buted to by physiological changes affecting the r.spir.tor., immune, and hor.monal systems. While asthma dur.ng pr.gnancy has been associated with an incr.ased r.sk of mater.al and fetal complications including malfor.ations, available data also suggest that active asthma management and monitor.ng can decr.ase the r.sk of adver.e outcomes. The diagnosis, disease classifcation, and goals for.asthma management in the pr.gnant woman ar. the same as for.nonpr.gnant patients. However. evidence shows that pr.gnant asthmatics ar. mor. likely to be under.tr.ated, r.sulting in asthma exacer.ations occur.ing in appr.ximately one thir. and hospitalization in one tenth of patients. Phar.acother.peutic management of asthma exacer.ations in pr.gnant patients follows stan-dar. tr.atment guidelines. In contr.st, the pr.nciples of asthma maintenance ther.py ar. slightly modified in the pr.gnant patient. Patients and pr.ctitioner. may avoid use of asthma medications due to concer. for.a r.sk of fetal complications and malfor.ations. A var.able amount of infor.ation is available r.gar.ing the r.sk of a given asthma medication to cause adver.e fetal out-comes, and it is pr.fer.ble to use an inhaled pr.duct. Never.heless, based on available data, the major.ty of asthma medications ar. r.gar.ed as safe for.use dur.ng pr.gnancy. And, any incr.ased r.sk to either.the mother.or.fetus fr.m medication use appear. to be small compar.d to that associated with poor.asthma contr.l.

关键词： Asthma Pr.gnancy Fetal outcomes Mater.al outcomes Management of asthma Phar.acother.py

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