Expert review of clinical pharmacology
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Expert Rev Clin Pharmacol · Jan 2015
EditorialPrediction of treatment outcomes in major depressive disorder.
Improving the treatment of major depressive disorder will require identification of moderators that predict differential outcomes across treatments at the level of the individual patient, referred to as precision medicine. Currently, there are no biological measures demonstrated to enhance treatment selection accuracy although there are some clinical variables that have prognostic value. ⋯ Genetic combination tests, systemic inflammation, electroencephalography and neuroimaging, in particular, show significant potential for near-term development as clinically meaningful moderators for use in treatment selection. Ultimately, combinations of moderators may provide the greatest level of precision in selecting optimal treatment approaches for individual depressed patients.
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Expert Rev Clin Pharmacol · Jan 2015
EditorialFactors to consider in the choice of intrathecal drug in the treatment of neuropathic pain.
Medication selection for neuropathic pain follows a path of evidence, with respect to appreciating the patient's entry into the pain care algorithm. As we decide how to approach neuropathic pain, the considerations for intrathecal therapy medication selection are bound by catheter location, region of pain, and patient selection, to name a few. Future research and the 2016 polyanalgesic consensus conference may further provide patient care through a mindful eye on the improvement of patient safety and a reduction of the societal needs of opioids.
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Expert Rev Clin Pharmacol · Jan 2015
EditorialClinical trial design for rare cancers: why a less conventional route may be required.
Major recent advances in the diagnosis, treatment, prevention and screening of cancer have led to improvements in survival and other outcomes for cancer patients. When the 198 identified rare cancers are taken in aggregate, rare cancers account for 22% of all cancer diagnoses, higher than any single common cancer. ⋯ Overcoming the challenges inherent in the study of rare diseases is critical to achieve improvements in outcomes for patients. Combining a redesign of clinical trial protocols with the new paradigm for the treatment of all cancers, may lead to improvements in survival benefits for rare cancers in line with those achieved in the treatment of more common types.