Prevention and treatment of dyslipidemia should be considered as an integral part of individual cardiovascular prevention interventions, which should be addressed primarily to those at higher risk who benefit most. To date, statins remain the first-choice therapy, as they have been shown to reduce the risk of major vascular events by lowering low-density lipoprotein cholesterol (LDL-C). However, due to adherence to statin therapy or statin resistance, many patients do not reach LDL-C target levels. Ezetimibe, fibrates, and nicotinic acid represent the second-choice drugs to be used in combination with statins if lipid targets cannot be reached. In addition, anti-PCSK9 drugs (evolocumab and alirocumab) provide an effective solution for patients with familial hypercholesterolemia (FH) and statin intolerance at very high cardiovascular risk. Recently, studies demonstrated the effects of two novel lipid-lowering agents (lomitapide and mipomersen) for the management of homozygous FH by decreasing LDL-C values and reducing cardiovascular events. However, the costs for these new therapies made the cost–effectiveness debate more complicated.
Median toxicity/patient was 3 (1-13), appearing in an average time of 18 months (28 days-8 years) and 10 months (8 days-7 years) for TH (23/122) and NHT (99/122), respectively. Dose was reduced because of toxicity in 7/37 patients and was discontinued in 14/37. Conclusion and relevance The analysis has allowed the implementation of a specific proactive follow-up for each drug, which means early recognition and management of the toxicities associated with TKIs to optimise treatment efficacy and safety, as well as patient quality of life.
The compounded product has suitable pharmaceutical characteristics, such as rheology, in vitro release profile and a pH value suitable for oral administration.Its clinical application in a patient with grade 3 mucositis resulted in excellent acceptability and significant reduction in the degree of mucositis (for grade I) and re-introduction of EVR into the therapeutic regimen at the end of a week of treatment with the gel. Conclusion This mucoadhesive gel can be an effective option for the prophylaxis/treatment of oral mucositis, for its prolonged residence time in the oral cavity and easier administration. The pleasant taste promotes a good therapeutic compliance, as well as the smooth and suitable texture for the treatment of an aggressive mucosa. The inclusion of more patients in this study will validate these assumptions.
REFERENCE AND/OR ACKNOWLEDGEMENTSRugo HS, et al. Prevention of everolimus-related stomatitis in women with hormone receptor-positive, HER2-negative metastatic breast cancer using dexamethasone mouthwash (SWISH): a single-arm, phase 2 trial. Lancet Oncol [Internet]
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