Genevieve Hale

Cardiovascular-kidney-metabolic syndrome describes a complex interplay between cardiovascular disease, chronic kidney disease, and metabolic disorders. Recent randomized controlled trials have demonstrated beneficial effects of SGLT2 inhibitors in patients with this multifaceted condition. This review aims to critically evaluate the available evidence supporting the role of SGLT2 inhibitors in patients with cardiovascular-kidney-metabolic syndrome and familiarize healthcare providers with the evidence surrounding significant renal and cardiac benefits of SGLT2 inhibitors. A comprehensive narrative literature review was conducted using PubMed. Eligible studies included randomized controlled trials, systematic reviews, and meta-analyses published in English between 2018 and 2025, focusing on SGLT2 inhibitors in the context of cardio-renal syndrome and cardio-kidney-metabolic syndrome. Multiple landmark trials have shown that SGLT2 inhibitors significantly reduce the risk of chronic kidney disease progression, MACE, and hospitalization for HF. These benefits were seen in patients both with and without type 2 diabetes. Importantly, SGLT2 inhibitors such as canagliflozin, dapagliflozin, empagliflozin, and sotagliflozin were well tolerated, though caution is advised in volume-depleted patients or those at risk for genitourinary infections. Positive effects, ranging from glycemic control to renoprotective and cardioprotective properties, support SGLT2 inhibitors as first-line therapy in improving clinical outcomes and quality of life in patients affected by this interconnected disease spectrum.

This report describes vutrisiran (Amvuttra^®), a novel double-stranded small interfering ribonucleic acid (siRNA)–N-acetylgalactosamine (GalNAc) conjugate. A narrative literature review was conducted using a secondary database, PubMed, from 2018 to 2025. Articles were limited to those written in English. Inclusion criteria consisted of randomized controlled trials and systematic reviews that analyzed the use of vutrisiran to treat amyloidosis. Other drug information resources, including the package inserts and UpToDate, were also utilized for general information. Two phase 3 publications were included in this report. Vutrisiran significantly improved neuropathy, quality of life, and functional measures in patients with hereditary transthyretin amyloidosis with polyneuropathy. Additionally, vutrisiran reduced the risk of death and recurrent cardiovascular events, preserved functional capacity and quality of life, and slowed New York Heart Association (NYHA) class progression compared with placebo. A favorable safety profile was also found in landmark trials. Vutrisiran is a therapeutic option for amyloidosis, directly targeting the underlying pathogenic mechanism through RNA interference. Clinical trials have demonstrated a reduction in transthyretin protein levels, slowing neuropathic and cardiac disease progression, and improving functional and quality-of-life outcomes. Ongoing research on long-term outcomes is still to be elucidated.

This project evaluated telehomecare technologies in the management of heart failure, with a focus on comparing invasive and noninvasive devices and impact on clinical outcomes, hospitalizations, and patient self-management. A literature review was conducted using PubMed to identify studies published in adults between 2015 and 2024 that examined telehomecare and telemonitoring interventions in heart failure. Search terms included telehealth, telehomecare, telemonitoring, and heart failure. Eligible studies included randomized controlled trials, observational studies, systematic reviews, and meta-analyses evaluating both invasive and noninvasive technologies. Across the reviewed studies, several invasive and noninvasive telehomecare interventions were identified that were associated with improvements in clinical and patient-centered outcomes. Remote monitoring enabled earlier detection of clinical deterioration, reduced all-cause and heart failure-related hospitalizations, and enhanced patient engagement and self-management. Benefits were greatest when monitoring tools were used consistently, integrated into structured care programs, and supported by timely clinical follow-up. Telehomecare represents an effective and patient-centered approach to heart failure management. Invasive monitoring devices provide strong evidence and benefits for high-risk patients through continuous physiologic assessment, while noninvasive tools offer accessible solutions for daily monitoring and self-management. When incorporated into coordinated care models, telehomecare improves outcomes and reduces the burden of heart failure.

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a common, multifactorial neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and/or impulsivity. Beyond behavioral therapy approaches, methylphenidate and amphetamine stimulant agents are recommended as first-line pharmaceutical treatments for ADHD. Because of the adverse effect profile and misuse potential of stimulants, other psychiatric medications have been explored in the literature as a potential alternative treatment in pediatric patients with ADHD. This report aimed to consolidate the body of knowledge published surrounding the exploration of using the antidepressant class as primary treatment for ADHD in pediatric and adolescent populations. Methods: PubMed secondary databases were used. Key terms included pediatric ADHD, ADHD, ADHD treatments, and antidepressants in ADHD. Randomized control trials and observational trials were included for analysis. Results: Most (11/12) studies revealed that antidepressants were efficacious in reducing ADHD symptoms but not necessarily superior to first-line stimulant medications. Particular focus on selective serotonin reuptake inhibitors, SNRIs, tricyclic antidepressants, and bupropion was demonstrated in the literature. Discussion: More research needs to be conducted to fully explore the effects and efficacy of antidepressants compared with first-line medications for ADHD. In addition, data supporting long-term effects and efficacy for antidepressants in ADHD are not yet established.

The shift in health care toward value‐based payment models has allowed for the integration of pharmacists into innovative care models to improve patient outcomes. Home visits are useful in value‐based settings as they can enhance care management and help patients with complex needs manage their conditions. However, the ideal interprofessional team to conduct these home visits is unknown. In efforts to improve care and quality outcomes as well as assess feasibility and identify barriers to implementation, an interprofessional home visit team consisting of paramedics and pharmacists was utilized within a managed services organization. Pharmacists and paramedics possess the expertise and skill to manage primary care patients in the home setting to provide medication management and needs assessments. There is limited research on pharmacist‐paramedic collaboration in home visits in the value‐based primary care setting. In this article, experiences in conducting home visits with pharmacists and paramedics, the role of the pharmacist and the paramedic, and considerations regarding interprofessional home visit care are described in detail.

This report illustrates the Food and Drug Administration (FDA) approval of first-in-its-class activin A receptor IIA inhibitor, sotatercept (Winrevair™), for the treatment of pulmonary arterial hypertension (PAH). Sotatercept is used to increase exercise capacity, improve WHO functional class, and decrease the risk of clinical worsening events in adults with PAH. One phase 2 trial, one phase 3 trial, and an ongoing open-label extension study is described in detail within the current text. Sotatercept significantly improved the 6-min walk distance in patients with PAH after 24 weeks with a mean change increase of 40.1 meters in the experimental group versus 1.4 meters decrease in the placebo group. Epistaxis, telangiectasia, increased hemoglobin, hematocrit, red blood cell levels, and dizziness were adverse events more frequently observed in the sotatercept group than in the placebo group. Sotatercept has shown significant benefits in the reduction of pulmonary vascular resistance and N-terminal pro b-type natriuretic peptide in patients with PAH. However, more studies are needed to evaluate the reduction in mortality. Limitations in practice include high cost and unknown long-term effects. Graphical Abstract