Preventive Cardiovascular Care in Patients With HIV Infection in an Outpatient Clinic.

BACKGROUND: People/patients living with human immunodeficiency virus (PLWH) are at an increased risk for atherosclerotic cardiovascular disease due to normal disease processes, antiretroviral medication adverse effects, and age-related comorbid conditions. Preventive cardiovascular (CV) screenings such as the need for statin, low-dose aspirin, or smoking cessation counseling are not well studied in PLWH. OBJECTIVES: To investigate whether there are differences in preventive CV care offered to patients with and without human immunodeficiency virus (HIV) infection in 1 outpatient clinic. METHODS: This retrospective study enrolled 150 consecutive patients if they had at least 4 appointments in 2 years and they did not have a history and they do not have a history of CV events. A randomly selected sample of patients without HIV infection receiving primary care services in the same clinic were used as the control group and were enrolled using the same inclusion criteria. RESULTS: More patients met statin criteria and were prescribed it in the HIV-negative arm [(70% vs. 24.67%; p < 0.0001); (89.52% vs. 54.05%; p < 0.0001)]. More patients in the HIV-negative arm met aspirin criteria and were prescribed it [(10.67% vs. 8.16%; p = 0.46); (50% vs. 33.3%; p = 0.33)]. There were more current smokers in the HIV-positive arm and a slightly greater number that received smoking cessation counseling [(38% vs. 11.33%; p < 0.0001); (82.46% vs. 76.47%; p = 0.58)]. CONCLUSION: Our results found that PLWH receive less preventive CV care compared to non-HIV-infected patients in the same outpatient clinic. Increased efforts are needed to ensure PLWH are receiving primary preventive CV care they need.

Call to Action: Addressing Social Determinants of Health in Pharmacy Practice.

Social determinants of health (SDOH) are conditions in which individuals are born, live, work, learn, play, and age that affect health, risks, functioning, and outcomes. SDOH are recognized barriers to care, risk factors for certain diseases, and associated with poorer health outcomes. Screening for SDOH in physician practices and hospitals is reportedly low. The accessibility of pharmacists and established relationships with patients make pharmacy settings ideal for identifying and mitigating social needs. An evaluation of the impact of SDOH on health outcomes and opportunities for pharmacists to embed screening into practice is warranted.

Clascoterone: A Novel Topical Androgen Receptor Inhibitor for the Treatment of Acne.

OBJECTIVE: To review the efficacy and safety of clascoterone 1% cream for the treatment of acne vulgaris in patients 12 years of age and older. DATA SOURCES: A literature search through PubMed, MEDLINE, and ClinicalTrials.gov was conducted using the following keywords: clascoterone, cream, acne, and CB-03-01. Articles published between 2004 and 2020 were included in this review. STUDY SELECTION AND DATA EXTRACTION: Preclinical and clinical studies describing the efficacy and safety of topical clascoterone cream were included. DATA SYNTHESIS: Early preclinical studies demonstrated that clascoterone exhibits local antiandrogenic effects without any systemic effects. Phase 2 and 3 trials demonstrated a statistically significant reduction in inflammatory and noninflammatory lesions and mild erythema with clascoterone use. Long-term studies confirmed the favorable safety profile of the drug in subjects for up to 9 months of use, with erythema being the most common treatment-emergent local skin reaction. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE: Pharmacological treatment options for acne vulgaris include topical and systemic agents. Systemic antiandrogen medications are associated with adverse effects and should be avoided in pregnancy and male patients. Clascoterone is a novel topical antiandrogen drug with no systemic adverse effects. This drug provides prescribers with an appealing treatment option for male and female patients 12 years of age and older, who are not candidates for systemic drugs because of contraindications or adverse effects or who have failed other topical therapies. CONCLUSION: Clascoterone, a novel topical androgen receptor inhibitor, is a safe and effective treatment option for patients with acne vulgaris.

Pre-Exposure Prophylaxis (PrEP) in the Prevention of HIV: Strategies, Target Populations and Upcoming Treatments.

Pre-exposure prophylaxis (PrEP) against HIV infection with tenofovir/emtricitabine is proven to be effective yet uptake of this preventive measure has been difficult due to several barriers such as cost, access, and misinformation. Certain subpopulations are disproportionately affected by this problem. Several methods have been developed to close the gap in care. New antiretroviral treatment strategies are being investigated for safety and efficacy in preventing HIV infection.