CLINICAL THERAPEUTICS临床治疗学
CLINICAL THERAPEUTICS(英文缩写 CLIN THER),ISSN 0149-2918,eISSN 1879-114X,中文译名:临床治疗学 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 3.637 | Q2 |
| 2022 | 3.200 | Q3 |
| 2023 | 3.200 | Q2 |
| 2024 | 3.600 | Q2 |
| 2025 | 3.700 | Q2 |
CLINICAL THERAPEUTICS 最新收录文献
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2. Advancing Sport and Exercise Medicine Across the Translational Spectrum.
PMID:日期:2026-10-01该文献暂无摘要。
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4. A Prospective Clinical Series of Outcomes Following Radial Extracorporeal Shockwave Therapy as Part of a Combined Program for Refractory Plantar Fasciopathy.
PMID:日期:2026-10-01Plantar fasciopathy is the most common cause of heel pain in adults and is estimated to affect about 10% of people over their lifetime. The National Institute for Health and Care Excellence notes that extracorporeal shockwave therapy (ESWT) for refractory plantar fasciitis raises no major safety concerns but has inconsistent efficacy evidence and should be used with special governance/audit arrangements; further research with validated outcomes and ≥1‑year follow-up is encouraged. This prospective, single-arm clinical series followed consecutive patients treated for refractory plantar fasciopathy in a publicly funded UK musculoskeletal service. Participants received a standardized program of 3 weekly radial ESWT (rESWT) sessions (2500 impulses; 10 Hz; 2-4 bar according to tolerance; no local anesthetic). The primary outcome was participant-level Foot Function Index (FFI) total score at baseline, 6 and 12 months. Of 50 patients (71 heels) with plantar fasciopathy underwent the treatment protocol. Mean (SD) FFI improved from 60.3 (20.9) at baseline to 37.3 (23.0) at 6 months and remained improved at 39.5 (24.6) at 12 months. Improvements from baseline to 6 months (mean difference 23.0, P < 0.001) and baseline to 12 months (mean difference 20.8, P < 0.001) were statistically significant. There was no significant change between 6 and 12 months (P = 0.451). In this real-world NHS cohort with refractory plantar fasciopathy, rESWT was associated with substantial improvement in FFI by 6 months, sustained through to 12 months. As the study had no comparator, causality cannot be confirmed in this the single-arm study. However, these findings support further controlled trials and provide useful data to confirm their design and sample size.
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5. Pharmacologic Adjuncts for Bone Stress Injuries in Athletes: A Narrative Review of Current Evidence and Clinical Practice.
PMID:日期:2026-10-01Bone stress injuries (BSIs) are common in athletes, carry substantial time-loss and recurrence risk, and are increasingly managed with bone-active drugs despite a limited evidence base. This narrative review appraises the evidence for pharmacologic adjuncts in BSI, distinguishes the separate clinical indications for which they are proposed, and defines where current evidence does and does not support their use. This is a narrative review; therefore ethical approval was not required. PubMed/MEDLINE, Embase, and the Cochrane Library were searched from inception to June 2026 combining terms for BSI, stress fracture and athletes. Evidence is summarized in an evidence table that states whether each source is directly applicable to BSI in athletes or extrapolated from osteoporosis, traumatic fracture, spinal surgery, military, or animal studies. Greatest weight is given to controlled studies conducted in patients with BSI. Contemporary practice is illustrated by a previously published survey of 126 clinicians working in professional football and by the 2025 international Delphi consensus. The evidence base for treatment options in BSI varies substantially based on the clinical context. Correction of a documented abnormality of energy availability, calcium or protein intake, vitamin D status is a key initial step, but there is no clear evidence that supplementation of replete athletes accelerates healing of an established injury. Evidence for bisphosphonates in BSI is limited to small uncontrolled case series and may even impair bone healing or risk reinjury. Teriparatide data derive predominantly from osteoporotic, fragility fracture, and spinal fusion populations, with a single randomized controlled trial in stress fracture in progress. Newer agents, abaloparatide and romosozumab have no direct evidence in BSI, likely because of their novelty. Across all agents, apparent benefit may represent analgesia and earlier controlled loading rather than accelerated biological healing, given that return-to-play timing is determined by numerous clinical, occupational, and organizational factors. There is currently insufficient evidence to recommend routine use of bisphosphonates or osteoanabolic agents as treatment for an uncomplicated acute BSI in an otherwise healthy athlete. Assessment and correction of nutritional, and metabolic abnormalities, together with load management and rehabilitation, remain the foundation of care. Off-label treatment adjuncts discussed should be considered in recurrent, high-risk or delayed-healing BSI, with shared decision-making focus. Prospective outcome collection is likely to be the most pragmatic way to advance available evidence.
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6. Exercise as a Core Component of Axial Spondyloarthritis Management: Translating Evidence into Clinical Practice.
PMID:日期:2026-10-01Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease associated with impaired physical function, reduced cardiorespiratory fitness, sarcopenia, and increased cardiometabolic comorbidity. Although exercise is consistently recommended within international management guidelines, implementation in routine clinical practice remains inconsistent. The purpose of this review was to examine the role of exercise as a therapeutic co-intervention in axSpA and to explore practical approaches for translating evidence into clinical care. A narrative review was performed using evidence identified from guideline documents, systematic reviews, randomized controlled trials, and translational literature relating to exercise, physical activity, rehabilitation, cardiorespiratory fitness, multimorbidity, and sarcopenia in axSpA. Exercise interventions, including aerobic, resistance, and combined training approaches, consistently improve disease activity, physical function, spinal mobility, fatigue, and health-related quality of life in axSpA. Emerging evidence also suggests beneficial effects on cardiovascular risk factors, body composition, and muscle health, with moderate- to high-intensity exercise demonstrating a favorable safety profile when appropriately prescribed and supervised. Physical inactivity and sedentary behavior contribute substantially to long-term disease burden and may exacerbate deconditioning, reduced cardiorespiratory fitness, and sarcopenia. Despite strong endorsement from international guidelines, exercise prescription in routine care is frequently delivered as nonspecific advice rather than as a structured and progressive therapeutic intervention. Exercise should be considered a core component of long-term axSpA management rather than an optional lifestyle adjunct. Greater emphasis on structured assessment, individualized prescription, progression, and multidisciplinary support may improve implementation of exercise-based interventions and help address the broader functional and cardiometabolic burden of axSpA.
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8. Nutritional Support With Or Without Exercise for Older Adults With GLIM-Compatible Malnutrition: A Meta-Analysis of Randomized Controlled Trials.
PMID:日期:2026-10-01This meta-analysis sought to evaluate whether the addition of exercise to nutritional support (NS) improves physical function compared with NS alone in older adults diagnosed with malnutrition retrospectively verified as compatible with the updated Global Leadership Initiative on Malnutrition (GLIM) 2025 phenotypic-etiologic framework. A comprehensive search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library to identify randomized controlled trials (RCTs) comparing combined exercise and NS versus NS alone in malnourished older adults. Studies were included if participants met GLIM-defined malnutrition criteria and the trial reported relevant physical function or nutritional outcomes. Predefining upper and lower limb strength as distinct endpoints, data were analyzed using a random-effects model, with results expressed as standardized mean differences (SMDs) and 95% confidence intervals (CIs). To facilitate interpretation, a positive SMD denotes an effect favoring the combined intervention, except for TUG, where a negative value is favorable. Seventeen RCTs were included. Compared with NS alone, the combined intervention improved lower limb strength (SMD 0.35; 95% CI, 0.18-0.52; P < 0.0001) but did not improve upper limb strength (handgrip) (SMD 0.15; 95% CI, -0.01 to 0.30; P = 0.07). Muscle mass (SMD 0.65; 95% CI, -0.23 to 1.54; P = 0.15) and lean body mass (LBM) (SMD 0.27; 95% CI, -0.12 to 0.66; P = 0.18) were not significantly different. A small standardized improvement in usual walking speed (UWS) was detected with the combined intervention (SMD 0.38; 95% CI, 0.10-0.66; P = 0.008). When expressed in absolute units, the pooled UWS improvement was 0.07 m/s (95% CI, 0.03-0.12; P = 0.001). Timed Up and Go (TUG) performance favored exercise plus NS but did not reach significance (SMD -0.33; 95% CI, -0.74 to 0.08; P = 0.11). Serum 25(OH)D did not differ between groups. Accordingly, GRADE certainty was moderate for lower limb strength, but low for upper limb strength and UWS, and very low for muscle mass and TUG, indicating that confidence is highest for the lower-limb strength benefit, while effects on mobility and body composition remain more uncertain. Adding exercise to nutritional support was associated with small but statistically significant improvements in lower limb strength and UWS in malnourished older adults. While this combined approach optimizes specific functional outcomes, current evidence does not demonstrate added benefits for overall body composition or upper limb strength.
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9. Combined Effects of Nicorandil and Enhanced External Counterpulsation on Coronary Microcirculation and Exercise Capacity in Patients With Coronary Slow Flow Phenomenon: A Randomized, Controlled, 3-Arm Trial.
PMID:日期:2026-10-01To evaluate the combined efficacy and safety of combined nicorandil and enhanced external counterpulsation (EECP) therapy compared with respective monotherapies in patients with coronary slow flow phenomenon (CSFP). In this prospective, randomized, 3-arm clinical trial, 309 patients with angiographically defined CSFP based on corrected TIMI frame count were assigned (1:1:1) to the Nicorandil group (N group, n = 103), the EECP group (E group, n = 103), or the Combined therapy group (N+E group, n = 103). The trial was prospectively registered at ClinicalTrials.gov (NCT07534410). IMR and CFR were measured to characterize coronary microvascular physiological status and treatment response. The primary endpoint was corrected TFC at 6 months. Key secondary endpoints included invasive physiological indices (IMR and CFR), Seattle Angina Questionnaire scores, 6-minute walk test (6MWT) distance, peak oxygen uptake via cardiopulmonary exercise testing, and the 12-month rate of re-hospitalization due to recurrent angina. At 6 months, the N+E group demonstrated superior improvement in coronary hemodynamics compared to the N and E monotherapy groups, with significantly lower TFC (30.4 ± 3.5 vs 38.2 ± 3.8 and 37.5 ± 4.0, respectively; P < 0.001) and IMR (21.2 ± 2.8 vs 28.4 ± 3.2 and 27.6 ± 3.5, respectively; P < 0.001). Clinical symptoms and functional capacity showed the most substantial gains in the N+E group, with significantly higher Seattle Angina Questionnaire angina frequency scores (87.5 ± 8.8) and 6MWT distances (506.8 ± 41.8 m) compared to monotherapy groups (all P < 0.001). Furthermore, peak oxygen uptake in the N+E group increased to 23.5 ± 2.6 mL/kg/min, significantly outperforming the N and E groups (P < 0.001). During the 12-month follow-up, the observed rate of re-hospitalization due to recurrent angina was lower in the N+E group (5.8%) than in the N group (17.5%, P = 0.017), although this clinical outcome should be interpreted cautiously because the trial was powered primarily for physiological endpoints. No significant differences were observed in the incidence of adverse reactions among the 3 groups (P = 0.954). For patients with CSFP, the combination of Nicorandil and EECP improved coronary microvascular function, anginal symptoms, and objective exercise tolerance more effectively than either active monotherapy. The lower observed rate of angina-related re-hospitalization suggests a potential clinical benefit, but this finding should be considered exploratory and requires confirmation in trials adequately powered for clinical outcomes.
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10. Phase 1 Study Evaluating Gefurulimab Pharmacokinetics and Safety Following Delivery Via Autoinjector or Prefilled Syringe With Needle Safety Device in Healthy Adults.
PMID:日期:2026-10-01Gefurulimab, a novel dual-binding nanobody targeting complement component 5 (C5), is in clinical development for anti-acetylcholine receptor antibody-positive generalized myasthenia gravis. Gefurulimab has a low molecular weight, enabling subcutaneous (SC) self-administration by autoinjector (AI) or prefilled syringe with needle safety device (PFS-SD). We compared gefurulimab pharmacokinetic (PK) exposure and safety in healthy adults following a single SC dose administered by AI versus PFS-SD. In this phase 1, open-label, randomized, parallel-group study (NCT06208488), healthy participants aged 18 to 65 years were stratified by weight and randomized equally to 1 of 6 combination groups of device and injection site (abdomen/thigh/upper arm). Participants received a single SC dose of gefurulimab on day 1 and were assessed throughout the 92-day evaluation period. Primary endpoints were PK parameters for each device: maximum observed concentration (C) and area under the serum concentration-time curve (AUC, AUC). PK across injection sites, pharmacodynamics, safety, immunogenicity, and device performance were also assessed. Overall, 175 participants were randomized: AI (n = 87), PFS-SD (n = 88). Geometric least squares mean ratios (90% CI) comparing AI/PFS-SD for C, AUC, and AUC were 97.6% (94.5-100.8), 99.6% (96.1-103.3), and 98.8% (95.2‒102.6), respectively. Secondary analyses found no meaningful differences in PK parameters across injection sites. Serum-free C5 concentrations over time, treatment-emergent adverse event (TEAE) profiles, and antidrug antibody responses were similar between cohorts. Most TEAEs were mild; none led to study discontinuation. SC administration of gefurulimab by AI and PFS-SD was well tolerated with comparable exposure, meeting bioequivalence criteria.