Slovo úvodem

MUDr. David Suchý, Ph.D.

Klin Farmakol Farm. 2025;39(2):71  

Metformin and vitamin B₁₂ deficiency - own observations from clinical practice

Dana Weberová, Pavel Weber, Hana Meluzínová

Klin Farmakol Farm. 2025;39(2):72-76 | DOI: 10.36290/far.2025.033  

Introduction: Long-term use of metformin can lead to digestive problems, lactic acidosis, and deterioration of renal function, as well as vitamin B₁₂ deficiency. The aim of our work was to point out the risk of long-term use of metformin, especially in higher doses, in a specific group of patients with type 2 diabetes treated by us. Patients and methodology: In 2024, a total of 2,136 patients with type 2 diabetes (T2DM) were treated in the diabetes outpatient clinic Diastop, l. t. d. (non-state healthcare facility) a long time - 1,111 men and 1,025 women. Of these, 70 % were ≥ 65 years old and 12.6 % were ≥ 80 years old. Their...

The safety of biological and targeted therapies in rheumatology

Marta Olejárová

Klin Farmakol Farm. 2025;39(2):77-83 | DOI: 10.36290/far.2025.034  

Biological and targeted synthetic agents have fundamentally transformed the thera­peutic approach to patients with inflammatory rheumatic diseases, including rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), and more recently also systemic lupus erythematosus (SLE) and systemic sclerosis (SSc). By targeting key components of the immune response, biologic therapies demonstrate superior efficacy and often a more favorable safety profile compared to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). However, biologic and targeted synthetic therapies are not without risks. The spectrum and nature...

Adverse effects of systemic treatment for psoriasis

David Suchý, Petra Cetkovská

Klin Farmakol Farm. 2025;39(2):84-88 | DOI: 10.36290/far.2025.035  

Psoriasis is a chronic genetically determined immunologically mediated inflammatory condition associated with systemic comorbidities. Local therapy and phototherapy is usually recommended for mild psoriasis. When this treatment is not effective, not tolerated or contraindicated, as well as in patients with severe disease or significantly decreased quality of life the systemic therapy is prescribed. It is clinically important to consider the potential adverse events risks associated with the long-term use of synthetic oral and biological systemic therapies. The aim of this paper is to summarize profil of adverse events reported in context of psoriasis...

Primum non nocere: How safe is modern therapy for multiple sclerosis?

Dominika Šťastná, Dana Horáková

Klin Farmakol Farm. 2025;39(2):89-95 | DOI: 10.36290/far.2025.036  

Multiple sclerosis is a chronic autoimmune disease of the central nervous system which, if left untreated, leads to significant neurological disability. The early initiation of high-efficacy disease-modifying therapy has fundamentally improved patient prognosis, effectively suppressing inflammatory activity and slowing disease progression. However, higher efficacy comes with an increased risk of serious adverse events, including infections, autoimmune complications, and potentially malignancies. Infections remain the most frequent adverse event, with the risk particularly pronounced in therapies involving anti-CD20 monoclonal antibodies. This article...

A brief overview of pharmacotherapy in palliative medicine - part one

Miroslav Žiaran

Klin Farmakol Farm. 2025;39(2):96-102 | DOI: 10.36290/far.2025.037  

Palliative medicine is dedicated to enhancing the quality of life in patients with incurable illnesses through comprehensive, interdisciplinary care, in which pharmacotherapy plays a central role. Pharmacological treatment in this context seeks to manage distressing symptoms and alleviate suffering during the final stages of life. This article outlines the principles and specific considerations of pharmacotherapy in palliative care, with emphasis on individualized treatment approaches, patient safety, ethical implications, and multidisciplinary collaboration. Considering the altered physiology commonly seen in advanced illness, the need to tailor pharmacological...

Antidepressants in the treatment of depressive disorder during pregnancy: to treat or not to treat?

Lenka Sušilová

Klin Farmakol Farm. 2025;39(2):103-110 | DOI: 10.36290/far.2025.038  

Antidepressants, as well as untreated depressive disorder during pregnancy, represent risk factors for the course of pregnancy, fetal development, and neonatal adaptation after birth. This review summarizes currently published data on the impact of untreated depressive disorder and the risks associated with antidepressant treatment on the course of pregnancy, fetal development, and early neonatal adaptation. Available studies do not indicate that most antidepressants have teratogenic potential or clinically significantly increase the risk of pregnancy complications or impaired fetal development. However, exposure to antidepressants may increase the...

The role of glucocorticoids in rheumatology

Tomáš Lederer, Tomáš Soukup

Klin Farmakol Farm. 2025;39(2):111-116 | DOI: 10.36290/far.2025.039  

Glucocorticoids remain an important pillar in the treatment of rheumatologic diseases due to their strong anti-inflammatory and immunosuppressive effects. Their benefit is undeniable, but prolonged use carries significant risks such as accelerated osteoporosis, steroid-induced diabetes mellitus, cardiovascular diseases, and immunosuppression. These risks must be monitored and prevented. By using new approaches, we aim to minimize side effects. Dosage is optimized, and the duration of use is shortened to the necessary minimum. Glucocorticoid therapy is combined with other medications that have a glucocorticoid-sparing effect.

Conservative treatment od endometriosis

Martin Trhlík

Klin Farmakol Farm. 2025;39(2):117-121 | DOI: 10.36290/far.2025.040  

Endometriosis is a chronic gynaecological condition affecting up to 10 % of women of reproductive age. Fertility disorders, pain, and organ involvement significantly impact the quality of life and health of those affected. The socioeconomic burden is considerable, with substantial resources allocated to treatment. Management includes both radical surgical approaches and conservative methods, namely the administration of various groups of medicinal products. Analgesics are used to alleviate painful symptoms. Hormonal therapies include progestins alone or in combination with oestrogens, which influence the activity of endometriotic lesions. Another group...

Retatrutide: A novel approach in the treatment of obesity, diabetes mellitus, and MASLD (metabolic dysfunction-associated steatotic liver disease)

Robert Prosecký, Klaudia Hálová Karoliová

Klin Farmakol Farm. 2025;39(2):122-129 | DOI: 10.36290/far.2025.041  

Obesity and metabolic diseases represent a global challenge requiring innovative therapeutic approaches. Retatrutide (LY3437943) is a new pharmacological option that combines agonistic action on GLP-1, GIP, and glucagon receptors, offering a comprehensive approach to the treatment of obesity, type 2 diabetes, and metabolic dysfunction-associated steatotic liver disease (MASLD). Its mechanism of action includes appetite regulation, delayed gastric emptying, enhanced insulin secretion, and improved energy metabolism. Clinical trials TRIUMPH demonstrate significant weight loss (up to 24.2 % after 48 weeks of treatment) and improvement in...