medication development

  • 文章类型: Journal Article
    结论:为了加快文章的发表,AJHP在接受后尽快在线发布手稿。接受的手稿经过同行评审和复制编辑,但在技术格式化和作者打样之前在线发布。这些手稿不是记录的最终版本,将在以后替换为最终文章(按照AJHP样式格式化并由作者证明)。
    目的:卫生系统药师在监控药品管道管理处方中起着至关重要的作用,分配资源,并优化新疗法的临床计划。本文旨在通过提供有关新药和预期新药批准的定期更新来支持药剂师。
    结论:审查了预计在2024年第二季度至2025年第一季度的12个月内的部分药物批准。该分析强调了预计会在医院和诊所产生重大临床和财务影响的药物,从52种正在等待美国食品和药物管理局批准的新药中选出。针对癌症的新细胞和基因疗法继续加强了管道,除了针对以前无法治疗的疾病的新药。正在开发几种新药,用于治疗罕见和超罕见疾病,如血友病,尼曼-皮克病C型,遗传性血管性水肿,和芳香族L-氨基酸脱羧酶缺乏症。
    结论:目前的药物管道包括具有各种癌症和罕见疾病以及糖尿病适应症的新药,急性冠脉综合征,慢性皮肤病,和慢性阻塞性肺疾病。
    OBJECTIVE: Health-system pharmacists play a crucial role in monitoring the pharmaceutical pipeline to manage formularies, allocate resources, and optimize clinical programs for new therapies. This article aims to support pharmacists by providing periodic updates on new and anticipated novel drug approvals.
    CONCLUSIONS: Selected drug approvals anticipated in the 12-month period covering the second quarter of 2024 through the first quarter of 2025 are reviewed. The analysis emphasizes drugs expected to have significant clinical and financial impact in hospitals and clinics, as selected from 52 novel drugs awaiting US Food and Drug Administration approval. New cellular and gene therapies for cancers continued to strengthen the pipeline, in addition to new drugs targeting previously untreatable conditions. Several novel drugs are being developed for rare and ultra-rare diseases such as hemophilia, Niemann-Pick disease type C, hereditary angioedema, and aromatic l-amino acid decarboxylase deficiency.
    CONCLUSIONS: The current drug pipeline includes new drugs with various indications for cancers and rare diseases as well as diabetes, acute coronary syndrome, chronic skin disorder, and chronic obstructive pulmonary disease.
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  • 文章类型: Journal Article
    背景:酒精提示暴露范例是评估酒精使用障碍(AUD)新疗法的常用方法;但是,目前尚不清楚在人体实验室中与药物相关的提示诱导的渴求减少是否可以预测这些药物在临床试验中减少饮酒的临床成功.
    目的:在临床试验中使用一种新的荟萃分析方法来测试药物对线索诱导的酒精渴望的影响大小是否与临床疗效相关。
    方法:我们使用酒精提示反应性范式和随机临床试验(RCT)搜索了用于AUD治疗的药物的文献。对于酒精提示反应性研究,我们计算了提示诱导的酒精渴望的药物效应大小(k=36项研究,15种药物)。对于RCT,我们计算了大量饮酒和禁欲的药物效应大小(k=139项研究,19种药物)。使用药物作为分析单位,我们应用Williamson-York双变量加权最小二乘估计来考虑自变量和因变量的误差.我们还进行了留一法交叉验证模拟,以检查提示渴望药物效应大小对RCT大量饮酒和禁欲终点的预测效用。
    结果:在人类实验室中,药物对提示引起的酒精渴望的作用与药物对大量饮酒(β^=0.253,SE=0.189,p=0.090)和禁欲(β^=0.829,SE=0.747,p=0.133)之间没有显着关系。
    结论:当前研究的初步结果挑战了单独的酒精提示反应性可以用作AUD药物治疗开发的早期疗效指标的假设。这些发现表明,对于新型化合物的II期测试,应考虑更广泛的早期疗效指标和实验范例。
    BACKGROUND: The alcohol cue exposure paradigm is a common method for evaluating new treatments for alcohol use disorder (AUD); however, it is unclear if medication-related reductions in cue-induced craving in the human laboratory can predict the clinical success of those medications in reducing alcohol consumption during clinical trials.
    OBJECTIVE: To use a novel meta-analytic approach to test whether medication effect sizes on cue-induced alcohol craving are associated with clinical efficacy in clinical trials.
    METHODS: We searched the literature for medications tested for AUD treatment using both the alcohol cue-reactivity paradigm and randomized clinical trials (RCTs). For alcohol cue-reactivity studies, we computed medication effect sizes for cue-induced alcohol craving (k = 36 studies, 15 medications). For RCTs, we calculated medication effect sizes for heavy drinking and abstinence (k = 139 studies, 19 medications). Using medication as the unit of analysis, we applied the Williamson-York bivariate weighted least squares estimation to account for errors in both independent and dependent variables. We also conducted leave-one-out cross validation simulations to examine the predictive utility of cue-craving medication effect sizes on RCT heavy drinking and abstinence endpoints.
    RESULTS: There was no significant relationship between medication effects on cue-induced alcohol craving in the human laboratory and medication effects on heavy drinking ( β ^ = 0.253, SE = 0.189, p = 0.090) and abstinence ( β ^ = 0.829, SE = 0.747, p = 0.133) in RCTs.
    CONCLUSIONS: The preliminary results of the current study challenge the assumption that alcohol cue-reactivity alone can be used as an early efficacy indicator for AUD pharmacotherapy development. These findings suggest that a wider range of early efficacy indicators and experimental paradigms be considered for Phase II testing of novel compounds.
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  • 文章类型: Journal Article
    结论:为了加快文章的发表,AJHP在接受后尽快在线发布手稿。接受的手稿经过同行评审和复制编辑,但在技术格式化和作者打样之前在线发布。这些手稿不是记录的最终版本,将在以后替换为最终文章(按照AJHP样式格式化并由作者证明)。
    目的:卫生系统药师在监控药品管道管理处方中起着至关重要的作用,分配资源,并优化新疗法的临床计划。本文旨在通过提供有关新药和预期新药批准的定期更新来支持药剂师。
    结论:审查了2024年第一季度至2024年第四季度的12个月内预期的部分药物批准。该分析强调了预计会在医院和诊所产生重大临床和财务影响的药物,从等待美国食品和药物管理局批准的59种新药中选出。今年的管道包括最近添加的具有各种适应症的药物,包括肿瘤学,传染病,遗传性疾病,和罕见的疾病。新的细胞和基因疗法正在迅速发展,并正在研究几种罕见的疾病和癌症。
    结论:更多肿瘤药物,包括基因疗法,口服药物,和单克隆抗体,今年正在筹备中。新新药针对的其他疾病,包括细胞和基因疗法,是血友病,非酒精性脂肪性肝炎,老年痴呆症,和罕见的疾病,如半乳糖血症和大疱性表皮松解症。
    OBJECTIVE: Health-system pharmacists play a crucial role in monitoring the pharmaceutical pipeline to manage formularies, allocate resources, and optimize clinical programs for new therapies. This article aims to support pharmacists by providing periodic updates on new and anticipated novel drug approvals.
    CONCLUSIONS: Selected drug approvals anticipated in the 12-month period covering the first quarter of 2024 through the fourth quarter of 2024 are reviewed. The analysis emphasizes drugs expected to have significant clinical and financial impact in hospitals and clinics, as selected from 59 novel drugs awaiting US Food and Drug Administration approval. This year\'s pipeline includes recently added drugs with various indications including oncology, infectious diseases, genetic disorders, and rare diseases. New cellular and gene therapies are rapidly evolving and being studied for several rare diseases and cancers.
    CONCLUSIONS: More oncology agents, including gene therapies, oral agents, and monoclonal antibodies, are in the pipeline this year. Additional diseases targeted by new novel drugs, including cellular and gene therapies, are hemophilia, nonalcoholic steatohepatitis, Alzheimer\'s disease, and rare diseases such as galactosemia and epidermolysis bullosa.
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  • 文章类型: Journal Article
    结论:为了加快文章的发表,AJHP在接受后尽快在线发布手稿。接受的手稿经过同行评审和复制编辑,但在技术格式化和作者打样之前在线发布。这些手稿不是记录的最终版本,将在以后替换为最终文章(按照AJHP样式格式化并由作者证明)。
    目的:卫生系统药师在监控药品管道管理处方中起着至关重要的作用,分配资源,并优化新疗法的临床计划。本文旨在通过提供有关新药和预期新药批准的最新信息来支持药剂师。
    结论:审查了预计在2023年第四季度至2024年第三季度的12个月内的部分药物批准。该分析强调了从58种等待FDA批准的新药中选择的药物,这些药物有望在医院和诊所产生重大的临床和财务影响。该管道包括最近添加的具有各种适应症的药物,包括肿瘤学,感染性疾病,如复杂的尿路感染和肺炎,和罕见的疾病。
    结论:细胞和基因疗法作为遗传性疾病的潜在新治疗选择,继续加强了管道。罕见疾病,和癌症。新药物治疗的其他疾病包括肺动脉高压,慢性阻塞性肺疾病,糖尿病,和肥胖。
    OBJECTIVE: Health-system pharmacists play a crucial role in monitoring the pharmaceutical pipeline to manage formularies, allocate resources, and optimize clinical programs for new therapies. This article aims to support pharmacists by providing updates on new and anticipated novel drug approvals.
    CONCLUSIONS: Selected drug approvals anticipated in the 12-month period covering the fourth quarter of 2023 through the third quarter of 2024 are reviewed. The analysis emphasizes drugs selected from 58 novel drugs awaiting FDA approval that are expected to have significant clinical and financial impact in hospitals and clinics. The pipeline includes recently added drugs with various indications, including oncology, infectious diseases such as complicated urinary tract infection and pneumonia, and rare diseases.
    CONCLUSIONS: Cellular and gene therapies continue to strengthen the pipeline as potential new treatment options for genetic disorders, rare diseases, and cancer. Additional diseases treated by new agents include pulmonary arterial hypertension, chronic obstructive pulmonary disease, diabetes, and obesity.
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  • 文章类型: Journal Article
    结论:为了加快文章的发表,AJHP在接受后尽快在线发布手稿。接受的手稿经过同行评审和复制编辑,但在技术格式化和作者打样之前在线发布。这些手稿不是记录的最终版本,将在以后替换为最终文章(按照AJHP样式格式化并由作者证明)。
    目的:卫生系统药师在监控药品管道管理处方中起着至关重要的作用,分配资源,并优化新疗法的临床计划。本文旨在通过分享新的和预期的新药批准来支持药剂师。
    结论:审查了预计在2023年第二季度至2024年第一季度的12个月内的部分药物批准。该分析强调了预计会在医院和诊所产生重大临床和财务影响的药物,从数据提取时正在等待食品和药物管理局(FDA)批准的58种新药中选择。管道包括各种适应症的药物,比如肿瘤学,炎症条件,和罕见的疾病。肿瘤学的关键进展以及治疗骨髓纤维化的显着进展得到了强调,转移性结直肠癌,和低度胶质瘤.预计细胞和基因疗法将成为严重血友病A和镰状细胞病的治疗选择。几种靶向自身免疫性疾病的单克隆抗体正在等待FDA批准。
    结论:正在开发中的几种新药旨在用于治疗癌症,自身免疫性疾病,和罕见的疾病,如镰状细胞病。
    Health-system pharmacists play a crucial role in monitoring the pharmaceutical pipeline to manage formularies, allocate resources, and optimize clinical programs for new therapies. This article aims to support pharmacists by sharing new and anticipated novel drug approvals.
    Selected drug approvals anticipated in the 12-month period covering the second quarter of 2023 through the first quarter of 2024 are reviewed. The analysis emphasizes drugs expected to have significant clinical and financial impact in hospitals and clinics, as selected from 58 novel drugs awaiting Food and Drug Administration (FDA) approval at the time of data extraction. The pipeline includes drugs with various indications, such as oncology, inflammatory conditions, and rare diseases. Key developments in oncology are highlighted along with notable advancements in treating myelofibrosis, metastatic colorectal cancer, and low-grade gliomas. Cellular and gene therapies are anticipated to emerge prominently as treatment options for severe hemophilia A and sickle cell disease. Several monoclonal antibodies targeting autoimmune diseases are awaiting FDA approval.
    Several new novel drugs in the pipeline are intended for use in treating cancers, autoimmune conditions, and rare diseases such as sickle cell disease.
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  • 文章类型: Journal Article
    在过去的十年里,在美国,女性的饮酒量增加了84%,而男性的饮酒量为35%。此外,研究表明,性别和性别相关的差异可能在发展一系列心理、认知,他们饮酒史的医疗问题比男性早得多,尽管消耗了类似数量的物质。虽然这种“伸缩”过程已经在文献中得到承认,对潜在生物行为机制的理解,并增加了针对女性的特定治疗方法的开发,没有发生。在本章中,我们专注于理解为什么需要个性化,性别特异性药物势在必行,并强调了一些潜在的性别特异性性腺和与压力相关的适应,这些适应支撑了女性从控制性药物和酒精寻求到强迫性药物和酒精的加速发展。我们还讨论了这些机制作为药物开发的新目标的功效,以外源性孕酮和胍法辛为例。最后,我们评估了在开发女性创新药物方面面临的一些挑战和取得的进展.我们建议外源性孕酮和肾上腺素能药物等药物,比如胍法辛,可能在减轻应激诱导的对几种物质的渴望方面提供一些功效,以及提高面对压力的情绪调节能力,优先于女性。然而,充分利用这些疗法在使用药物的女性中的潜力,需要更多地关注通过鼓励女性参与临床试验来减少治疗和研究的障碍。
    In the last decade, alcohol consumption in the US has risen by 84% in women compared with 35% in men. Furthermore, research has shown that sex- and gender-related differences may disadvantage women in terms of developing a range of psychological, cognitive, and medical problems considerably earlier in their drinking history than men, and despite consuming a similar quantity of substances. While this \"telescoping\" process has been acknowledged in the literature, a concomitant understanding of the underlying biobehavioral mechanisms, and an increase in the development of specific treatments tailored to women, has not occurred. In the current chapter we focus on understanding why the need for personalized, sex-specific medications is imperative, and highlight some of the potential sex-specific gonadal and stress-related adaptations underpinning the accelerated progress from controlled to compulsive drug and alcohol seeking in women. We additionally discuss the efficacy of these mechanisms as novel targets for medications development, using exogenous progesterone and guanfacine as examples. Finally, we assess some of the challenges faced and progress made in terms of developing innovative medications in women. We suggest that agents such as exogenous progesterone and adrenergic medications, such as guanfacine, may provide some efficacy in terms of attenuating stress-induced craving for several substances, as well as improving the ability to emotionally regulate in the face of stress, preferentially in women. However, to fully leverage the potential of these therapeutics in substance-using women, greater focus needs to the placed on reducing barriers to treatment and research by encouraging women into clinical trials.
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    细胞外信号向细胞内反应的翻译涉及许多信号转导分子。这种信号转导功能的主要成分是腺苷酸环化酶,产生细胞内的第二信使,\"循环AMP。最初被认为是环AMP产生的单一酶,现在已知是九种膜结合酶的家族,和一种细胞溶质酶。腺苷酸环化酶家族的每个成员的区别在于调节其催化活性的因素,通过细胞,组织,家庭成员的器官分布,以及特定家庭成员所服务的生理/行为功能。本文重点介绍了7型腺苷酸环化酶(AC7)的催化特性及其与酒精使用障碍的关系(AUD,酒精中毒),和重度抑郁症(MDD)。AC7可能是遗传系统的一部分,使个体以性别特异性方式感染AUD和/或MDD。或者该酶可以响应于疾病的进展或响应于治疗而改变其表达或活性。表达AC7的大脑区域与对压力的反应有关,并且有证据表明CRF1受体与杏仁核和垂体中的AC7偶联。有趣的是,AC7是包含在免疫系统和血小板的骨髓衍生细胞中的环化酶的主要形式,和小胶质细胞。因此,AC7是,准备在外周和脑免疫功能中发挥不可或缺的作用,被认为在病因上与AUD和MDD有关。血小板和淋巴细胞腺苷酸环化酶活性已被提议作为AUD和MDD的标志物,以及对MDD药物反应阳性的预后标志物。我们最后考虑了可以选择性调节AC7活性作为MDD和AUD治疗的药物开发途径。
    The translation of extracellular signals to intracellular responses involves a number of signal transduction molecules. A major component of this signal transducing function is adenylyl cyclase, which produces the intracellular \"second messenger,\" cyclic AMP. What was initially considered as a single enzyme for cyclic AMP generation is now known to be a family of nine membrane-bound enzymes, and one cytosolic enzyme. Each member of the adenylyl cyclase family is distinguished by factors that modulate its catalytic activity, by the cell, tissue, and organ distribution of the family members, and by the physiological/behavioral functions that are subserved by particular family members. This review focuses on the Type 7 adenylyl cyclase (AC7) in terms of its catalytic characteristics and its relationship to alcohol use disorder (AUD, alcoholism), and major depressive disorder (MDD). AC7 may be part of the inherited system predisposing an individual to AUD and/or MDD in a sex-specific manner, or this enzyme may change in its expression or activity in response to the progression of disease or in response to treatment. The areas of brain expressing AC7 are related to responses to stress and evidence is available that CRF1 receptors are coupled to AC7 in the amygdala and pituitary. Interestingly, AC7 is the major form of the cyclase contained in bone marrow-derived cells of the immune system and platelets, and in microglia. AC7 is thus, poised to play an integral role in both peripheral and brain immune function thought to be etiologically involved in both AUD and MDD. Both platelet and lymphocyte adenylyl cyclase activity have been proposed as markers for AUD and MDD, as well as prognostic markers of positive response to medication for MDD. We finish with consideration of paths to medication development that may selectively modulate AC7 activity as treatments for MDD and AUD.
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  • 文章类型: Journal Article
    背景:甲基苯丙胺使用障碍(MUD)是一个日益增长的健康问题,没有FDA批准的治疗方法。本系列研究建立在我们先前为MUD开发抗甲基苯丙胺(MA)疫苗的工作基础上。我们确定了包含与吸附在氢氧化铝(明矾)上的琥珀酰-甲基苯丙胺(TT-SMA)结合的破伤风类毒素(TT)与新型Toll样受体-5激动剂的制剂的作用,entolimod.
    方法:用TT-SMA+明矾和各种剂量的恩多莫德对小鼠进行接种(0、3、6周),以确定增强针对MA的免疫原性的最佳剂量。然后在小鼠中使用MA诱导的运动激活来评估功能效果。使用由疫苗产生的抗体的被动免疫的实验测试了其减弱MA诱导的心血管作用和改变MA在MA诱导的药物寻求模型在雄性和雌性大鼠中复发的恢复中的增强作用的能力。
    结果:在用TT-SMA+明矾与entolimod(1、3和10μg)组合的疫苗接种后10周,抗体水平达到峰值。MA诱导的运动激活在接种疫苗中明显减弱。未接种疫苗的小鼠和抗体水平与步行水平显着相关。在两种性别的大鼠中,被动免疫均降低了MA给药后的平均动脉压,但没有改变心率。被动免疫还减弱了MA在雄性和雌性大鼠中恢复消失的药物寻求行为的能力。结果支持该疫苗用于MUD个体的复发预防的进一步开发。
    BACKGROUND: Methamphetamine use disorder (MUD) is a growing health concern with no FDA-approved treatment. The present series of studies build upon our previous work developing an anti-methamphetamine (MA) vaccine for MUD. We determined the effects of a formulation that included tetanus-toxoid (TT) conjugated to succinyl-methamphetamine (TT-SMA) adsorbed onto aluminum hydroxide (alum) in combination with the novel Toll-Like Receptor-5 agonist, entolimod.
    METHODS: Mice were vaccinated (0, 3, 6 weeks) with TT-SMA+alum and various doses of entolimod to determine an optimal dose for enhancing immunogenicity against MA. Functional effects were then assessed using MA-induced locomotor activation in mice. Experiments using passive immunization of antibodies generated by the vaccine tested its ability to attenuate MA-induced cardiovascular effects and alter the reinforcing effects of MA in an MA-induced reinstatement of a drug seeking model of relapse in male and female rats.
    RESULTS: Antibody levels peaked at 10 weeks following vaccination with TT-SMA+alum combined with entolimod (1, 3 and 10 μg). MA-induced locomotor activation was significantly attenuated in vaccinated vs. unvaccinated mice and antibody levels significantly correlated with ambulation levels. Passive immunization decreased mean arterial pressure following MA dosing in rats of both sexes but did not alter heart rate. Passive immunization also attenuated the ability of MA to reinstate extinguished drug-seeking behavior in male and female rats. Results support further development of this vaccine for relapse prevention for individuals with MUD.
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  • 文章类型: Journal Article
    在美国,物质使用继续导致显著的发病率和死亡率。无论男女,比其他可预防的健康状况更重要。为了减轻物质造成的公共卫生负担,国家药物滥用研究所和国家酒精滥用和酒精中毒研究所已经确定,药物使用障碍的药物开发是一个高度优先的研究领域。此外,两家研究所都表示,药物使用药物开发中的性别和性别差异研究是一个关键领域。当前叙述回顾的目的是强调在药物使用障碍的药物试验中如何考虑(或不考虑)性别和性别,以澄清和总结有关性别和性别差异的功效,并为该领域提供指导,以促进与当前NIH“性别作为生物学变量”(SABV)政策一致的药物开发。为此,我们回顾了主要类别的滥用物质(尼古丁,酒精,可卡因,大麻,阿片类药物)证明,性别和性别在成瘾药物开发研究中没有得到很好的考虑。然而,当评估了关于性别和性别差异的足够数据时(即,在戒烟中),已确定女性和男性之间的临床显着反应差异。在审查的其他滥用药物中,数据还表明,性别和性别可能是某些药物预后的预测因素,尽管女性在临床研究样本中的代表性相对较低限制了做出明确的结论。我们建议将性别和性别纳入临床护理指南,并改善对药物开发调查中公开可用的性别分层数据的获取。
    Substance use continues to contribute to significant morbidity and mortality in the United States, for both women and men, more so than another other preventable health condition. To reduce the public health burden attributable to substances, the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism have identified that medication development for substance use disorder is a high priority research area. Furthermore, both Institutes have stated that research on sex and gender differences in substance use medication development is a critical area. The purpose of the current narrative review is to highlight how sex and gender have been considered (or not) in medication trials for substance use disorders to clarify and summarize what is known regarding sex and gender differences in efficacy and to provide direction to the field to advance medication development that is consistent with current NIH \'sex as a biological variable\' (SABV) policy. To that end, we reviewed major classes of abused substances (nicotine, alcohol, cocaine, cannabis, opioids) demonstrating that, sex and gender have not been well-considered in addiction medication development research. However, when adequate data on sex and gender differences have been evaluated (i.e., in tobacco cessation), clinically significant differences in response have been identified between women and men. Across the other drugs of abuse reviewed, data also suggest sex and gender may be predictive of outcome for some agents, although the relatively low representation of women in clinical research samples limits making definitive conclusions. We recommend the incorporation of sex and gender into clinical care guidelines and improved access to publicly available sex-stratified data from medication development investigations.
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  • 文章类型: Journal Article
    尽管与酒精使用障碍(AUD)相关的高患病率和负面影响,目前可用的药物疗法在数量和疗效上都是有限的。已经确定了几种神经内分泌途径,并正在研究作为AUD的潜在药物治疗靶标。这里,我们提出了盐皮质激素受体(MR)作为一个新的目标的前景,并讨论了醛固酮/MR系统和AUD之间的关联,MR拮抗作用对饮酒的影响,以及这些影响的潜在神经生物学。
    Despite the high prevalence and negative consequences associated with alcohol use disorder (AUD), currently available pharmacotherapies are limited in number and efficacy. Several neuroendocrine pathways have been identified and are under investigation as potential pharmacotherapeutic targets for AUD. Here, we present the promise of the mineralocorticoid receptor (MR) as a novel target and discuss associations between the aldosterone/MR system and AUD, the effects of MR antagonism on alcohol consumption, and the underlying neurobiology of these effects.
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