Journal of Clinical Pharmacy and Therapeutics (J Clin Pharm Therapeut)

Publisher: Wiley

Journal description

The Journal of Clinical Pharmacy and Therapeutics has become established among pharmacists in various disciplines and areas of specialization as a forum for the communication of significant developments in clinical and hospital pharmacy. Its scope embraces: the manufacture, quality control and formulation of medicines; drug information services; pharmacokinetics; radiopharmacy; organisation and management of the hospital pharmacy; drug distribution systems including unit dose systems; clinical pharmacy education; all other aspects of clinical pharmacy.

Current impact factor: 1.67

Impact Factor Rankings

2016 Impact Factor Available summer 2017
2014 / 2015 Impact Factor 1.668
2013 Impact Factor 1.533
2012 Impact Factor 2.104
2011 Impact Factor 1.57
2010 Impact Factor 1.649
2009 Impact Factor 1.671
2008 Impact Factor 1.755
2007 Impact Factor 1.364
2006 Impact Factor 0.966
2005 Impact Factor 1.164
2004 Impact Factor 0.984
2003 Impact Factor 1.157
2002 Impact Factor 1.324
2001 Impact Factor 1.245
2000 Impact Factor 0.902
1999 Impact Factor 0.409
1998 Impact Factor 0.529
1997 Impact Factor 0.431
1996 Impact Factor 0.355
1995 Impact Factor 0.328
1994 Impact Factor 0.442
1993 Impact Factor 0.437
1992 Impact Factor 0.281

Impact factor over time

Impact factor
Year

Additional details

5-year impact 1.71
Cited half-life 7.20
Immediacy index 0.38
Eigenfactor 0.00
Article influence 0.50
Website Journal of Clinical Pharmacy and Therapeutics website
Other titles Journal of clinical pharmacy and therapeutics (Online), Journal of clinical pharmacy & therapeutics
ISSN 1365-2710
OCLC 45469824
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Wiley

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • Some journals have separate policies, please check with each journal directly
    • On author's personal website, institutional repositories, arXiv, AgEcon, PhilPapers, PubMed Central, RePEc or Social Science Research Network
    • Author's pre-print may not be updated with Publisher's Version/PDF
    • Author's pre-print must acknowledge acceptance for publication
    • Non-Commercial
    • Publisher's version/PDF cannot be used
    • Publisher source must be acknowledged with citation
    • Must link to publisher version with set statement (see policy)
    • If OnlineOpen is available, BBSRC, EPSRC, MRC, NERC and STFC authors, may self-archive after 12 months
    • If OnlineOpen is available, AHRC and ESRC authors, may self-archive after 24 months
    • Publisher last contacted on 07/08/2014
    • This policy is an exception to the default policies of 'Wiley'
  • Classification
    yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Ibrutinib is a recently approved oral anticancer agent with pharmacokinetics that is very sensitive to metabolic inhibition. We report a serious side effect of ibrutinib potentially attributable to interaction with the moderate CYP3A4 inhibitor verapamil. A patient with mantle cell lymphoma was admitted to our emergency department with severe diarrhoea. During a prescription review, the clinical pharmacist identified a potential drug interaction between ibrutinib and verapamil present in a branded combination product also containing trandolapril. Ibrutinib was discontinued for 5 days, and verapamil was stopped. Lercanidipine 10 mg daily was prescribed as an alternative antihypertensive drug. The patient was discharged after 3 days with symptomatic treatment for his diarrhoea. Three months later, the patient maintained control with ibrutinib and olmesartan, but without verapamil. This is the first description of a serious side effect of ibrutinib likely due to an interaction with the CYP3A4 inhibitor verapamil. Prescriptions of ibrutinib must be carefully checked to identify possible interactions with CYP3A4 inhibitors and patients monitored accordingly.
    No preview · Article · Feb 2016 · Journal of Clinical Pharmacy and Therapeutics

  • No preview · Article · Feb 2016 · Journal of Clinical Pharmacy and Therapeutics
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    ABSTRACT: What is known and objective: There is a disparity between the Korean treatment guidelines and actual clinical prescription habits. This study was designed to evaluate the department-specific disparities and achievement rates for low-density lipoprotein cholesterol (LDL-C) targets, based on each department's specific statin prescription patterns. Methods: We retrospectively evaluated data from 31 718 patients who had been prescribed a statin at least once between January 2008 and June 2013 at our institution. Patients were classified into the high-risk (target LDL-C < 100 mg/dL) or moderate-risk (target LDL-C < 130 mg/dL) groups, according to the National Cholesterol Education Programme-Adult Treatment Panel III guidelines. Results and discussion: Statins were most commonly prescribed in the cardiology (32·0%) and endocrinology (26·6%) departments. For the high-risk group, 70% of patients in the cardiology, endocrinology and cardiac surgery departments achieved their target LDL-C levels (<100 mg/dL). However, the target achievement rates in most other departments were <70%. For the moderate-risk group, 79·2% of patients achieved their target levels. Departments that prescribed a greater number of high- or intermediate-potency statins were more likely to achieve their target LDL-C levels. The group that achieved their target LDL-C levels (<100 mg/dL) exhibited a significant positive relationship (Spearman's correlation coefficient = 0·8571, P = 0·0065), from low to high potency. What is new and conclusion: Some departments tend to undertreat when prescribing statins. However, to reach to the target LDL-C levels, physicians must overcome their tendency to undertreat with statins. We believe that the target achievement rate will increase if doctors are more actively aware of a patient's individual status and related risk factors before prescribing statins.
    No preview · Article · Jan 2016 · Journal of Clinical Pharmacy and Therapeutics
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    ABSTRACT: What is known and objective: Regular blood transfusions in the management of myelodysplastic syndrome (MDS) often lead to iron overload. The main objective of this study was to evaluate the impact of medication adherence on the effectiveness of deferasirox for the treatment of transfusional iron overload in patients with MDS. Secondary objectives were to describe treatment effectiveness and safety in daily clinical practice. Methods: A longitudinal, retrospective, observational study was carried out in a university hospital. The inclusion criteria were age over 18 years, MDS diagnosis and treatment with deferasirox for transfusion-dependent iron overload during the period of study (from January 2011 to April 2015). Treatment effectiveness was estimated by serum ferritin (SF), and adherence was measured by medication possession ratio (MPR). Clinically relevant analytical alterations during the treatment and reasons for treatment discontinuation were also assessed. Results: Thirty-five patients were included in the study. Median SF at baseline was 1636 μg/L, and it decreased to 1399 μg/L during follow-up. The median adherence rate was 92%, although only 54·8% of the patients maintained deferasirox adherence ≥90% during the whole duration of treatment. Adherence rate was inversely correlated to SF (r = -0·288, P = 0·004). The median (p25, p75) duration of treatment was 11 (3·0, 37·8) months. The most common reasons for treatment discontinuation were renal toxicity (35%) and patient's death (25%). What is new and conclusion: Deferasirox's effectiveness, measured by the decrease in SF, was significantly better in adherent patients. The most frequent reason for treatment discontinuation was renal toxicity. Developing strategies to improve deferasirox treatment adherence and monitoring renal function in those patients should be key points in pharmaceutical care.
    No preview · Article · Jan 2016 · Journal of Clinical Pharmacy and Therapeutics
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    ABSTRACT: What is known and objective: There is conclusive evidence demonstrating that formulary restrictions are associated with reduced utilization and pharmacy spending of the restricted drugs. However, prior efforts to implement restrictive formularies have been associated with inconsistent rates of therapy discontinuation and mixed impacts on adherence to therapy. Also, the impact of transferring patients from an already restrictive formulary to a more aggressive model has not been previously examined. This study evaluated the impact of implementation of a more restrictive formulary on therapy disruption, adherence rates, pharmacy costs and generic utilization among patients with common chronic conditions. Methods: In 2014, CVS Health implemented Value Formulary (VF), a restrictive benefit design with the aim of reducing spending while preserving access to and adherence to essential therapy, was used. A retrospective cohort study was conducted to assess changes in therapy disruption rates, pharmacy costs and generic dispensing rate (GDR) (for continuers) and medication adherence (for initiators) following the implementation of VF. The study group was selected from members of three existing employer clients transitioned from standard formulary (SF) to VF on January 2014. The control population was a matched group of six employers with the same preperiod formulary structure, business unit, adherence programmes and patient out-of-pocket cost as the study group. The control group retained SF in 2014. To assess therapy disruption after VF implementation, we categorized patients by their subsequent medication use into three groups: (i) therapy stopped, (ii) therapy continued and (iii) therapy switched. Medication adherence was measured as monthly proportion of days covered (PDC). Pharmacy cost and GDR were measured per utilizer per month (PUPM). Rates of therapy disruption in study and control groups were compared using the chi-square test. Differences in monthly PDC between matched groups were evaluated using multivariate linear regression. Impact of VF on pharmacy cost and GDR was measured through segmented regression of interrupted time series data with generalized estimating equations. Results and discussion: A transition from SF to VF influenced drug coverage for approximately 13% of members (as their medications were either no longer covered, or covered restrictively under VF). Compared to patients whose plan sponsors retained SF, the patients that transitioned to VF had a modest (1·3%) but statistically significant increase in therapy discontinuation rates. This was offset by similarly modest improvements in adherence; patients who initiated therapy under VF demonstrated a 1·5% higher adherence to medications as compared to SF patients (P < 0·001). Medication costs in the VF group were lower by $20 PUPM (P < 0·001), and GDR was greater by 4·2% (P < 0·001). What is new and conclusion: Transition of patients to a more restrictive drug formulary led to modest therapy discontinuation, similarly modest improvements in medication adherence and substantial prescription drug cost savings. As healthcare payors search for ways to control the rapid rise in spending for medications without compromising quality, the Value Formulary can serve as a useful tool.
    No preview · Article · Jan 2016 · Journal of Clinical Pharmacy and Therapeutics
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    ABSTRACT: Chronic obstructive pulmonary disease (COPD), a preventable and treatable disease, has been described as ‘10% medication and 90% education’. Extreme physician scarcity limits the implementation of quality healthcare delivery in India. We conducted this study to evaluate the effectiveness of clinical pharmacist intervention on health-related quality of life (HRQoL) in patients with COPD in an Indian tertiary care hospital. An open-labelled randomized controlled study was conducted over a 3-year period, at Kasturba Medical College Hospital, Manipal, India, after obtaining institutional ethics clearance (IEC 88/2012). The study was registered with the Indian clinical trial registry (CTRI/2014/08/004848). Patients were randomly assigned to two groups (intervention group [IG] and control group [CG]) by envelope method. St. George's Respiratory Questionnaire (SGRQ) was used to assess the HRQoL. The pharmacist intervention laid emphasis on (i) importance of medication compliance, (ii) need for smoking cessation, (iii) simple exercise, (iv) proper use of inhaler devices and (v) need for timely follow-up by pulmonary medicine department. SGRQ assessment was repeated at 6, 12, 18 and 24 months. Of 328 patients with COPD screened during the study period (March 2012 to June 2013), 260 (79%) were recruited. Of these, 202 (78%) patients completed follow-up (98 in CG and 104 in IG). Both groups were matched for baseline, sociodemographics and clinical characteristics. SGRQ scores and its subscales (symptoms, activity and impact) improved significantly after the pharmacist intervention in IG at follow-up (P < 0·001). Our randomized controlled study shows that pharmacist intervention improved the HRQoL of patients with COPD in India. The generalizability of our results requires exploration even within other settings in India. Nonetheless, our results provide support for a greater involvement of pharmacists in the care of patients with COPD.
    No preview · Article · Jan 2016 · Journal of Clinical Pharmacy and Therapeutics
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    ABSTRACT: What is known and objective: Cytochrome P450 1A2 (CYP1A2), CYP2B6 and inducible nitric oxide synthase (iNOS) are involved in the metabolism and action of many important therapeutic drugs, and genetic variants have been associated with interethnic differences in response to treatment, including chemotherapy. Methods: Eight hundred and forty-two unrelated Chinese healthy subjects (323 Tibetan, 134 Mongolian, 162 Uygur and 223 Han) were recruited for genotyping. Frequencies of CYP1A2 -163C>A, CYP2B6 516G>T and iNOS -954G>C were determined by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods. Results and discussion: The frequency of CYP1A2-163A was higher in Chinese Mongolian (0·698) than in Chinese Tibetan (0·633), Uygur (0·633) and Han populations (0·608, P < 0·05), respectively. The frequency of CYP1A2-163A in the Chinese population (total, 0·636) was intermediate between those reported in Caucasians (0·682, P < 0·05) and Africans (0·549, P < 0·01). The frequency of CYP2B6 516T in Chinese Uygur (0·287) was significantly higher than those in Chinese Tibetan (0·147, P < 0·01) and Mongolian (0·179, P < 0·01), respectively, but was similar to the frequency in Chinese Han (0·226). The frequencies of CYP2B6 516T were in the order of Africans (0·500) > Caucasians (0·286) > Chinese (0·200). The variant iNOS-954C was rare in Chinese Tibetan (0·005), Mongolian (0·004), Uygur (0·000) and Han (0·007), respectively, but showed higher frequencies in African ethnic groups. The frequencies of iNOS-954C were in the order of Africans (0·098) > Chinese (0·004) > Caucasians (0·000). What is new and conclusion: This is the first report of the distribution frequencies of functional CYP1A2, CYP2B6 and iNOS genes among mainland Chinese Tibetan, Mongolian, Uygur and Han populations. These results should help inform studies of interethnic differences in disease susceptibility or drug responses.
    No preview · Article · Jan 2016 · Journal of Clinical Pharmacy and Therapeutics
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    ABSTRACT: What is known and objective: Tuberculosis, an infectious disease caused by the bacteria Mycobacterium tuberculosis, has significant public health implications. Despite the decreasing prevalence of tuberculosis cases and the availability of well-established treatment guidelines, errors with antituberculosis medications remain a concern as clinician experience with the infection has waned and the goal of eradicating tuberculosis has remained unfulfilled. Whereas inappropriate use of other anti-infective classes has been extensively studied, the evaluation of medication errors associated with antituberculosis therapy has been limited to a small number of studies conducted more than two decades ago. This study evaluated the prevalence of inpatient medication errors with antituberculosis therapy in patients with suspected or confirmed tuberculosis disease. Methods: All admitted patients treated with at least one antituberculosis medication between July 2010 and June 2013 were evaluated for inclusion in the retrospective study. Multidrug antituberculosis regimens were reviewed for medication errors, which were categorized as dosing errors, drug interactions, omission of therapy and inappropriate continuation of therapy in the presence of drug toxicity. Appropriate management was determined in accordance with the national guidelines for the treatment of tuberculosis, as well as guidelines on the use of antiretroviral agents for patients with both human immunodeficiency virus (HIV) infection and tuberculosis disease. The impact of infectious diseases and pulmonary consultation on the prevalence of medication errors was also examined. Results and discussion: More than half of all study patients (44/72, 61%) experienced at least one medication error associated with antituberculosis therapy. Dosing errors were the most common type of medication error identified and were predominantly related to weight-based dosing. Seven dosing errors were related to drug interactions between rifamycins and antiretroviral therapy in HIV-infected patients. Medication error rates were similar between patients receiving consultation from infectious diseases and/or pulmonary specialties and those without consultation. The large majority of antituberculosis medication errors (56/66 errors, 85%) remained uncorrected during the patient's hospital admission. What is new and conclusion: Medication errors associated with antituberculosis therapy remain a common occurrence in the current clinical practice setting. Greater vigilance when prescribing medications for tuberculosis disease is needed.
    No preview · Article · Jan 2016 · Journal of Clinical Pharmacy and Therapeutics
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    ABSTRACT: What is known and objective: Nalmefene, a new opioid system regulator, has recently been approved for the treatment of alcohol dependence, primarily for reducing heavy drinking days. Cases description: Two patients with a diagnosis of alcohol use disorder were treated with nalmefene. Both patients developed fatigue and deep sleepiness after 2 days of treatment. Only after 1 day of drug discontinuation, symptoms normalized. What is new and conclusion: We have analysed symptoms' development before and after treatment discontinuation and the possible association with nalmefene therapy. This case should pinpoint our attention on this adverse event for a careful choice of anticraving therapy in patients with severe alcohol use disorder.
    No preview · Article · Dec 2015 · Journal of Clinical Pharmacy and Therapeutics
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    ABSTRACT: What is known and objective: Diabetes mellitus (DM) is major cause of death and disability, and regular administration of medications is important in its management. A better understanding of the factors associated with medication non-adherence or underuse may help to improve adherence. This study was performed to identify and compare possible risk factors associated with medication adherence to antidiabetic medication in two different community-based populations in Korea. Methods: In this large, cross-sectional study, data on DM patients from the rural area of Ansung and the urban area of Ansan obtained during biennial health examinations in 2011-2012 were analysed. Demographic information and anthropometric and laboratory test results were collected. The study population consisted of rural and urban communities which were each categorized into two groups according to medication adherence: those who were currently on antidiabetic medication (adherent group), and those who did not take the medication despite knowing that they are diabetic (non-adherent group). Results and discussion: A total of 1675 inhabitants who were diagnosed as diabetic were included in this study comprised of 803 patients from the rural community and 872 patients from the urban community. Over half of the study population (55·76%, 934 patients) belonged to the non-adherent group. Adherence was greater in the rural (52·43%) than in the urban (36·70%) group. There were significant associations between medication non-adherence and age, male gender, alcohol consumption, high blood pressure, high total cholesterol and lack of family history of diabetes, but not with income, smoking status, exercise, marital status and occupation. What is new and conclusion: Despite the proven beneficial effects of antidiabetic medications in the management of DM, we observed low rates of medication adherence, particularly in the urban area. Further study to identify barriers to adherence among urban residents is needed. In addition, there is a need for effective strategies that will lead to improved medication adherence.
    No preview · Article · Dec 2015 · Journal of Clinical Pharmacy and Therapeutics
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    ABSTRACT: What is known and objective: Antiretroviral treatment (ART) is hampered by complicated regimens, high pill burden, drug-drug interactions, and frequent short- and long-term adverse effects, leading to decreased adherence. Over recent years, considerable effort has been directed at developing regimens that are less burdening. We undertook a 7-year retrospective study of the records of 264 HIV-infected subjects enrolled in a pharmaceutical care programme to document the progress made and to study the influence of the number of ART pills and doses on the level of treatment adherence. Methods: Antiretroviral dispensing records were analysed for the number of pills and doses administered and the ART adherence rate estimated. Results and discussion: In 2005, the patients took a mean of 6·2 pills daily (CI 95%: 5·9-6·6), and 92·9% of them were on a twice-a-day (BID) dosage regimen. By 2012, the mean number of pills was reduced to 4·1 (CI 95%: 3·8-4·4), and only 50·9% were on a BID regimen. No statistically significant relation was observed between number of daily pills and doses and ART adherence reached by the patients in any of the analyses performed. What is new and conclusions: There has been a continuous reduction in the number of pills and doses of antiretrovirals taken by individual patients over the last 7 years due largely to the introduction of improved treatments and regimens. More daily pills or doses was not associated with worse ART adherence in our pharmaceutical care programme.
    No preview · Article · Dec 2015 · Journal of Clinical Pharmacy and Therapeutics
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    ABSTRACT: What is known and objective: Adjustment of drug dosage in patients with end-stage renal disease prevents serious adverse effects, which occur due to the accumulation of drugs or other toxic metabolites. Nevertheless, dosing errors occur most commonly among patients with end-stage renal disease. The aim of this study was to assess the quality of care for end-stage renal disease outpatients using their renal dosing adjustment status. Methods: A cross-sectional study was performed using the data collected from 43 South Korean medical institutions via questionnaires. A total of 2428 patients on haemodialysis, who were at least 18 years of age, were included. Among these patients, the study population was confined to patients who were taking medications and required renal dosing adjustments from three therapeutic classes: antihypertensives, antihyperglycaemics and lipid-modifying agents. The study population (n = 828) was prescribed a total of 1097 drug orders for the target drugs. Determination of appropriate dosage adjustment was based on GFR (glomerular filtration rate) using the Modification of Diet in Renal Disease revised 4-variable equation. The primary outcome was non-adherence to drug dosing requirements for end-stage renal disease patients with consideration to their renal function. Results and discussion: Among the study population (n = 828), 469 haemodialysis patients were identified as having drug orders that were adherent to renal dosing recommendations. There were significant differences between the patient groups who received recommendation-adherent and non-adherent drug orders in the characteristics of the medical institutions they visited, causes of chronic renal failure and prevalence of concurrent diabetes mellitus. The primary factor of non-adherence to renal dosing adjustment recommendations was characteristics of medical institutions. Compared to tertiary hospitals, secondary hospitals and primary care clinics were 1·16 and 1·22 times, respectively, more non-adherent in accordance with the multivariate analysis (OR: 1·16, 95% CI: 1·02-1·20, OR: 1·22, 95% CI: 1·00-1·36, respectively). What is new and conclusions: Dosing error is one of the most common problems among patients with renal failure. To decrease the dosing errors, an improvement needs to be made in medical institutions. This can be accomplished by implementing the clinical decision support systems that educate physicians on appropriate renal dosing and help them prescribe appropriate drug dosages.
    No preview · Article · Dec 2015 · Journal of Clinical Pharmacy and Therapeutics
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    ABSTRACT: What is known and objective: Given the data for four factor prothrombin complex concentrate (PCC) for vitamin K antagonist (VKA) reversal, there is great interest to determine whether PCC can improve patient outcomes in patients with bleeds associated with the newer oral anticoagulants (NOAC). Case description: We describe the case of an adult trauma patient anticoagulated with apixaban, presenting with a severe life-threatening bleed. PCC was administered at the maximum dose when the patient was determined to be refractory to supportive care with blood products. What is new and conclusion: Despite maximal treatment efforts, haemostasis was not achieved and the patient expired.
    No preview · Article · Dec 2015 · Journal of Clinical Pharmacy and Therapeutics
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    ABSTRACT: What is known and objective: Antimicrobial stewardship is required to ensure the appropriate use of antimicrobials. However, no reports have been published on clinical outcomes of implementation of antimicrobial stewardship in patients receiving pathogen-specific antibiotics. Method: To evaluate the clinical outcomes of patients who received drugs, we conducted a single-centre, retrospective study of the effects of an antimicrobial stewardship programme targeting methicillin-resistant Staphylococcus aureus (MRSA). Results: The time to administer effective antimicrobials was significantly (median number of days, 3 before vs. 0 after, P < 0·001) shortened, and the rate of de-escalation was significantly elevated (47·1% vs. 96·2%, P < 0·001) after implementation of daily review. The 60-day clinical failure associated with Gram-positive bacterial infection was significantly reduced (33·3% vs. 17·6%, P = 0·007) after intervention. What is new and conclusions: Daily review of administration of antimicrobials targeting MRSA was highly effective in improving clinical outcomes by optimizing early antimicrobial therapy.
    No preview · Article · Dec 2015 · Journal of Clinical Pharmacy and Therapeutics
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    ABSTRACT: What is known and objective: Difference in median survival is an erratic measure and sometimes does not provide a good assessment of survival benefit. The aim of this study was to reanalyse the overall survival benefit of pomalidomide from pivotal clinical trial using a new area under curve (AUC)-based method. Comment: In the pivotal trial, pomalidomide plus low-dose dexamethasone showed a significant survival benefit over high-dose dexamethasone, with a difference between medians of 4·6 months. The new AUC method applied to the survival curves, obtained an overall survival benefit of 2·6 months for the pomalidomide treatment. This average difference in OS was calculated for the 61·5% of patients for whom the time to event is reliable enough. What is new and conclusion: This 2-month differential would have major clinical and pharmacoeconomic implications, on both cost-effectiveness studies and on the willingness of the healthcare systems to pay for this treatment.
    No preview · Article · Dec 2015 · Journal of Clinical Pharmacy and Therapeutics
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    ABSTRACT: What is known and objective: Calcinosis cutis (or cutaneous calcification) is a type of calcinosis wherein calcium deposits form in the skin and frequently encountered in limited cutaneous subtype of disease. So far, no treatment has shown an explicit beneficial effect. Medical therapy for calcinosis cutis with rituximab is limited and of variable benefit. Case summary: Our patient was 54-year-old lady, a case of limited cutaneous scleroderma with widespread progressive calcinosis cutis unresponsive to current therapy. She went under treatment with rituximab with no successful outcome. What is new and conclusion: Results of therapy with rituximab on regression/improvement of systemic sclerosis-related calcinosis are limited and non-conclusive.
    No preview · Article · Dec 2015 · Journal of Clinical Pharmacy and Therapeutics