Malvina Hoxha

RESEARCH, TEACHING, or OTHER INTERESTS

Pharmacy, Pharmacology (medical), Pharmacology, Toxicology and Pharmaceutics, Pharmaceutical Science

Scopus Publications

Healthcare worker views on antimicrobial resistance in chronic respiratory disease
Sachin Ananth, Adekunle O. Adeoti, Animesh Ray, Peter G. Middleton, Miquel Ekkelenkamp, Stephanie Thee, Anand Shah, , Abayomi Fadeyi, Abdoul Risgou Ouedraogo,et al.
Springer Science and Business Media LLC
Abstract Background and objective Antimicrobial resistance (AMR) is a global crisis, however, relatively little is known regarding its impact in chronic respiratory disease and the specific challenges faced by healthcare workers across the world in this field. We aimed to assess global healthcare worker views on the challenges they face regarding AMR in chronic respiratory disease. Methods An online survey was sent to healthcare workers globally working in chronic respiratory disease through a European Respiratory Society clinical research collaboration (AMR-Lung) focussed on AMR in chronic lung disease. Responses from different geographic regions were analysed. Results 279 responses were received across 60 countries. 54.5% of respondents encountered AMR in chronic respiratory disease weekly. There were differences in perceived high-priority diseases and species with AMR burden between Europe, Asia and Africa. 76.4% of respondents thought that inappropriate antimicrobial prescribing in chronic respiratory disease was common. However, only 43.4% of respondents thought that there were adequate antimicrobial stewardship programmes in their area for chronic respiratory disease, with limited availability in outpatient (29.0%) and ambulatory settings (24.7%). Developing rapid diagnostics for antimicrobial susceptibility (59.5%) was perceived to be the most common challenge in implementing antimicrobial stewardship, with an improved understanding of regional epidemiology of AMR strains the most important factor to improve outcome (55.2%). Conclusions AMR has significant perceived burden in chronic respiratory disease by healthcare professionals globally. However, current implementation of antimicrobial stewardship is limited, with significant challenges related to the availability of rapid diagnostics and understanding of regional epidemiology of AMR strains.


A Questionnaire-based Survey of the Suspected Adverse Reactions Reporting Associated with Dietary and Herbal Supplements by Pharmacists and Patients in Albania
Hedie Haxhiu, Malvina Hoxha, Bruno Zappacosta, Visar Malaj, and Najada Firza
Horizon Research Publishing Co., Ltd.



Mycotoxins and neuropsychiatric symptoms: possible role in special refugee populations
Malvina Hoxha, Mariagrazia Abbasciano, Giuseppina Avantaggiato, Bruno Zappacosta, and Domenico Tricarico
Frontiers Media SA



Estimating the Prevalence of Cognitive Impairment and Its Associated Factors in Albania: A Nationwide Cross-Sectional Study
Malvina Hoxha, Simonetta Galgani, Jera Kruja, Ilir Alimehmeti, Viktor Rapo, Frenki Çipi, Domenico Tricarico, and Bruno Zappacosta
MDPI AG
Background/Objectives: Cognitive impairment is an intermediate state between normal aging and dementia, and its detection in the early stages is essential to prevent dementia, an incurable pathology. The aim of this study is to screen and estimate the prevalence of cognitive impairment, including dementia, and its correlated factors in a community-based sample of the Albanian population over 50 years old. Methods: We carried out a door-to-door neuropsychological screening of Albanian residents older than 50 years from November 2023 to June 2024 in 12 Albanian districts. Participants completed the Early Dementia Questionnaire (EDQ) and the Mini Mental State Examination (MMSE). Results: The overall estimating prevalence of cognitive impairment and early dementia among the Albanian population over 50 years old was 14.04% using the MMSE, with 2.31% for MMSE ≤18 (serious cognitive impairment), 5.51% for MMSE 19–22 (mild cognitive impairment (MCI)), and 6.22 for MMSE 23–24 (suspected cognitive impairment or dementia),respectively. The prevalence of early dementia using the EDQ was significantly higher (53.99%).The number of male participants with MMSE scores of 23–24 (suspected cognitive impairment or early dementia) was 2.5 times higher with respect to female participants. Smoking and alcohol consumption decreased the MMSE scores. The number of participants with normal cognitive function (MMSE scores 25–30) was lower among participants with hypertension, diabetes, hyperlipidemia, and cerebral ischemia. Conclusions: A diagnostic evaluation, including a clinical examination, neuroimaging, and laboratory studies, is further required for a diagnosis. Despite limitations, the data provided in this study are the only ones reported for a large community-based sample of the older adult Albanian population, which can help health care providers to diagnose cognitive impairment.


Analysis of evidence on nutraceutical interventions for Peyronie's disease: a guideline-based critical review
Daniele Tienforti, Malvina Hoxha, Alfonso Boris Di Pasquale, Vinicio Rizza, and Arcangelo Barbonetti
Oxford University Press (OUP)
Abstract Introduction The management of Peyronie's disease (PD) is a challenge for the clinician. Despite the lack of etiologic therapy, different nonsurgical approaches have often been empirically proposed. The most used treatment is based on nutraceutical drugs with antioxidant activity, although such an intervention remains controversial. Objectives We reviewed the evidence from the randomized controlled trials included in the recommendations of the American Urological Association (AUA), Canadian Urological Association (CUA), European Association of Urology, and International Society for Sexual Medicine. Methods We searched PubMed, Scopus, Web of Science, and Cochrane Library for randomized controlled trials, reviews, and guidelines on nutraceutical interventions for PD. Results Our analysis provides detailed information on potential interventions, underlying the inconsistent evidence. Acetyl esters of carnitine, although not recommended by any of the available guidelines, showed potential benefit in some selected studies. Omega-3 fatty acids are not recommended due to withdrawn study evidence. The CUA and AUA were the only societies to consider the use of coenzyme Q10. While the CUA suggested that it might be offered as a treatment option, the AUA refrained from taking a definitive stance due to insufficient evidence. Similarly, conflicting recommendations have been produced on potassium para-aminobenzoate. While the CUA considers potassium para-aminobenzoate potentially useful in slowing PD progression, the AUA deems the evidence insufficient. Conversely, both the International Society for Sexual Medicine and European Association of Urology do not recommend its use. Conclusion This critical comparative analysis of the most recent guidelines produced by the leading scientific societies highlights some inconsistencies in the recommendations on nutraceutical intervention for PD, even within a background of overall ineffectiveness of this treatment approach.


The Current State of Knowledge on Osteoporosis in Holocaust Survivors and Their Descendants
, Malvina Hoxha, Visar Malalj, and
Rambam Health Corporation
Objective: Starvation in early life can cause poor bone health and metabolic aberrations in bone minerals, leading to abnormal bone development. Holocaust survivors have been exposed to starvation and malnutrition before and during World War II. This paper aims to provide the current state of knowledge on the osteoporosis risk in Holocaust survivors and their descendants. Methods: The PubMed and Scopus databases were searched. Papers that reported original data on the risk of osteoporosis in Holocaust survivors and in their offspring were included in the study. Results: Ten studies were included in this review. The majority of studies were case-control ones (n=7) versus two self-reported and one longitudinal study. Despite the limited cohort numbers and the small number of studies in the literature, the data showed a potential increased risk of osteoporosis in Holocaust survivors and especially in their descendants. Conclusions: The review of these studies showed a higher prevalence of osteoporosis among Holocaust survivors and their offspring. Knowledge of the trans-generational inheritance of osteoporosis in the descendants of Holocaust survivors should increase the awareness of primary care health workers on osteoporosis screening and early diagnosis and implementation of preventive measures, including adequate vitamin D and calcium supplementation, and pharmacological treatment.


Reporting of Adverse Drug Reactions by Dentists and Dental Patients in Albania
Malvina Hoxha, Erila Spahiu, Mishel Spahiu, and Bruno Zappacosta
Elsevier BV



Health Economic Evaluations of Hemochromatosis Screening and Treatment: A Systematic Review
Malvina Hoxha, Visar Malaj, and Bruno Zappacosta
Springer Science and Business Media LLC



Pharmacoeconomic Evaluation of Costs of Myelomeningocele and Meningocele Treatment and Screening
Malvina Hoxha, Visar Malaj, Bruno Zappacosta, and Najada Firza
Informa UK Limited
Background The prevention of myelomeningocele (MMC) and meningocele (MC) is a public health concern. A systematic review on economic factors associated with MMC and MC can help the policy makers to evaluate the cost-effectiveness of screening and treatment. To our knowledge, this is the first systematic review to provide up-to date pharmacoeconomic evidence of all economic studies present in literature on different aspects of MMC and MC. Methods We searched in the National Health Service Economic Evaluation Database (NHSEED), PubMed, Cost-effectiveness Analysis Registry (CEA Registry), Centre for Reviews and Dissemination (CRD), Health Technology Assessment Database (HTAD), Cochrane Library, and Econlit. The PRISMA guidelines were followed in the search and evaluation of literature. Only articles in English not limited by the year of publication that fulfilled the eligibility criteria were included in this systematic review. Results Nineteen papers were included in the study. The studies were very heterogeneous and reported a comparison of the costs between prenatal versus postnatal repair, the cost of fetoscopic approach versus open surgery, the cost of ventriculoperitoneal shunting (VPS) versus endoscopic third ventriculostomy (ETV), and ETV with choroid plexus cauterization (ETV/CPC), the cost of hospitalization, and the cost of diagnosis for MMC. Conclusion The results of this study can help in implementing new policies in different countries to assist MC and MMC patients with the cost of treatment and screening.


Arachidonic Acid Pathways and Male Fertility: A Systematic Review
Malvina Hoxha, Arcangelo Barbonetti, and Bruno Zappacosta
MDPI AG
Arachidonic acid (AA) is a polyunsaturated fatty acid that is involved in male fertility. Human seminal fluid contains different prostaglandins: PGE (PGE1 and PGE2), PGF2α, and their specific 19-hydroxy derivatives, 18,19-dehydro derivatives of PGE1 and PGE2. The objective of this study is to synthesize the available literature of in vivo animal studies and human clinical trials on the association between the AA pathway and male fertility. PGE is significantly decreased in the semen of infertile men, suggesting the potential for exploitation of PGE agonists to improve male fertility. Indeed, ibuprofen can affect male fertility by promoting alterations in sperm function and standard semen parameters. The results showed that targeting the AA pathways could be an attractive strategy for the treatment of male fertility.


Anxiety and depression in geriatric hemodialysis patients: factors that influence the border of diseases
Brunilda Elezi, Erjona Abazaj, Bruno Zappacosta, and Malvina Hoxha
Frontiers Media SA
IntroductionThe two main psychological issues that people with end-stage renal disease (ESRD) experience are depression and anxiety. We conducted this study to determine both the prevalence of depression and anxiety, and the factors associated with them, among hemodialysis patients.MethodsPatients aged 18 years or older, who had received hemodialysis in a hemodialysis center in Elbasan, for at least 3 months were included in this study. Beck Anxiety Inventory and Beck Depression Inventory Instruments were used to assess hemodialysis patients levels of depression and anxiety.ResultsOverall, 107 hemodialysis patients (men 65.4%) with a mean age of 57 ± 8.9 years were enrolled in the study. The prevalence of anxiety and depression resulted to be 85.98, and 84.11%, respectively. We found a significant difference in depression and anxiety scores in patients age groups of 61–70 years old (OR = 1.8; 95% CI [0.7–3.7]; p = 0.041), in non-smoking patients (OR 3.4; 95% CI [1.09–8.2]; p = 0.04), in diabetic patients (OR 3.4; 95% CI [1.09–8.2]; p = 0.04), and in patients with a time in dialysis of 6–10 years and >11 years, respectively, (OR 3.4; 95% [1.5–9.0]; p = 0.01), (OR1.3; 95% CI [0.4–3.6]; p = 0.04).ConclusionOur study shows that the prevalence of mental disorders (depression and anxiety) is high among patients with ESRD on maintenance hemodialysis. We recommend a routine screening and referral to psychological health specialists to evaluate the mental health disorders among hemodialysis patients with the primary aim of improving their quality of life.


Meteoropathy: a review on the current state of knowledge
Malvina Hoxha, , Bruno Zappacosta, and
S.C. JURNALUL PENTRU MEDICINA SI VIATA S.R.L
Meteoropathy is no longer considered a popular myth, but a new disease that significantly impacts daily life, particularly in individuals who experience mental illness, cardiovascular disorders, and respiratory conditions. However, there are very limited data on this condition. This study aimed to comprehensively review and analyze existing in vivo animal studies and human clinical trials investigating the effects of meteoropathy on health and its pharmacological treatment. A thorough literature search was conducted across databases such as PubMed and Scopus to gather relevant information. Our analysis primarily focused on the relationship between meteoropathy and mental health, including the influence on affective temperaments. Additionally, we explored various treatment approaches, emphasizing the combination of muscle exercises, pharmacological interventions, and naturopathy, which have shown promise in alleviating pain among individuals affected by meteoropathy. Future research in meteoropathy should shed light on synthesizing new pharmacological compounds.


A review on the role of fatty acids in colorectal cancer progression
Malvina Hoxha and Bruno Zappacosta
Frontiers Media SA
Colorectal cancer (CRC) is the third leading cause of mortality in cancer patients. The role of fatty acids (FA) and their metabolism in cancer, particularly in CRC raises a growing interest. In particular, dysregulation of synthesis, desaturation, elongation, and mitochondrial oxidation of fatty acids are involved. Here we review the current evidence on the link between cancer, in particular CRC, and fatty acids metabolism, not only to provide insight on its pathogenesis, but also on the development of novel biomarkers and innovative pharmacological therapies that are based on FAs dependency of cancer cells.


Compatibility of prolonged infusion antibiotics during Y-site administration
María Nunez‐Nunez, Manuel Murillo‐Izquierdo, Marisa Moya‐Martin, Malvina Hoxha, M. Teresa Quesada Pérez, Fernando Oltra‐Hostalet, Hector Alonso‐Ramos, Jaime Cordero‐Ramos, Jose Barrera‐Cabeza, Pilar Retamar‐Gentil,et al.
Wiley
AbstractBackgroundAntimicrobial resistance is a threat to global public health. The use of prolonged infusions in the hospital setting for certain antimicrobials is widely increasing in order to improve their efficacy and safety, including resistance development. Due to limited vascular access, it is important to clarify whether they can be infused through the same line with other drugs during Y‐site administration.AimThe aim of this review is to update and summarize the evidence on Y‐site compatibility of antibacterial agents administered as prolonged infusions in intensive care units (ICUs).Study DesignA literature review of PubMed, EMBASE and Trissel's Handbook on Injectable Drugs databases was conducted on the compatibility of selected antimicrobials administered simultaneously at a Y‐site connection with parenteral nutrition and other widely used drugs in ICUs. All articles published up to October 30, 2021, in English or Spanish were included, regardless of the type of publication (original articles, case reports, letters, etc.). Eligible antimicrobials were those that can be administered as prolonged infusions: ceftazidime, cefepime, piperacillin/tazobactam, meropenem, ceftolozane/tazobactam, ceftaroline, cloxacillin, ceftobiprole, vancomycin and fosfomycin.ResultsA total of 1302 drug‐to‐drug potential combinations were explored, 196 (15.05%) were found to be incompatible, and in 541 (41.55%), data were not available. The results were presented in a simple 2‐dimensional consultation chart as a quick reference for health care professionals.ConclusionsThis review provides useful and reliable information on the compatibility of antimicrobials administered as Y‐site infusion with other drugs commonly used in the critical setting. This review contributes to patient safety in nursing practice.Relevance to Clinical PracticeTo our knowledge, this is the first review on Y‐site compatibility of antimicrobials used as prolonged infusions with other commonly used drugs, including anti‐emetics, analgesics and anti‐epileptic and parenteral nutrition. The results of the current review need to be addressed to promote the knowledge sharing between health professionals and improve the quality and safety of patients. We believe that this review may serve as a simple and effective 2‐dimensional updated drug‐to‐drug compatibility reference chart for critical care nurses.


The Importance of Nutraceuticals in COVID-19: What’s the Role of Resveratrol?
Elisa Domi, Malvina Hoxha, Entela Kolovani, Domenico Tricarico, and Bruno Zappacosta
MDPI AG
Since COVID-19 has affected global public health, there has been an urgency to find a solution to limit both the number of infections, and the aggressiveness of the disease once infected. The main characteristic of this infection is represented by a strong alteration of the immune system which, day by day, increases the risk of mortality, and can lead to a multiorgan dysfunction. Because nutritional profile can influence patient’s immunity, we focus our interest on resveratrol, a polyphenolic compound known for its immunomodulating and anti-inflammatory properties. We reviewed all the information concerning the different roles of resveratrol in COVID-19 pathophysiology using PubMed and Scopus as the main databases. Interestingly, we find out that resveratrol may exert its role through different mechanisms. In fact, it has antiviral activity inhibiting virus entrance in cells and viral replication. Resveratrol also improves autophagy and decreases pro-inflammatory agents expression acting as an anti-inflammatory agent. It regulates immune cell response and pro-inflammatory cytokines and prevents the onset of thrombotic events that usually occur in COVID-19 patients. Since resveratrol acts through different mechanisms, the effect could be enhanced, making a totally natural agent particularly effective as an adjuvant in anti COVID-19 therapy.


ATP-sensitive Potassium Channel Subunits in Neuroinflammation: Novel Drug Targets in Neurodegenerative Disorders
Fatima Maqoud, Rosa Scala, Malvina Hoxha, Bruno Zappacosta, and Domenico Tricarico
Bentham Science Publishers Ltd.
: Arachidonic acids and its metabolites modulate plenty of ligand-gated, voltage-dependent ion channels, and metabolically regulated potassium channels including ATP-sensitive potassium channels (KATP). KATP channels are hetero-multimeric complexes of sulfonylureas receptors (SUR1, SUR2A or SUR2B) and the pore-forming subunits (Kir6.1 and Kir6.2) likewise expressed in the pre-post synapsis of neurons and inflammatory cells, thereby affecting their proliferation and activity. KATP channels are involved in amyloid-β (Aβ)-induced pathology, therefore emerging as therapeutic targets against Alzheimer’s and related diseases. The modulation of these channels can represent an innovative strategy for the treatment of neurodegenerative disorders; nevertheless, the currently available drugs are not selective for brain KATP channels and show contrasting effects. This phenomenon can be a consequence of the multiple physiological roles of the different varieties of KATP channels. Openings of cardiac and muscular KATP channel subunits, are protective against caspase-dependent atrophy in these tissues and some neurodegenerative disorders, whereas in some neuroinflammatory diseases, benefits can be obtained through the inhibition of neuronal KATP channel subunits. For example, glibenclamide exerts an anti-inflammatory effect in respiratory, digestive, urological, and central nervous system (CNS) diseases, as well as in ischemia-reperfusion injury associated with abnormal SUR1-Trpm4/TNF-α or SUR1-Trpm4/ Nos2/ROS signaling. Despite this strategy being promising, glibenclamide may have limited clinical efficacy due to its unselective blocking action of SUR2A/B subunits also expressed in cardiovascular apparatus with pro-arrhythmic effects and SUR1 expressed in pancreatic beta cells with hypoglycemic risk. Alternatively, neuronal selective dual modulators showing agonist/antagonist actions on KATP channels can be an option.


A Systematic Review on the Role of Arachidonic Acid Pathway in Multiple Sclerosis
Malvina Hoxha, Erila Spahiu, Emanuela Prendi, and Bruno Zappacosta
Bentham Science Publishers Ltd.
Background & Objective: Multiple sclerosis (MS) is an inflammatory neurodegenerative disease characterized by destruction of oligodendrocytes, immune cell infiltration and demyelination. Inflammation plays a significant role in MS, and the inflammatory mediators such as eicosanoids, leukotrienes, superoxide radicals are involved in pro-inflammatory responses in MS. In this systematic review we tried to define and discuss all the findings of in vivo animal studies and human clinical trials on the potential association between arachidonic acid (AA) pathway and multiple sclerosis. Methods: A systematic literature search across Pubmed, Scopus, Embase and Cochrane database was conducted. This systematic review was performed according to PRISMA guidelines. Results: A total of 146 studies were included, of which 34 were conducted in animals, 58 in humans, and 60 studies reported the role of different compounds that target AA mediators or their corresponding enzymes/ receptors, and can have a therapeutic effect in MS. These results suggest that eicosanoids have significant roles in experimental autoimmune encephalomyelitis (EAE) and MS. The data from animal and human studies elucidated that PGI2, PGF2α, PGD2, isoprostanes, PGE2, PLA2, LTs are increased in MS. PLA2 inhibition modulates the progression of the disease. PGE1 analogues can be a useful option in the treatment of MS. Conclusions: All studies reported the beneficial effects of COX and LOX inhibitors in MS. The hybrid compounds, such as COX-2 inhibitors/TP antagonists and 5-LOX inhibitors can be an innovative approach for multiple sclerosis treatment. Future work in MS should shed light in synthesizing new compounds targeting arachidonic acid pathway.


Arachidonic Acid Mediators and their Role in Neurological Disease
Malvina Hoxha
Bentham Science Publishers Ltd.
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Folic acid and autism: A systematic review of the current state of knowledge
Bianka Hoxha, Malvina Hoxha, Elisa Domi, Jacopo Gervasoni, Silvia Persichilli, Visar Malaj, and Bruno Zappacosta
MDPI AG
Folic acid has been identified to be integral in rapid tissue growth and cell division during fetal development. Different studies indicate folic acid’s importance in improving childhood behavioral outcomes and underline its role as a modifiable risk factor for autism spectrum disorders. The aim of this systematic review is to both elucidate the potential role of folic acid in autism spectrum disorders and to investigate the mechanisms involved. Studies have pointed out a potential beneficial effect of prenatal folic acid maternal supplementation (600 µg) on the risk of autism spectrum disorder onset, but opposite results have been reported as well. Folic acid and/or folinic acid supplementation in autism spectrum disorder diagnosed children has led to improvements, both in some neurologic and behavioral symptoms and in the concentration of one-carbon metabolites. Several authors report an increased frequency of serum auto-antibodies against folate receptor alpha (FRAA) in autism spectrum disorder children. Furthermore, methylene tetrahydrofolate reductase (MTHFR) polymorphisms showed a significant influence on ASD risk. More clinical trials, with a clear study design, with larger sample sizes and longer observation periods are necessary to be carried out to better evaluate the potential protective role of folic acid in autism spectrum disorder risk.


A systematic review on the role of sirt1 in duchenne muscular dystrophy
Elisa Domi, Malvina Hoxha, Emanuela Prendi, and Bruno Zappacosta
MDPI AG
Duchenne muscular dystrophy (DMD) is a muscular disease characterized by progressive muscle degeneration. Life expectancy is between 30 and 50 years, and death is correlated with cardiac or respiratory complications. Currently, there is no cure, so there is a great interest in new pharmacological targets. Sirtuin1 (SIRT1) seems to be a potential target for DMD. In muscle tissue, SIRT1 exerts anti-inflammatory and antioxidant effects. The aim of this study is to summarize all the findings of in vivo and in vitro literature studies about the potential role of SIRT1 in DMD. A systematic literature search was performed according to PRISMA guidelines. Twenty-three articles satisfied the eligibility criteria. It emerged that SIRT1 inhibition led to muscle fragility, while conversely its activation improved muscle function. Additionally, resveratrol, a SIRT1 activator, has brought beneficial effects to the skeletal, cardiac and respiratory muscles by exerting anti-inflammatory activity that leads to reduced myofiber wasting.


Montelukast Use Decreases Cardiovascular Events in Asthmatics
Malvina Hoxha, Calogero C. Tedesco, Silvana Quaglin, Visar Malaj, Linda Pustina, Valerie Capra, Jilly F. Evans, Angelo Sala, and G. Enrico Rovati
Frontiers Media SA
Cysteinyl leukotrienes are proinflammatory mediators with a clinically established role in asthma and a human genetic and preclinical role in cardiovascular pathology. Given that cardiovascular disease has a critical inflammatory component, the aim of this work was to conduct an observational study to verify whether the use of a cysteinyl leukotriene antagonist, namely, montelukast, may protect asthmatic patients from a major cardiovascular event and, therefore, represent an innovative adjunct therapy to target an inflammatory component in cardiovascular disease. We performed an observational retrospective 3-year study on eight hundred adult asthmatic patients 18 years or older in Albania, equally distributed into two cohorts, exposed or nonexposed to montelukast usage, matched by age and gender according to information reported in the data collection. Patients with a previous history of myocardial infarction or ischemic stroke were excluded. In summary, 37 (4.6%) of the asthmatic patients, 32 nonexposed, and five exposed to montelukast suffered a major cardiovascular event during the 3-year observation period. All the cardiovascular events, in either group, occurred among patients with an increased cardiovascular risk. Our analyses demonstrate that, independent from gender, exposure to montelukast remained a significant protective factor for incident ischemic events (78% or 76% risk reduction depending on type of analysis). The event-free Kaplan–Meier survival curves confirmed the lower cardiovascular event incidence in patients exposed to montelukast. Our data suggest that there is a potential preventative role of montelukast for incident cardiac ischemic events in the older asthmatic population, indicating a comorbidity benefit of montelukast usage in asthmatics by targeting cysteinyl leukotriene-driven cardiac disease inflammation.


The interaction between arachidonic acid metabolism and homocysteine
Elisa Domi, Malvina Hoxha, Bianka Hoxha, and Bruno Zappacosta
Bentham Science Publishers Ltd.
Hyperhomocysteinemia (HHcy) has been considered a risk factor for different diseases, including cardiovascular disease (CVD), inflammation, neurological diseases, cancer, and many other pathological conditions. Likewise, arachidonic acid (AA) metabolism is implicated in both vascular homeostasis and inflammation, as shown by the development of CVD, following the imbalance of its metabolites. This review summarizes how homocysteine (Hcy) can influence the metabolism of AA. In silico literature searches were performed on PubMed and Scopus as main sources. Several studies have shown that altered levels of Hcy, through AA release and metabolism, can influence the synthesis and the activity of prostaglandins (PGs), prostacyclin (PGI2), thromboxane (TXA), epoxyeicosatrienoic acids (EETs), and hydroxyeicosatetraenoic acids (HETEs). It is believed that by targeting Hcy in the AA pathways, novel compounds with better pharmacological and pharmacodynamics benefits may be obtained and that this information is valuable for a dietician to manipulate diets to improve health.


A case–control study: Evaluating the role of leukotriene receptor antagonists in preventing the cardiovascular and cerebrovascular disease
M. Hoxha, V. Malaj, M. Vara-Messler, C.R. Doce, and A.B. Cavanillas
Elsevier BV



What about COVID-19 and arachidonic acid pathway?
Malvina Hoxha
Springer Science and Business Media LLC



CYP-derived eicosanoids: Implications for rheumatoid arthritis
Malvina Hoxha and Bruno Zappacosta
Elsevier BV

RECENT SCHOLAR PUBLICATIONS

Mycotoxins and neuropsychiatric symptoms: possible role in special refugee populations
M Hoxha, M Abbasciano, G Avantaggiato, B Zappacosta, D Tricarico
Frontiers in Pharmacology 16, 1524152 2025



Pharmacoeconomic Evaluation of Costs of Myelomeningocele and Meningocele Treatment and Screening
M Hoxha, V Malaj, B Zappacosta, N Firza
ClinicoEconomics and Outcomes Research, 69-80 2024



Analysis of evidence on nutraceutical interventions for Peyronie’s disease: a guideline-based critical review
D Tienforti, M Hoxha, AB Di Pasquale, V Rizza, A Barbonetti
Sexual Medicine Reviews 12 (4), 747-753 2024



Estimating the Prevalence of Cognitive Impairment and Its Associated Factors in Albania: A Nationwide Cross-Sectional Study
M Hoxha, S Galgani, J Kruja, I Alimehmeti, V Rapo, F ipi, D Tricarico, ...
Brain Sciences 14 (10), 955 2024



Aflatoxins cardiotoxicity and ways to mitigation in humans
M Hoxha, M Abbasciano, B Zappacosta, G Avantaggiato, D Tricarico
Atherosclerosis 395 2024



The Current State of Knowledge on Osteoporosis in Holocaust Survivors and Their Descendants
M Hoxha, V Malaj
Rambam Maimonides Medical Journal 15 (2), e0009 2024



Reporting of adverse drug reactions by dentists and dental patients in Albania
M Hoxha, E Spahiu, M Spahiu, B Zappacosta
international dental journal 74 (2), 242-245 2024



Health economic evaluations of hemochromatosis screening and treatment: a systematic review
M Hoxha, V Malaj, B Zappacosta
PharmacoEconomics-Open 8 (2), 147-170 2024



A Questionnaire-based Survey of the Suspected Adverse Reactions Reporting Associated with Dietary and Herbal Supplements by Pharmacists and Patients in Albania
H Haxhiu, M Hoxha, B Zappacosta, V Malaj, N Firza
UNIVERSAL JOURNAL OF PUBLIC HEALTH 13, 1-10 2024



An overview of Albanian pharmacovigilance system and its harmonization with the European pharmacovigilance legislation
M Hoxha, B Zappacosta, M Franco
Biomedicine & Prevention Issues, 1 (249), 1-8 2024



Anxiety and depression in geriatric hemodialysis patients: factors that influence the border of diseases
B Elezi, E Abazaj, B Zappacosta, M Hoxha
Frontiers in Psychology 14, 1281878 2023



Respiratory symptoms and access to physiotherapy in children with cerebral palsy in Albania
M Hoxha, V Malaj, E Prendi, B Zappacosta
European Respiratory Journal 62 (suppl 67) 2023



Meteoropathy: a review on the current state of knowledge
M Hoxha, B Zappacosta
Journal of medicine and life 16 (6), 837 2023



Arachidonic acid pathways and male fertility: A systematic review
M Hoxha, A Barbonetti, B Zappacosta
International Journal of Molecular Sciences 24 (9), 8207 2023



A review on the role of fatty acids in colorectal cancer progression
M Hoxha, B Zappacosta
Frontiers in Pharmacology 13, 1032806 2022



Compatibility of prolonged infusion antibiotics during Y‐site administration
M Nunez‐Nunez, M Murillo‐Izquierdo, M Moya‐Martin, M Hoxha, ...
Nursing in Critical Care 27 (6), 849-858 2022



Cardiovascular disease and hyperhomocysteinemia: the role of eicosanoids
M Hoxha, E Kolovani, B Zappacosta
Atherosclerosis 355, 235-236 2022



COVID-19 and eicosanoids
M Hoxha, B Zappacosta
EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY 78 (SUPPL 1), S52-S52 2022



AB0097 EFFECT OF CYTOCHROME P450 METABOLITES OF ARACHIDONIC ACID IN RHEUMATOID ARTHRITIS
M Hoxha, V Malaj, B Zappacosta
Annals of the Rheumatic Diseases 81, 1179 2022



The Importance of Nutraceuticals in COVID-19: What’s the Role of Resveratrol?
E Domi, M Hoxha, E Kolovani, D Tricarico, B Zappacosta
Molecules 27 (8), 2376 2022

MOST CITED SCHOLAR PUBLICATIONS

What about COVID-19 and arachidonic acid pathway?
M Hoxha
European Journal of Clinical Pharmacology 2020
Citations: 92



A systematic review on the role of eicosanoid pathways in rheumatoid arthritis
M Hoxha
Advances in medical sciences 63 (1), 22-29 2018
Citations: 92



The leukotriene receptor antagonist montelukast and its possible role in the cardiovascular field
M Hoxha, GE Rovati, AB Cavanillas
European Journal of Clinical Pharmacology 73, 799-809 2017
Citations: 65



Folic acid and autism: a systematic review of the current state of knowledge
B Hoxha, M Hoxha, E Domi, J Gervasoni, S Persichilli, V Malaj, ...
Cells 10 (8), 1976 2021
Citations: 58



CYP-derived eicosanoids: Implications for rheumatoid arthritis
M Hoxha, B Zappacosta
Prostaglandins & Other Lipid Mediators 146, 106405 2020
Citations: 34



ATP-sensitive potassium channel subunits in neuroinflammation: novel drug targets in neurodegenerative disorders
F Maqoud, R Scala, M Hoxha, B Zappacosta, D Tricarico
CNS & Neurological Disorders-Drug Targets-CNS & Neurological Disorders) 21 2022
Citations: 33



Designing multitarget anti‐inflammatory agents: chemical modulation of the lumiracoxib structure toward dual thromboxane antagonists–COX‐2 inhibitors
M Bertinaria, MAAG Shaikh, C Buccellati, C Cena, B Rolando, ...
ChemMedChem 7 (9), 1647-1660 2012
Citations: 33



The Importance of Nutraceuticals in COVID-19: What’s the Role of Resveratrol?
E Domi, M Hoxha, E Kolovani, D Tricarico, B Zappacosta
Molecules 27 (8), 2376 2022
Citations: 27



Duchenne muscular dystrophy: Focus on arachidonic acid metabolites
M Hoxha
Biomedicine & pharmacotherapy 110, 796-802 2019
Citations: 27



A potential role of PUFAs and COXIBs in cancer chemoprevention
M Vara-Messler, C Buccellati, L Pustina, G Folco, GE Rovati, M Hoxha
Prostaglandins & other lipid mediators 120, 97-102 2015
Citations: 25



Potential role of leukotriene receptor antagonists in reducing cardiovascular and cerbrovascular risk: a systematic review of human clinical trials and in vivo animal studies
M Hoxha, AM Lewis-Mikhael, A Bueno-Cavanillas
Biomedicine & Pharmacotherapy 106, 956-965 2018
Citations: 23



Montelukast Use Decreases Cardiovascular Events in Asthmatics
GE Hoxha, M., Tedesco, C. C., Quaglin, S., Malaj, V., Pustina, L., Capra, V ...
Frontiers in Pharmacology 11 (611561), doi: 10.3389/fphar.2020.611561 2021
Citations: 19



In vitro pharmacological evaluation of multitarget agents for thromboxane prostanoid receptor antagonism and COX-2 inhibition
M Hoxha, C Buccellati, V Capra, D Garella, C Cena, B Rolando, ...
Pharmacological Research 103, 132-143 2016
Citations: 16



A review on the role of fatty acids in colorectal cancer progression
M Hoxha, B Zappacosta
Frontiers in Pharmacology 13, 1032806 2022
Citations: 15



Dentists knowledge about over the counter-NSAIDs: An emerging need for NSAID-avoidance education
M Hoxha, V Malaj, E Spahiu, M Spahiu
Journal of Applied Pharmaceutical Science 10 (1), 070-076 2020
Citations: 15



A Systematic Review on the Role of Arachidonic Acid Pathway in Multiple Sclerosis
Malvina Hoxha et al.
CNS & Neurological Disorders - Drug Targets 2020
Citations: 12



Arachidonic acid pathways and male fertility: A systematic review
M Hoxha, A Barbonetti, B Zappacosta
International Journal of Molecular Sciences 24 (9), 8207 2023
Citations: 11



THE INTERACTION BETWEEN ARACHIDONIC ACID METABOLISM AND HOMOCYSTEINE
E Domi, M Hoxha
19th European Congress of internal medicine 8 (1), DOI: 10.12890/2021_V8Sup1 2021
Citations: 8



Meteoropathy: a review on the current state of knowledge
M Hoxha, B Zappacosta
Journal of medicine and life 16 (6), 837 2023
Citations: 7



Arachidonic acid mediators and their role in neurological disease
M Hoxha
CNS & Neurological Disorders-Drug Targets (Formerly Current Drug Targets-CNS 2022
Citations: 7