1
In Brief: Subcutaneous Lecanemab (Leqembi Iqlik) for Initial Treatment of Alzheimer's Disease
The Medical Letter on Drugs and Therapeutics • September 14, 2026; (Issue 1763)
The FDA has approved Leqembi Iqlik, the subcutaneous
(SC) formulation of the amyloid beta-directed monoclonal
antibody lecanemab, for once-weekly initiation dosing in
patients with Alzheimer's disease (AD). The SC formulation
was previously approved only for maintenance treatment
in patients who had received IV lecanemab for at least
18 months.
2
Comparison Table: Triptans (online only)
The Medical Letter on Drugs and Therapeutics • September 14, 2026; (Issue 1763)
View the Comparison Table: Triptans
3
Comparison Table: Amyloid Beta-Directed Antibodies for Alzheimer's Disease (online only)
The Medical Letter on Drugs and Therapeutics • September 14, 2026; (Issue 1763)
View the Comparison Table: Amyloid Beta-Directed Antibodies for Alzheimer's Disease
4
In Brief: Rextovy — Another OTC Naloxone Nasal Spray
The Medical Letter on Drugs and Therapeutics • August 31, 2026; (Issue 1762)
The FDA has approved the over-the-counter (OTC) sale
of Rextovy (Amphastar), a nasal spray formulation of the
opioid antagonist naloxone, for emergency treatment of
opioid overdose. Other naloxone nasal sprays (Narcan,
and generics; RiVive) are also available OTC (see Table 1).
5
Treatment of Allergic Rhinitis and Allergic Conjunctivitis
The Medical Letter on Drugs and Therapeutics • March 31, 2025; (Issue 1725)
Initial treatment of allergic rhinitis (AR) depends
on the severity of symptoms and whether they are
intermittent or persistent (see Table 1).
6
Drugs for Acute Treatment of Migraine
The Medical Letter on Drugs and Therapeutics • September 14, 2026; (Issue 1763)
Treatment of migraine headache pain when it is still mild
to moderate in intensity improves response and reduces
the risk of recurrence. An oral nonopioid analgesic such
as a nonsteroidal anti-inflammatory drug (NSAID) or
acetaminophen is often sufficient for acute treatment of
mild to moderate migraine pain without severe nausea or
vomiting. When moderate to severe migraine pain is not
managed adequately with a nonopioid analgesic alone,
addition of a triptan is recommended.
7
mFLUSIVA — An mRNA-Based Influenza Vaccine
The Medical Letter on Drugs and Therapeutics • September 14, 2026; (Issue 1763)
The FDA has licensed mFLUSIVA (Moderna), the first
mRNA-based influenza vaccine in the US, for prevention of
influenza in adults ≥50 years old. mFLUSIVA will be available
for the 2026-2027 influenza season. Three mRNA COVID-19
vaccines (Comirnaty, Spikevax, and mNEXSPIKE) and one
mRNA RSV vaccine (mRESVIA) are also licensed in the US.
8
Enlicitide (Lipfendra) – An Oral PCSK9 Inhibitor for LDL-Cholesterol Lowering
The Medical Letter on Drugs and Therapeutics • August 31, 2026; (Issue 1762)
Enlicitide (Lipfendra – Merck), an oral proprotein convertase
subtilisin-kexin type 9 (PCSK9) inhibitor, has been approved
by the FDA to reduce low-density lipoprotein cholesterol
(LDL-C) in adults with hypercholesterolemia, including
heterozygous familial hypercholesterolemia (HeFH). It is the
first oral PCSK9 inhibitor to be approved in the US; the other
FDA-approved PCSK9 inhibitors (alirocumab [Praluent],
evolocumab [Repatha], and lerodalcibep [Lerochol]) and the
PCSK9-directed small interfering RNA inclisiran (Leqvio) are
injected subcutaneously. Lipfendra was approved under the
Commissioner's National Priority Voucher program, which
accelerates the FDA review process for drugs that align with
critical national health priorities.
9
Doravirine/Islatravir (Idvynso) for HIV
The Medical Letter on Drugs and Therapeutics • August 31, 2026; (Issue 1762)
The FDA has approved Idvynso (Merck), a once-daily
fixed-dose combination of the non-nucleoside reverse
transcriptase inhibitor (NNRTI) doravirine and the first-in-
class nucleoside reverse transcriptase translocation
inhibitor (NRTTI) islatravir, to replace the current anti-retroviral
(ARV) regimen in adults with HIV-1 infection who
are virologically suppressed (HIV-1 RNA <50 copies/mL)
on a stable ARV regimen with no history of virologic
treatment failure and no known substitutions associated
with resistance to doravirine. Idvynso is the first two-drug regimen for HIV that does not contain an integrase strand transfer inhibitor (INSTI) or tenofovir. Doravirine is also
available alone (Pifeltro) and in combination with lamivudine
and tenofovir disoproxil fumarate (Delstrigo).
10
Olezarsen (Tryngolza) for Severe Hypertriglyceridemia
The Medical Letter on Drugs and Therapeutics • August 31, 2026; (Issue 1762)
The FDA has approved olezarsen (Tryngolza – Ionis), a
subcutaneously injected apolipoprotein C-III (apoC-III)-directed antisense oligonucleotide, to reduce triglyceride
levels and the risk of acute pancreatitis in adults with severe
hypertriglyceridemia. Olezarsen and the apoC-III-directed
small interfering RNA plozasiran (Redemplo) were approved
earlier to reduce triglyceride levels in adults with familial
chylomicronemia syndrome (FCS).
