The FDA has approved the hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) vadadustat (Vafseo – Akebia) for oral treatment of anemia due to chronic kidney disease (CKD) in adults who have been on dialysis for at least 3 months. Vadadustat is the second HIF-PHI to be approved in the US for this indication; daprodustat (Jesduvroq) was approved earlier, but it was withdrawn from the US market in 2024 for commercial reasons.

The interleukin (IL)-23 antagonist guselkumab (Tremfya – Janssen Biotech) has now been approved by the FDA for treatment of moderately to severely active ulcerative colitis (UC) in adults; it was approved earlier for treatment of plaque psoriasis and psoriatic arthritis. Guselkumab is the third IL-23 antagonist to be approved in the US for treatment of UC; risankizumab (Skyrizi) and mirikizumab (Omvoh) were approved earlier.

The injectable interleukin (IL)-23 antagonist mirikizumab-mrkz (Omvoh – Lilly) is now FDA-approved for treatment of moderately to severely active Crohn's disease (CD) in adults. Mirikizumab was approved in 2023 for treatment of ulcerative colitis. Two other IL-23 antagonists, risankizumab (Skyrizi) and guselkumab (Tremfya), are also approved for treatment of CD.

The FDA has approved a 2% cream formulation of delgocitinib (Anzupgo – Leo), a Janus kinase (JAK) inhibitor, for treatment of moderate to severe chronic hand eczema (dermatitis) in adults who had an inadequate response to or are unable to use topical corticosteroids. Delgocitinib is the first drug to be approved in the US for this indication. Ruxolitinib, another JAK inhibitor, is available in a 1.5% cream formulation (Opzelura) for treatment of mild to moderate atopic dermatitis in patients ≥2 years old.

The FDA has approved changes to the wording of the cardiovascular risk reduction indications for the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors evolocumab (Repatha) and alirocumab (Praluent). Both drugs are now approved to reduce the risk of major adverse cardiovascular events (MACE) in adults at increased risk for these events; they were previously approved to reduce the risk of MACE only in patients with established cardiovascular disease (CVD).

The FDA has approved the second-generation antipsychotic drug lumateperone (Caplyta — Intra-Cellular Therapies) for adjunctive treatment of major depressive disorder (MDD) in adults. Lumateperone was approved earlier for treatment of schizophrenia and bipolar depression.

The FDA has approved depemokimab (Exdensur – GSK), a long-acting interleukin-5 (IL-5) antagonist, for add-on maintenance treatment of severe asthma characterized by an eosinophilic phenotype in patients ≥12 years old. Depemokimab is the fourth IL-5-directed treatment to be approved in the US for this indication; the IL-5 antagonists mepolizumab (Nucala) and reslizumab (Cinqair) and the IL-5 receptor alpha antagonist benralizumab (Fasenra) were approved earlier.

The FDA has approved pivmecillinam (Pivya – Utility Therapeutics), an oral penicillin-class antibacterial drug, for treatment of uncomplicated urinary tract infections (uUTIs) caused by susceptible isolates of Escherichia coli, Proteus mirabilis, or Staphylococcus saprophyticus in adult females. Pivmecillinam was approved by the FDA in 2024 but only recently became available in the US. It has been used in Europe for over 40 years.

The FDA has approved lerodalcibep (Lerochol – Lib Therapeutics), a subcutaneously injected proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, to reduce low-density lipoprotein cholesterol (LDL-C) in adults with hypercholesterolemia, including heterozygous familial hypercholesterolemia (HeFH). Lerodalcibep is the fourth subcutaneously injected PCSK9-directed therapy to be approved in the US; the monoclonal antibodies alirocumab (Praluent) and evolocumab (Repatha) and the small interfering RNA inclisiran (Leqvio) were approved earlier (see Table...

The drugs of choice for treatment of fungal infections are listed in the table that begins on page 62. Some of the indications and dosages recommended here have not been approved by the FDA. More detailed guidelines for some of these infections are available online from the Infectious Diseases Society of America (www.idsociety.org).