The FDA has approved clesrovimab-cfor (Enflonsia – Merck), a long-acting monoclonal antibody, for prevention of respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) in neonates and infants born during or entering their first RSV season. Clesrovimab is the second drug to be approved for this indication; nirsevimab (Beyfortus), another long-acting monoclonal antibody, was the first. Palivizumab (Synagis), a shorter-acting antibody, is FDA-approved for prevention of severe RSV LRTI in certain high-risk children ≤24 months old.

The FDA has approved the neonatal Fc receptor (FcRn) blocker nipocalimab (Imaavy – Janssen) for IV treatment of generalized myasthenia gravis (gMG) in patients ≥12 years old with anti-acetylcholine receptor (AChR) or anti-muscle-specific tyrosine kinase (MuSK) antibodies. The FcRn blocker rozanolixizumab (Rystiggo) was approved earlier for the same indication.

Ifosfamide (Ifex - Mead Johnson), a synthetic analog of cyclophosphamide (Cytoxan; and others), has been approved by the US Food and Drug Administration (FDA) for concurrent use with other drugs in third-line chemotherapy of metastatic germ-cell testicular cancer. Given concomitantly, a synthetic sulfhydryl compound known as mesna (Mesnex - Asta) acts in the urine to detoxify metabolites of ifosfamide that cause hemorrhagic cystitis (H Burkert, Cancer Treat Rev, 10 suppl A:175, 1983). Ifosfamide and mesna are available together from Bristol-Myers Oncology Division.

Etidronate (e ti droe' nate) disodium (Didronel - Norwich Eaton), an oral bisphosphonate available for many years for treatment of Paget's disease (Medical Letter, 20:78, 1978), recently has also been used for treatment of postmenopausal osteoporosis.

Podofilox 0.5% solution (Condylox - Oclassen) was recently approved by the US Food and Drug Administration for treatment of (condylomata acuminata). The drug requires a prescription, but is labeled for application by the patient. Similar topical solutions previously available for this indication are approved only for application by the physician.

Pravastatin - Bristol-Myers Squibb) and simvastatin (Zocor -Merck), two new inhibitors of cholesterol synthesis similar to lovastatin (Mevacor - Merck), have now been marketed in the USA for treatment of hypercholesterolemia. Lovastatin (Medical Letter, 29:99, 1987) is the most frequently prescribed of all cholesterol-lowering drugs in the USA. Pravastatin and simvastatin were previously reviewed in The Medical Letter when they became available in Canada (volume 33, page 18, 1991).

Nedocromil sodium (Tilade - Fisons), an anti-inflammatory drug similar to cromolyn sodium (Intal - Fisons), although chemically unrelated, is now available in the USA as a metered-dose inhaler for maintenance treatment of mild to moderate asthma.

Recombinant human deoxyribonuclease I (rhDNase; dornase alfa; Pulmozyme - Genentech), an enzyme that hydrolyzes extracellular DNA, is now available as a purified solution to decrease the viscosity of sputum in patients with cystic fibrosis. It requires a nebulizer to produce an aerosol mist for inhalation.

A 0.05% ophthalmic solution of levocabastine hydrochloride (Livostin - Iolab), a histamine H 1 -receptor antagonist, has been approved by the US Food and Drug Administration for treatment of seasonal allergic conjunctivitis. The new drug is a cyclohexylpiperidine derivative with no structural relationship to any other antihistamine.

Mycophenolate mofetil (CellCept - Roche) has been approved by the US Food and Drug Administration for oral use in preventing organ rejection in patients receiving allogeneic renal transplants. It is being promoted as an improvement over azathioprine (Imuran) for concurrent use with cyclosporine (Sandimmune; Neoral) and corticosteroids.