The media recently reported that the FDA has threatened to withdraw Synthroid from the market, alarming many physicians and patients.

Antibiotic treatment of group A streptococcal pharyngitis can relieve symptoms, limit transmission of infection, and prevent suppurative and nonsuppurative sequelae. Clinical findings may be unreliable, however, in establishing the diagnosis, and conventional throat cultures take overnight or longer to produce results. Rapid office tests for streptococcal pharyngitis can make the diagnosis in about 10 minutes. Since the previous Medical Letter article on this subject (Medical Letter, 27:49, 1985), many new tests have been marketed, including some that use new technologies.

A long-pulse ruby laser (EpiLaser), has been cleared by the FDA for use in "permanent hair reduction."

The FDA has approved dimethyl fumarate (Tecfidera – Biogen Idec), formerly called BG-12, for treatment of relapsing forms of multiple sclerosis (MS). It is the third oral drug to be approved in recent years for this indication.

The FDA has approved revefenacin (Yupelri – Mylan/Theravance Biopharma), a long-acting antimuscarinic agent (LAMA) administered once daily by standard jet nebulizer, for maintenance treatment of chronic obstructive pulmonary disease (COPD). Revefenacin is the second nebulized LAMA to be approved for this indication; glycopyrrolate (Lonhala Magnair), which is administered twice daily with a portable handheld nebulizer, was the first.

Testing for drug use has become increasingly common, not only in health care, but also in drug rehabilitation, in the military, at the workplace, after accidents and in the criminal justice system. Performance-enhancing drugs such as anabolic steroids, growth hormone (Genotropin, and others) and erythropoietin (Procrit, Epogen) are not discussed here.

Decitabine (Dacogen - MGI Pharma), a pyrimidine nucleoside analog of cytidine, was approved by the FDA as an orphan drug for treatment of myelodysplastic syndromes (MDS), a heterogeneous group of clonal hemopathies that decrease production of normal blood elements (red cells, white cells and platelets) and are associated with a risk of progression to acute leukemia.

Rosacea is a common, chronic inflammatory facial eruption of unknown cause. It is more prevalent in women than in men, and disease onset typically occurs after age 30. Rosacea is characterized by erythema, telangiectasia, and flushing, and sometimes by recurrent, progressive crops of acneiform papules and pustules, usually on the central part of the face. Some patients develop granulomas and tissue hypertrophy, which may lead to rhinophyma (a bulbous nose), particularly in men. Blepharitis and conjunctivitis are common. Keratitis and corneal scarring occur rarely.

The FDA has approved Cabtreo (Bausch Health), a gel containing the retinoid adapalene, the oxidizing agent benzoyl peroxide, and the antibiotic clindamycin, for treatment of acne vulgaris in patients ≥12 years old. Cabtreo is the first three-drug topical formulation to become available in the US for treatment of acne.

The FDA has approved two new inhalers for long-term maintenance treatment of chronic obstructive pulmonary disease (COPD). Seebri Neohaler (Novartis) contains the long-acting anticholinergic glycopyrrolate. Utibron Neohaler (Novartis) contains both glycopyrrolate and the long-acting beta2-adrenergic agonist (LABA) indacaterol. Glycopyrrolate/indacaterol is the third fixed-dose combination of a long-acting anticholinergic and a LABA to become available in the US; umeclidinium/vilanterol (Anoro Ellipta) and tiotropium/olodaterol (Stiolto Respimat) were approved...