The FDA has approved the oral multikinase inhibitor midostaurin (Rydapt – Novartis) for first-line treatment, in addition to standard chemotherapy, of adults with FLT3 (fms-like tyrosine kinase 3) mutation-positive acute myeloid leukemia (AML). About 30% of patients with AML have FLT3 mutations. Midostaurin is also approved as a single agent for treatment of adults with aggressive systemic mastocytosis, systemic mastocytosis with associated hematological neoplasm, or mast-cell leukemia. In mastocytosis, midostaurin targets mutant c-KIT, not FLT3.In a randomized, double-blind trial, 717...

The sodium-glucose cotransporter 2 (SGLT2) inhibitor dapagliflozin (Farxiga – AstraZeneca) has been approved by the FDA for treatment of adults with chronic kidney disease (CKD) at risk of progression (not defined in the label). Dapagliflozin is the first SGLT2 inhibitor to be approved in the US for treatment of CKD.

Excessive exposure to ultraviolet (UV) radiation is associated with sunburn, photoaging, and skin cancer. Sunscreens are widely used to reduce these risks, but questions remain about their effectiveness and safety. The FDA has issued a proposed rule that would require manufacturers to perform additional safety studies for some sunscreen active ingredients and would mandate better UVA protection in sunscreen products. Some sunscreen products containing FDA-approved active ingredients are listed in Table 2.

The CDC has issued a recommendation for use of a single dose of doxycycline for post-exposure prophylaxis (PEP) of bacterial sexually transmitted infections (STIs), specifically syphilis, chlamydia, and gonorrhea, in men who have sex with men (MSM) and transgender women (TGW) who had a bacterial STI within the previous 12 months.

View the Table: GLP-1 and GIP/GLP-1 Receptor Agonists for Chronic Weight Management

A recent report in the New England Journal of Medicine suggested that in children with bacterial meningitis, adding the corticosteroid dexamethasone (Decadron; and others) to antibiotic treatment could decrease the incidence of moderate or severe hearing loss.

To avoid the morbidity and occasional mortality of transurethral resection or open prostatectomy, some urologists are now using balloon dilatation of the prostatic urethra to treat benign prostatic hypertrophy.

Accidental needlesticks can lead to infection with hepatitis viruses, human immunodeficiency virus, and other blood-borne bacterial, viral, and fungal pathogens (DK Henderson et al, Ann Intern Med, 113:740, 1990). Re-capping used needles is the most frequent cause of needlestick injuries (J Jagger et al, N Engl J Med, 319:284, 1988; MH Becker et al, Am J Infect Control, 18:232, 1990).

Many readers have asked the Medical Letter to evaluate St. John's wort, an herbal extract now widely sold in health food stores and pharmacies, for its effectiveness and safety in the treatment of depression. St. John's wort is licensed in Germany for treatment of anxiety, depression and insomnia. In the USA, it is considered a dietary supplement and has not been evaluated by the FDA.

Full-page advertisements in The New York Times and other newspapers have promoted use of the Crystal Ear hearing aid as an inexpensive rememdy for people with impaired hearing. Some patients may be asking their physicians about these devices.