The FDA has licensed Adacel (Aventis Pasteur) and Boostrix (GlaxoSmithKline), two new combination vaccines that include tetanus toxoid, diphtheria toxoid and acellular pertussis antigens (Tdap), for use as a booster in adolescents and adults. In the past, older children and adults were not re-immunized against pertussis because of concerns about reactions to the whole-cell vaccine previously used in younger children. The CDC Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics (AAP) have recommended that either of the new Tdap vaccines replace routine...

The FDA has licensed 4 new monovalent vaccines for prevention of respiratory illness caused by a new influenza A H1N1 virus that appears to be derived from a swine strain. The 5th vaccine should be licensed soon. All of these vaccines are expected to become available in October. An intranasal formulation is expected in the first week of October.

Dapagliflozin (dap" a gli fl oe' zin; Farxiga – Bristol-Myers Squibb/AstraZeneca), an SGLT2 (sodium-glucose co-transporter 2) inhibitor, has been approved by the FDA for oral treatment of type 2 diabetes. Dapagliflozin is the second SGLT2 inhibitor to be approved for this indication; canagliflozin (Invokana) was the first .

The FDA has approved oteseconazole (Vivjoa – Mycovia), a new oral azole antifungal, to reduce the incidence of recurrent vulvovaginal candidiasis (RVVC) in females with a history of RVVC. Oteseconazole is the first drug to be approved in the US specifically for treatment of RVVC.

The FDA has approved the oral Janus kinase (JAK) inhibitor upadacitinib (Rinvoq – Abbvie) for treatment of moderately to severely active ulcerative colitis in adults who have had an inadequate response to or cannot tolerate one or more tumor necrosis factor (TNF) inhibitors. Upadacitinib is the second JAK inhibitor to be approved for this indication; tofacitinib (Xeljanz) was the first. Upadacitinib is also approved for treatment of rheumatoid arthritis, psoriatic arthritis, atopic dermatitis, and ankylosing spondylitis.

Rozanolixizumab-noli (Rystiggo – UCB), a neonatal Fc receptor (FcRn) blocker, has been approved by the FDA for treatment of generalized myasthenia gravis in adults with anti-acetylcholine receptor (AChR) or anti-muscle-specific tyrosine kinase (MuSK) antibodies. It is the first drug to be approved for treatment of generalized myasthenia gravis in patients with anti-MuSK antibodies. Four other biologic drugs – the FcRn blocker efgartigimod alfa (Vyvgart; Vyvgart Hytrulo) and the complement inhibitors eculizumab (Soliris), ravulizumab (Ultomiris), and zilucoplan (Zilbrysq) – are...

Soft contact lenses have been in use for more than 20 years. Since the last Medical Letter review (vol. 24, page 109, 1982), new products have been developed, and some problems have emerged.

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.

Almost 300,000 cases of epidemic cholera have occurred in the Western Hemisphere in 1991, mostly in South and Central America (Morbid Mortal Weekly Rep, 40:562, Aug 16, 1991). The few US cases caused by the epidemic strain have been in returning travelers or associated with contaminated food they brought back illicitly, with no secondary spread to date.

Infliximab, a monoclonal antibody that inhibits tumor necrosis factor, has received an accelerated approval from the FDA for intravenous treatment of moderate to severe Crohn's disease refractory to other medical treatment.