The FDA has approved two new drugs for treatment of previously-treated unresectable or metastatic human epidermal growth factor receptor 2 (HER2)-positive breast cancer: fam-trastuzumab deruxtecannxki (Enhertu – Daiichi-Sankyo/AstraZeneca), an IV HER2-directed monoclonal antibody linked to the topoisomerase I inhibitor DXd, and tucatinib (Tukysa – Seagen), an oral tyrosine kinase inhibitor.

The FDA has approved an extended-release fixed-dose combination of dextromethorphan and bupropion (Auvelity – Axsome) for treatment of major depressive disorder (MDD) in adults.

Liraglutide (Victoza – Novo Nordisk), a glucagon-like peptide-1 (GLP-1) receptor agonist given by subcutaneous injection, has been approved by the FDA for treatment of patients with type 2 diabetes. It can be used alone or in addition to oral antidiabetic drugs such as metformin (Glucophage, and others) or glimepiride (Amaryl, and others). Liraglutide is not recommended for first-line therapy and is not approved for use with insulin.

Cognitive behavioral therapy for insomnia (CBT-I) is recommended for initial treatment of chronic insomnia. CBT-I includes stimulus control, sleep education and hygiene, sleep restriction, relaxation training, and cognitive therapy. When CBT-I alone is not effective, pharmacologic treatment should be added.

Endoscopic injection of sclerosing agents is now widely accepted as a primary treatment for bleeding esophageal varices (J Terblanche et al, N Engl J Med, 320:1393, 1469, May 25 and June 1, 1989). Ethanolamine oleate 5% (Ethamolin - Glaxo), a sclerosing agent that has been available in Canada and abroad for many years, was recently approved for this indication by the US Food and Drug Administration (FDA).

Recombinant alpha interferon has been marketed in the USA for treatment of hairy-cell leukemia, genital warts, and AIDS-related Kaposi's sarcoma (Medical Letter, 28:78, 1986; 30:70, 1988). Recent reports indicate it may also be useful for treatment of chronic viral hepatitis. Recombinant alpha interferon is available as alfa-2a (Roferon-A - Roche) or alfa-2b (Intron A - Schering), which are identical except for one amino acid.

Metipranolol hydrocholride 0.3% (OptiPranolol - Bausch & Lomb), a nonselective beta-adrenergic receptor blocking drug, was recently marketed of ophthalmic use to decrease intraolular pressure in ocular hypertension or chronic open-angle glaucoma. Beta-blockers available in the USA for treatment of glaucoma are listed in this article.

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.

The Norplant System (Wyeth-Ayerst) for subdermal delivery of the synthetic progestin levonorgestrel was recently approved by the US Food and Drug Administration for use as a long-term contraceptive.

BCG Live (TheraCys - Connaught) and BCG Vaccine U.S.P. (TiceBCG - Organon), freeze-dried suspensions of an attenuated strain of Mycobacterium bovis, were recently approved by the US Food and Drug Administration for intravesical treatment of primary or relapsed carcinoma in situ of the bladder, with or without associated papillary tumors. BCG is not recommended for treatment of papillary tumors occurring alone.