The CDC is recommending that persons at high risk of mpox (see Table 1) receive two doses of the Jynneos vaccine. The recommendation follows reports of a recent cluster of mpox cases in the US and warnings about the risk of a renewed outbreak during the spring and summer as people gather for festivals and other events. The CDC does not recommend routine immunization against mpox for the general population.

Astemizole (Hismanal - Janssen), a new antihistamine, was recently marketed in the USA for treatment of seasonal allergic rhinitis and chronic idiopathic urticaria. Like terfenadine (Seldane - Medical Letter, 27:65, 1985), astemizole is claimed to be no more sedating than placebo, but the new drug offers the advantage of a once-daily dosage schedule.

The US Food and Drug Administration (FDA) has approved two new retinoids for treatment of psoriasis. Tazarotene gel 0.05% and 0.1% (Tazorac - Allergan) is being marketed for topical use in patients with stable, mild to moderate plaque psoriasis. Acitretin (Soriatane - Roche) is being promoted for systemic use in severe psoriasis.

Zolmitriptan (Zomig - Zeneca), a selective serotonin (5-HT1)-receptor agonist, is now available in the USA for oral treatment of migraine headache. Zomitriptan structurally resembles sumatriptan (Imitrex - Medical Letter 34:91, 1992). Drugs currently used for acute treatment of migraine include injectable, oral and nasal spray formulations of sumaptriptan, injectable dihydroergotamine, dihydroergotamine nasal spray, ergotamine tartrate alone or with caffeine, and various analgesics. Anoterh 5-HT1-receptor agonist, naratriptan (Amerge - Gaxo Wellcome), has been approved by the FDA but has not...

Argatroban, a small-molecule synthetic derivative of L-arginine, is a direct thrombin inhibitor approved by the FDA for use as an anticoagulant in patients with heparin-induced thrombocytopenia (HIT).

In the past 2 years, the FDA has approved 3 new drugs for prevention or treatment of hereditary angioedema (HAE) in non-pregnant adolescents and adults: the C1 esterase inhibitor Cinryze for prophylaxis and the C1 esterase inhibitor Berinert and the kallikrein inhibitor ecallantide (Kalbitor) for treatment of acute attacks.

The FDA has approved the oral direct thrombin inhibitor dabigatran (da big’ a tran) etexilate (Pradaxa – Boehringer Ingelheim) for prevention of thromboembolic stroke in patients with non-valvular atrial fibrillation. It has been available in Canada (Pradax) since 2008 for prevention of thromboembolism in patients undergoing knee or hip replacement surgery and was recently approved there for use in atrial fibrillation.

The FDA has approved ferric carboxymaltose (Injectafer – American Regent), a 2-dose intravenous iron replacement product, for treatment of iron deficiency anemia (IDA) in adults who cannot tolerate or have had an unsatisfactory response to oral iron and in those who have non-dialysis-dependent chronic kidney disease (CKD). It is the sixth IV iron product approved in the US.

The FDA has approved efinaconazole 10% solution (Jublia – Valeant) for topical treatment of toenail onychomycosis due to Trichophyton rubrum and/or Trichophyton mentagrophytes. It is the first topical triazole antifungal drug to be approved for this indication. A topical oxaborole antifungal solution, tavaborole 5% (Kerydin – Anacor), also recently approved by the FDA for the same indication will be reviewed in a future issue.

The FDA has approved Incruse Ellipta (GSK), a single-agent inhaler containing the long-acting anticholinergic umeclidinium, for once-daily maintenance treatment of chronic obstructive pulmonary disease (COPD). Umeclidinium was initially approved in combination with the long-acting beta₂-adrenergic agonist vilanterol as Anoro Ellipta.