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Rozanolixizumab (Rystiggo) for Myasthenia Gravis

   
The Medical Letter on Drugs and Therapeutics • Feb 19, 2024  (Issue 1696)
or thymectomy.3,4 Off-label use of the anti-CD20 antibody rituximab (Rituxan, and others) in these patients ...
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...
Med Lett Drugs Ther. 2024 Feb 19;66(1696):29-31   doi:10.58347/tml.2024.1696c |  Show IntroductionHide Introduction

Nemolizumab (Nemluvio) for Atopic Dermatitis

   
The Medical Letter on Drugs and Therapeutics • Feb 17, 2025  (Issue 1722)
, and azathioprine have been used off-label for treatment of severe refractory atopic dermatitis. Oral cortico ...
Nemolizumab (Nemluvio – Galderma), a subcutaneously injected interleukin-31 (IL-31) receptor antagonist, has been approved by the FDA for use in combination with topical corticosteroids and/or calcineurin inhibitors for treatment of moderate to severe atopic dermatitis in patients ≥12 years old whose disease is not adequately controlled with topical prescription drugs. It is the first IL-31 receptor antagonist to be approved in the US for this indication. Nemolizumab was approved earlier for treatment of prurigo nodularis in adults.
Med Lett Drugs Ther. 2025 Feb 17;67(1722):25-7   doi:10.58347/tml.2025.1722a |  Show IntroductionHide Introduction

Drugs for Migraine

   
The Medical Letter on Drugs and Therapeutics • Jun 12, 2023  (Issue 1678)
. Other NSAIDs such as ibuprofen and naproxen are often used off-label. 4. Also approved for use in patients 12 ...
An oral nonopioid analgesic is often sufficient for acute treatment of mild to moderate migraine pain without severe nausea or vomiting. A triptan is the drug of choice for treatment of moderate to severe migraine in most patients without vascular disease. Treatment of pain when it is still mild to moderate in intensity improves headache response and reduces the risk of recurrence.
Med Lett Drugs Ther. 2023 Jun 12;65(1678):89-96   doi:10.58347/tml.2023.1678a |  Show IntroductionHide Introduction

Drugs for Chronic Insomnia

   
The Medical Letter on Drugs and Therapeutics • Jan 09, 2023  (Issue 1667)
, has been used off-label for this indication. Tolerance to the sedative effects of benzodiazepine receptor ...
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.
Med Lett Drugs Ther. 2023 Jan 9;65(1667):1-6   doi:10.58347/tml.2023.1667a |  Show IntroductionHide Introduction

Clascoterone Cream (Winlevi) for Acne

   
The Medical Letter on Drugs and Therapeutics • Dec 27, 2021  (Issue 1640)
patients. Spironolactone, an oral anti-androgen aldosterone receptor antagonist, has been used off-label ...
The FDA has approved Winlevi (Sun), a 1% cream formulation of the androgen receptor inhibitor clascoterone, for treatment of acne vulgaris in patients ≥12 years old. It is the first topical androgen receptor inhibitor to be approved by the FDA.
Med Lett Drugs Ther. 2021 Dec 27;63(1640):202-4 |  Show IntroductionHide Introduction

Expanded Table: Some Oral Drugs for Chronic Insomnia (online only)

   
The Medical Letter on Drugs and Therapeutics • Jan 09, 2023  (Issue 1667)
has been used off-label for insomnia following middle-ofthe- night awakening Onset of eszopiclone ...
View the Expanded Table: Some Oral Drugs for Chronic Insomnia
Med Lett Drugs Ther. 2023 Jan 9;65(1667):e6-10   doi:10.58347/tml.2023.1667b |  Show IntroductionHide Introduction

Drugs for Cognitive Loss and Dementia

   
The Medical Letter on Drugs and Therapeutics • Aug 22, 2022  (Issue 1657)
(1657) August 22, 2022 134 ANTIPSYCHOTICS Antipsychotic drugs are widely used off-label to treat ...
Alzheimer's disease (AD) is the most common cause of dementia, but cognitive decline is also associated with other neurological conditions such as Parkinson's disease, dementia with Lewy bodies, vascular dementia, and frontotemporal dementia.
Med Lett Drugs Ther. 2022 Aug 22;64(1657):129-36 |  Show IntroductionHide Introduction

Drugs for Chronic Heart Failure

   
The Medical Letter on Drugs and Therapeutics • May 26, 2025  (Issue 1729)
for treatment of HF; losartan has been used off-label.7 The Medical Letter ® Vol. 67 (1729) May 26, 2025 ...
Pharmacologic management of chronic heart failure (HF) is primarily determined by the patient's left ventricular ejection fraction (LVEF) and severity of symptoms. Patients with chronic HF who have an LVEF ≤40% are considered to have heart failure with reduced ejection fraction (HFrEF) and those with an LVEF ≥50% are considered to have heart failure with preserved ejection fraction (HFpEF). Patients with an LVEF of 41-49% have heart failure with mildly reduced or mid-range ejection fraction.
Med Lett Drugs Ther. 2025 May 26;67(1729):81-8   doi:10.58347/tml.2025.1729a |  Show IntroductionHide Introduction

Daridorexant (Quviviq) for Insomnia

   
The Medical Letter on Drugs and Therapeutics • Jul 11, 2022  (Issue 1654)
antipsychotic. The antidepressants trazodone and mirtazapine (Remeron, and generics) are often used off-label ...
The FDA has approved daridorexant (Quviviq – Idorsia), an orexin receptor antagonist, for treatment of sleep-onset and/or sleep-maintenance insomnia in adults. Daridorexant is the third orexin receptor antagonist to be approved for this indication; suvorexant (Belsomra) and lemborexant (Dayvigo) were approved earlier.
Med Lett Drugs Ther. 2022 Jul 11;64(1654):107-10 |  Show IntroductionHide Introduction

Two Vaccines (Arexvy and Abrysvo) for Prevention of RSV Disease

   
The Medical Letter on Drugs and Therapeutics • Oct 02, 2023  (Issue 1686)
to be offered to those who remain unvaccinated because some off-season RSV circulation is possible ...
Two recombinant vaccines, Arexvy (GSK) and Abrysvo (Pfizer), have been approved by the FDA for prevention of lower respiratory tract disease (LRTD) caused by respiratory syncytial virus (RSV) in adults ≥60 years old. They are the first RSV vaccines to be approved in the US. Abrysvo is also approved for use in pregnant women at 32-36 weeks' gestation to prevent LRTD caused by RSV in their infants from birth through 6 months of age.
Med Lett Drugs Ther. 2023 Oct 2;65(1686):155-6   doi:10.58347/tml.2023.1686a |  Show IntroductionHide Introduction