The FDA has approved Cobenfy (BMS), an oral fixed-dose combination of the muscarinic agonist xanomeline and the peripheral muscarinic antagonist trospium chloride, for treatment of schizophrenia in adults. It is the first antipsychotic drug to be approved in the US for treatment of schizophrenia that does not block dopamine receptors. This is the first approval for xanomeline; trospium has been available for many years for treatment of overactive bladder.

The FDA has approved an oral tablet formulation of the glucagon-like peptide-1 (GLP-1) receptor agonist semaglutide (Wegovy) for chronic weight management in adults. It is the first oral GLP-1 receptor agonist to be approved in the US for weight management. An injectable formulation of Wegovy was approved for the same indication in 2021.1 The injectable GLP-1 receptor agonist liraglutide (Saxenda, and generic) and the injectable glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonist tirzepatide (Zepbound) are also FDA-approved for chronic weight management (see...

Yutrepia (Liquidia), a dry powder inhaler formulation of the prostacyclin analog treprostinil, has been approved by the FDA to improve exercise ability in adults with pulmonary arterial hypertension (PAH; WHO Group 1) or pulmonary hypertension associated with interstitial lung disease (PH-ILD; WHO Group 3). Tyvaso DPI, another treprostinil dry powder inhaler, was approved earlier for the same indication.

The FDA has approved use of oral leucovorin calcium (folinic acid) for treatment of cerebral folate transport deficiency in patients who have a confirmed variant in the folate receptor 1 gene (FOLR1-CFTD). It is the first drug to be approved for this extremely rare disorder.

Aficamten (Myqorzo – Cytokinetics), an oral cardiac myosin inhibitor, has been approved by the FDA to improve functional capacity and symptoms in adults with symptomatic obstructive hypertrophic cardiomyopathy (HCM). It is the second cardiac myosin inhibitor to be approved in the US for this indication; mavacamten (Camzyos) was approved in 2022.

Nonopioid drugs can be used in the treatment of many nociceptive and neuropathic pain conditions. For severe pain, especially severe chronic cancer pain, use of opioids may be necessary. Noninvasive nonpharmacologic treatments, including physical and psychological therapies, have been shown to improve pain and function in patients with some common chronic pain conditions and are unlikely to cause serious harms. A multimodal approach to analgesic therapy can increase pain control while reducing opioid use and adverse effects.

Cholesterol management guidelines from the American College of Cardiology/American Heart Association Task Force were last published in 2019.

A new CDC guideline for prescribing opioids for pain recently became available. Nonopioid drugs for pain were reviewed in a previous issue.

Anxiety disorders (generalized anxiety disorder, panic disorder, social anxiety disorder, and various phobias) are the most common form of psychiatric illness. They can be treated effectively with cognitive behavioral therapy (CBT) and/or pharmacotherapy.

The main goals of treatment of chronic obstructive pulmonary disease (COPD) are to relieve symptoms, reduce the frequency and severity of exacerbations, prevent disease progression, and reduce mortality. GOLD (Global Initiative for Chronic Obstructive Lung Disease) guidelines for treatment of COPD were updated recently. Treatment of acute exacerbations is not discussed here. Drugs available for treatment of COPD are listed in Tables 1 and 3.