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Antiviral Drugs for COVID-19 in Vaccinated Outpatients

   
The Medical Letter on Drugs and Therapeutics • Mar 06, 2023  (Issue 1671)
in the US for treatment of high-risk (see Table 1),1 nonhospitalized adults with mild to moderate COVID-19: oral ...
Three products are currently available in the US for treatment of high-risk,1 nonhospitalized adults with mild to moderate COVID-19: oral ritonavir-boosted nirmatrelvir (Paxlovid), IV remdesivir (Veklury), and oral molnupiravir (Lagevrio). Remdesivir is FDA-approved for such use; nirmatrelvir/ritonavir and molnupiravir are available under an FDA Emergency Use Authorization. Because the pivotal clinical trials of these products for outpatient use were conducted in patients who were not vaccinated against COVID-19, some clinicians have questioned whether they can benefit vaccinated...
Med Lett Drugs Ther. 2023 Mar 6;65(1671):33-4   doi:10.58347/tml.2023.1671a | Show Introduction Hide Introduction

Live Fecal Microbiota (Rebyota) for Prevention of CDI Recurrence

   
The Medical Letter on Drugs and Therapeutics • Mar 06, 2023  (Issue 1671)
with multiple CDI recurrences.1 RECURRENT CDI — The recurrence rate after antibiotic treatment for an initial ...
The FDA has approved Rebyota (Ferring), a rectally-administered, live fecal microbiota suspension, for prevention of additional recurrences of Clostridioides difficile infection (CDI) following antibiotic treatment for a recurrent episode of CDI in adults. Rebyota is the first microbiome-based treatment to be approved for this indication. It is not approved for initial treatment of CDI. Fecal microbiota transplantation (FMT) has been used in patients with multiple CDI recurrences.
Med Lett Drugs Ther. 2023 Mar 6;65(1671):35-6   doi:10.58347/tml.2023.1671b | Show Introduction Hide Introduction

Ublituximab (Briumvi) for Relapsing Multiple Sclerosis

   
The Medical Letter on Drugs and Therapeutics • Mar 06, 2023  (Issue 1671)
) and SC ofatumumab (Kesimpta), are also FDA-approved for these indications.1,2 Table 1. Pharmacology ...
The FDA has approved the recombinant chimeric anti-CD20 antibody ublituximab-xiiy (Briumvi – TG Therapeutics) for IV treatment of adults with relapsing forms of multiple sclerosis (MS), including clinically isolated syndrome (initial neurological episode), relapsing-remitting disease, and active secondary progressive MS (SPMS). Two other anti-CD20 antibodies, IV ocrelizumab (Ocrevus) and SC ofatumumab (Kesimpta), are also FDA-approved for these indications.
Med Lett Drugs Ther. 2023 Mar 6;65(1671):36-8   doi:10.58347/tml.2023.1671c | Show Introduction Hide Introduction

Elacestrant (Orserdu) for Advanced or Metastatic Breast Cancer

   
The Medical Letter on Drugs and Therapeutics • Mar 06, 2023  (Issue 1671)
)-positive, human epidermal growth factor receptor 2 (HER2)-negative, estrogen receptor 1 (ESR1)-mutated ...
The FDA has approved elacestrant (Orserdu – Stemline), an oral estrogen receptor antagonist, for treatment of estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative, estrogen receptor 1 (ESR1)-mutated advanced or metastatic breast cancer in postmenopausal women or men who had disease progression following endocrine therapy. Elacestrant is the first oral selective estrogen receptor degrader (SERD) to be approved for treatment of breast cancer; the injectable SERD fulvestrant (Faslodex, and generics) was approved more than 20 years...
Med Lett Drugs Ther. 2023 Mar 6;65(1671):38-40   doi:10.58347/tml.2023.1671d | Show Introduction Hide Introduction

In Brief: Adstiladrin – A Gene Therapy for Bladder Cancer (online only)

   
The Medical Letter on Drugs and Therapeutics • Mar 06, 2023  (Issue 1671)
. The median duration of response was 9.7 months.1 ADVERSE EFFECTS — The most common adverse effects ...
Nadofaragene firadenovec-vncg (Adstiladrin – Ferring), an adenoviral vector-based gene therapy, has been approved by the FDA for treatment of adults with high-risk Bacillus Calmette-Guérin (BCG)-unresponsive non-muscle invasive bladder cancer (NMIBC) with carcinoma in situ with or without papillary tumors. It is the first adenoviral vector-based gene therapy to be approved in the US for this indication. The immune checkpoint inhibitor pembrolizumab (Keytruda) was approved for the same indication in 2021.
Med Lett Drugs Ther. 2023 Mar 6;65(1671):e40-1   doi:10.58347/tml.2023.1671e | Show Introduction Hide Introduction

Mosunetuzumab (Lunsumio) for Follicular Lymphoma (online only)

   
The Medical Letter on Drugs and Therapeutics • Mar 06, 2023  (Issue 1671)
follicular lymphoma.1,2 MECHANISM OF ACTION — Mosunetuzumab is a T-cell-engaging bispecific antibody ...
Mosunetuzumab-axgb (Lunsumio – Genentech), a bispecific CD20-directed CD3 T-cell engager, has received accelerated approval from the FDA for treatment of relapsed or refractory follicular lymphoma in adults who received ≥2 lines of systemic therapy. It is the first T-cell-engaging bispecific antibody to be approved in the US for this indication.
Med Lett Drugs Ther. 2023 Mar 6;65(1671):e41-2   doi:10.58347/tml.2023.1671f | Show Introduction Hide Introduction

In Brief: A New Breast Cancer Indication for Sacituzumab Govitecan (Trodelvy) (online only)

   
The Medical Letter on Drugs and Therapeutics • Mar 06, 2023  (Issue 1671)
platinum-based chemotherapy and a programmed death receptor-1 (PD-1) or programmed death-ligand 1 (PD-L1 ...
Sacituzumab govitecan-hziy (Trodelvy – Gilead) has been approved for treatment of unresectable locally advanced or metastatic hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer in adults who received prior endocrine therapy and ≥2 additional systemic therapies for metastatic disease. It was previously approved for treatment-refractory metastatic triplenegative breast cancer and for treatment of locally advanced or metastatic urothelial cancer in adults who received platinum-based chemotherapy and a programmed death receptor-1...
Med Lett Drugs Ther. 2023 Mar 6;65(1671):e43-4   doi:10.58347/tml.2023.1671g | Show Introduction Hide Introduction

In Brief: Expanded Access to Mifepristone

   
The Medical Letter on Drugs and Therapeutics • Feb 20, 2023  (Issue 1670)
to be dispensed by mail by certified prescribers or pharmacies.1 The FDA has now announced that certified retail ...
First approved in 2000 for termination of pregnancies of ≤49 days' gestation, the indication for the oral antiprogestin mifepristone (Mifeprex, and generics) was expanded in 2016 to include pregnancies of up to 10 weeks' gestation. A single 200-mg oral dose of mifepristone followed 24-48 hours later by a single 800-mcg buccal dose of the prostaglandin analog misoprostol terminates early intrauterine pregnancies in about 95% of women.
Med Lett Drugs Ther. 2023 Feb 20;65(1670):31   doi:10.58347/tml.2023.1670c | Show Introduction Hide Introduction

Drugs for Hypothyroidism

   
The Medical Letter on Drugs and Therapeutics • Feb 20, 2023  (Issue 1670)
, and others) is the drug of choice.1,2 LEVOTHYROXINE (LT4) — Pharmacokinetics – In healthy fasting adults ...
Primary hypothyroidism is usually the result of Hashimoto's (autoimmune) thyroiditis, thyroidectomy, or radioactive iodine therapy. Treatment of hypothyroidism with replacement doses of thyroid hormone is usually lifelong. Levothyroxine (LT4; synthetic thyroxine; Synthroid, and others) is the drug of choice.1
Med Lett Drugs Ther. 2023 Feb 20;65(1670):25-9   doi:10.58347/tml.2023.1670a | Show Introduction Hide Introduction

Deucravacitinib (Sotyktu) for Plaque Psoriasis

   
The Medical Letter on Drugs and Therapeutics • Feb 20, 2023  (Issue 1670)
as methotrexate, but its use is generally restricted to 1-2 years because of a risk of irreversible ...
The FDA has approved deucravacitinib (Sotyktu – BMS), an oral tyrosine kinase 2 (TYK2) inhibitor, for once-daily treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy. Deucravacitinib is the first selective TYK2 inhibitor to be approved in the US for any indication.
Med Lett Drugs Ther. 2023 Feb 20;65(1670):29-31   doi:10.58347/tml.2023.1670b | Show Introduction Hide Introduction