The FDA has approved istradefylline (Nourianz — Kyowa Kirin), an oral adenosine A_2A receptor antagonist, for use as an adjunct to carbidopa/levodopa in adults with Parkinson's disease (PD) who experience "off" episodes. Istradefylline is the first adenosine A_2A receptor antagonist to be approved in the US; it has been available in Japan since 2013.

Icosapent ethyl (Vascepa – Amarin), the ethyl ester of eicosapentaenoic acid (EPA), has been approved by the FDA for use as an adjunct to maximally tolerated statin therapy to reduce the risk of major adverse cardiovascular events in adults with hypertriglyceridemia (≥150 mg/dL) who have either established cardiovascular disease (CVD) or diabetes and ≥2 additional risk factors for CVD. It is the only omega-3 polyunsaturated fatty acid (PUFA) product to be approved in the US for this indication. Icosapent ethyl and two other omega-3 PUFA prescription products (Lovaza, Epanova),...

The FDA has approved a progestin-only oral contraceptive ("minipill") containing drospirenone (Slynd – Exeltis). All other progestin-only oral contraceptives available in the US contain norethindrone (Camila, and others). Progestin-only oral contraceptives are similar in efficacy to combination oral contraceptives. They are used predominantly by breastfeeding women and by those in whom estrogen is poorly tolerated or contraindicated. Combination oral contraceptives containing drospirenone and ethinyl estradiol have been available for years.

Brolucizumab-dbll (Beovu — Novartis), a vascular endothelial growth factor (VEGF) inhibitor, has been approved by the FDA as an intravitreal injection for treatment of neovascular (wet) age-related macular degeneration (AMD). It is the fourth VEGF inhibitor to be approved in the US for this indication; bevacizumab (Avastin, and others), a VEGF inhibitor FDA-approved for treatment of breast cancer and other malignancies, has been used off-label for this indication for years.

The FDA has approved tafamidis, an oral transthyretin stabilizer, in 2 different formulations (see Table 1) for treatment of adults with transthyretin-mediated amyloid cardiomyopathy (ATTR-CM). Tafamidis is the first drug to be approved in the US for this indication. Patisiran (Onpattro), a transthyretin-directed small interfering RNA, and inotersen (Tegsedi), a transthyretin-directed antisense oligonucleotide, were both recently approved for hereditary transthyretin amyloid polyneuropathy.THE DISEASE — ATTR-CM is a progressive life-threatening disease caused by destabilization of the...

Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder that has been diagnosed in up to 10% of school-age children in the US and frequently persists into adulthood. A study in a large Danish cohort found that ADHD was associated with higher mortality rates in children, adolescents, and adults, mainly due to accidents. Pharmacologic treatment of ADHD in children has been reported to decrease the risk of substance abuse in adolescents, and use of ADHD medications in adults has been associated with a reduced risk of serious traffic accidents and...

The FDA has approved Trikafta (Vertex), a fixed-dose combination of the cystic fibrosis transmembrane conductance regulator (CFTR) modulators elexacaftor, tezacaftor, and ivacaftor, for oral treatment of cystic fibrosis (CF) in patients ≥12 years old who have at least one Phe508del mutation in the CFTR gene. About 90% of patients with CF have at least one copy of the Phe508del (also called F508del) mutation. This is the first approval for elexacaftor. Ivacaftor is available alone (Kalydeco) and in 2-drug combinations with tezacaftor (Symdeco) and lumacaftor...

Recently updated guidelines from the American Thoracic Society (ATS) and the Infectious Diseases Society of America (IDSA) address the use of corticosteroids as an adjunct to antimicrobials for treatment of community-acquired pneumonia (CAP).

Psoriatic arthritis is a chronic inflammatory arthropathy associated with psoriasis. A recent review found that about 20% of patients with psoriasis have psoriatic arthritis. Updated guidelines for treatment of psoriatic arthritis have recently been published.

The FDA has approved trifarotene 0.005% cream (Aklief – Galderma) for topical treatment of acne vulgaris in patients ≥9 years old. Trifarotene is the fourth topical retinoid to be approved in the US for treatment of acne; tretinoin (Retin-A, and others), adapalene (Differin, and generics), and tazarotene (Tazorac, and others) have been available by prescription for decades. Adapalene 0.1% gel has been available over the counter since 2016 for treatment of acne in patients ≥12 years old.