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Addendum: Statins for Primary Prevention of Cardiovascular Disease
The Medical Letter on Drugs and Therapeutics • Dec 05, 2016 (Issue 1509)
:133)
In our recent article on Lipid-Lowering Drugs,1 we said
that statins can reduce the risk ...
In our recent article on Lipid-Lowering Drugs,1 we said that statins can reduce the risk of first cardiovascular events and death (primary prevention) in patients at high risk for atherosclerotic cardiovascular disease (CVD) and significantly reduce the incidence of cardiovascular events in patients at lower risk for CVD. Now the United States Preventive Services Task Force (USPSTF) has issued new recommendations on the appropriate use of statins for primary prevention of CVD.2The USPSTF states that clinicians should periodically screen all persons 40-75 years old for cardiovascular risk...
Drugs for Head Lice
The Medical Letter on Drugs and Therapeutics • Nov 21, 2016 (Issue 1508)
, but especially
in elementary school children. In most cases,
transmission occurs by head-to-head contact.1 ...
Head lice infestation occurs in all age groups, but especially
in elementary school children. In most cases,
transmission occurs by head-to-head contact.
Minimed 670G: A Hybrid Closed-Loop Insulin Delivery System
The Medical Letter on Drugs and Therapeutics • Nov 21, 2016 (Issue 1508)
≥14 years old with type 1 diabetes. The system
uses an algorithm to automatically adjust basal ...
The FDA has approved the Minimed 670G (Medtronic),
a hybrid closed-loop insulin delivery system for use in
patients ≥14 years old with type 1 diabetes. The system
uses an algorithm to automatically adjust basal insulin
doses based on readings from a continuous glucose
monitor (CGM). It fully automates basal insulin
delivery in "auto" mode, but is considered a "hybrid"
system (not a true "artificial pancreas") because it
requires some action by the patient. The 670G system
is expected to become available in Spring 2017.
Lesinurad (Zurampic) for Gout-Associated Hyperuricemia
The Medical Letter on Drugs and Therapeutics • Nov 21, 2016 (Issue 1508)
has approved lesinurad (Zurampic –
Ironwood), a uric acid transporter 1 (URAT1)
inhibitor, for adjunctive ...
The FDA has approved lesinurad (Zurampic –
Ironwood), a uric acid transporter 1 (URAT1)
inhibitor, for adjunctive treatment of gout-associated
hyperuricemia in patients whose serum uric acid
levels fail to reach goal with xanthine oxidase
inhibitor monotherapy.
Eteplirsen (Exondys 51) for Duchenne Muscular Dystrophy
The Medical Letter on Drugs and Therapeutics • Nov 07, 2016 (Issue 1507)
of the protein dystrophin in
muscle cells. Dystrophin is essential for maintenance
of myocyte integrity.1 About ...
Eteplirsen (Exondys 51 – Sarepta), an antisense
oligonucleotide, has received accelerated approval
from the FDA for treatment of Duchenne muscular
dystrophy (DMD) in patients who have a mutation
of the dystrophin gene that is amenable to exon
51 skipping. It is the first drug to be approved for
treatment of DMD.
Metformin for Prediabetes
The Medical Letter on Drugs and Therapeutics • Nov 07, 2016 (Issue 1507)
.1 Metformin has not been approved for
such use by the FDA.
CLINICAL STUDIES — In the Diabetes ...
The oral biguanide metformin (Glucophage, and
others) is generally the drug of choice for initial
treatment of type 2 diabetes. It has also been used
to prevent or at least delay the onset of diabetes
in patients considered to be at high risk for the
disease. Recent guidelines recommend considering
use of metformin in patients with prediabetes
(fasting plasma glucose 100-125 mg/dL, 2-hr post-load
glucose 140-199 mg/dL, or A1C 5.7-6.4%),
especially in those who are <60 years old, have
a BMI >35 kg/m2, or have a history of gestational
diabetes. Metformin has not been approved...
In Brief: Hepatitis B Reactivation with Direct-Acting Antiviral Drugs for Hepatitis C
The Medical Letter on Drugs and Therapeutics • Oct 24, 2016 (Issue 1506)
warning about a risk of hepatitis B virus (HBV)
reactivation associated with their use.1
Table 1. Direct ...
The FDA recently announced that it will require the labeling of all direct-acting antiviral drugs used for treatment of hepatitis C virus (HCV) infection to include a boxed warning about a risk of hepatitis B virus (HBV) reactivation associated with their use.1Twenty-four cases of HBV reactivation occurring during treatment with direct-acting antiviral drugs for HCV were identified from the FDA Adverse Event Reporting System and the medical literature.2-5 Before starting direct-acting antiviral treatment for HCV, some of these patients were hepatitis B surface antigen (HbsAG) positive and...
Glycopyrrolate/Formoterol (Bevespi Aerosphere) for COPD
The Medical Letter on Drugs and Therapeutics • Oct 10, 2016 (Issue 1505)
. Glycopyrrolate/indacaterol (Utibron
Neohaler),1 umeclidinium/vilanterol (Anoro Ellipta),2
and tiotropium ...
The FDA has approved a fixed-dose combination of
the long-acting anticholinergic glycopyrrolate and
the long-acting beta2-adrenergic agonist (LABA)
formoterol (Bevespi Aerosphere – AstraZeneca) for
long-term maintenance treatment of patients with
chronic obstructive pulmonary disease (COPD).
Glycopyrrolate/formoterol is the fourth long-acting
anticholinergic/LABA combination to be approved in
the US, but the first to become available in a metered-dose
inhaler. Glycopyrrolate/indacaterol (Utibron
Neohaler), umeclidinium/vilanterol (Anoro Ellipta),
and tiotropium/olodaterol (Stiolto...
In Brief: Nitisinone Oral Suspension (Orfadin) for Hereditary Tyrosinemia (online only)
The Medical Letter on Drugs and Therapeutics • Oct 10, 2016 (Issue 1505)
) for treatment of hereditary
tyrosinemia type 1 (HT-1). Orfadin has been available in a
capsule formulation ...
The FDA has approved an oral suspension formulation of nitisinone (Orfadin – Sobi) for treatment of hereditary tyrosinemia type 1 (HT-1). Orfadin has been available in a capsule formulation in Canada since 1994 and in the US since 2002.HT-1 is an autosomal recessive genetic disorder (estimated birth prevalence: 1:100,000) caused by mutations in the gene responsible for formation of fumarylacetoacetate hydrolase (FAH), which catalyzes the last step in tyrosine metabolism. FAH deficiency results in accumulation of upstream toxic metabolites, causing liver and kidney failure and developmental...
In Brief: An Over-the-Counter Retinoid for Acne
The Medical Letter on Drugs and Therapeutics • Sep 26, 2016 (Issue 1504)
Differin Gel 0.1% (Galderma), a topical formulation of the
retinoid adapalene, will soon be available over ...
Differin Gel 0.1% (Galderma), a topical formulation of the retinoid adapalene, will soon be available over the counter (OTC) for once-daily treatment of acne in patients ≥12 years old. It is the first topical retinoid to be approved for sale over the counter.All topical retinoids normalize keratinization and appear to have anti-inflammatory effects; whether any one topical retinoid is more effective than any other is not clear. Many dermatologists now recommend topical retinoids for first-line treatment of acne; they can be used alone or in combination with antibiotics to treat both inflamed...