Matching articles for "infliximab"
Risankizumab (Skyrizi) for Ulcerative Colitis
The Medical Letter on Drugs and Therapeutics • November 11, 2024; (Issue 1715)
The injectable interleukin (IL)-23 antagonist
risankizumab-rzza (Skyrizi – Abbvie), previously
approved by the FDA for treatment of Crohn's disease
(CD), has now been approved for treatment of
moderately...
The injectable interleukin (IL)-23 antagonist
risankizumab-rzza (Skyrizi – Abbvie), previously
approved by the FDA for treatment of Crohn's disease
(CD), has now been approved for treatment of
moderately to severely active ulcerative colitis (UC)
in adults. Risankizumab is the first IL-23 antagonist
to be approved for treatment of both CD and UC. It is
also approved for treatment of plaque psoriasis and
psoriatic arthritis.
Drugs for Plaque Psoriasis
The Medical Letter on Drugs and Therapeutics • September 30, 2024; (Issue 1712)
Mild to moderate plaque psoriasis can be treated
with topical drugs and phototherapy. Patients
with moderate to severe disease generally require
systemic therapy. Guidelines for the treatment of
psoriasis...
Mild to moderate plaque psoriasis can be treated
with topical drugs and phototherapy. Patients
with moderate to severe disease generally require
systemic therapy. Guidelines for the treatment of
psoriasis with topical therapy, phototherapy, and
systemic drugs have recently been published.
Comparison Table: Some Drugs for Plaque Psoriasis (online only)
The Medical Letter on Drugs and Therapeutics • September 30, 2024; (Issue 1712)
...
View the Comparison Table: Some Drugs for Plaque Psoriasis
Mirikizumab (Omvoh) for Ulcerative Colitis
The Medical Letter on Drugs and Therapeutics • March 18, 2024; (Issue 1698)
The FDA has approved the interleukin (IL)-23
antagonist mirikizumab-mrkz (Omvoh – Lilly) for
treatment of moderately to severely active ulcerative
colitis (UC) in adults. Mirikizumab is the first...
The FDA has approved the interleukin (IL)-23
antagonist mirikizumab-mrkz (Omvoh – Lilly) for
treatment of moderately to severely active ulcerative
colitis (UC) in adults. Mirikizumab is the first selective
IL-23 antagonist to be approved for this indication.
Ustekinumab (Stelara), an IL-12/23 antagonist, was
approved for treatment of UC in 2019. The IL-23
antagonist risankizumab (Skyrizi) is approved for
treatment of Crohn's disease.
Bimekizumab (Bimzelx) for Psoriasis
The Medical Letter on Drugs and Therapeutics • January 22, 2024; (Issue 1694)
The FDA has approved the injectable interleukin (IL)-17A/17F antagonist bimekizumab-bkzx (Bimzelx
– UCB) for treatment of moderate to severe plaque
psoriasis in adults who are candidates for...
The FDA has approved the injectable interleukin (IL)-17A/17F antagonist bimekizumab-bkzx (Bimzelx
– UCB) for treatment of moderate to severe plaque
psoriasis in adults who are candidates for systemic
treatment or phototherapy. Bimekizumab is the first
IL-17A/17F antagonist to be approved in the US. It
was approved in the European Union for the same
indication in 2021.
Drugs for Inflammatory Bowel Disease
The Medical Letter on Drugs and Therapeutics • July 10, 2023; (Issue 1680)
Ulcerative colitis (UC) and Crohn's disease (CD),
referred to collectively as inflammatory bowel disease
(IBD), are chronic immune-mediated inflammatory
conditions. Guidelines for treatment of UC and...
Ulcerative colitis (UC) and Crohn's disease (CD),
referred to collectively as inflammatory bowel disease
(IBD), are chronic immune-mediated inflammatory
conditions. Guidelines for treatment of UC and CD
have been updated in recent years
Expanded Table: Some Drugs for Inflammatory Bowel Disease (online only)
The Medical Letter on Drugs and Therapeutics • July 10, 2023; (Issue 1680)
...
View the Table: Some Drugs for Inflammatory Bowel Disease
Expanded Table: Some Drugs for Inflammatory Bowel Disease (online only)
The Medical Letter on Drugs and Therapeutics • July 10, 2023; (Issue 1680)
...
View the Table: Some Drugs for Inflammatory Bowel Disease
Risankizumab (Skyrizi) - An IL-23 Antagonist for Crohn's Disease
The Medical Letter on Drugs and Therapeutics • December 26, 2022; (Issue 1666)
The injectable interleukin (IL)-23 antagonist
risankizumab-rzaa (Skyrizi – Abbvie) has been
approved by the FDA for treatment of moderately
to severely active Crohn's disease (CD) in adults.
Risankizumab...
The injectable interleukin (IL)-23 antagonist
risankizumab-rzaa (Skyrizi – Abbvie) has been
approved by the FDA for treatment of moderately
to severely active Crohn's disease (CD) in adults.
Risankizumab was approved earlier for treatment of
plaque psoriasis and psoriatic arthritis.
Upadacitinib (Rinvoq): A Second JAK Inhibitor for Ulcerative Colitis
The Medical Letter on Drugs and Therapeutics • September 5, 2022; (Issue 1658)
The FDA has approved the oral Janus kinase (JAK)
inhibitor upadacitinib (Rinvoq – Abbvie) for treatment
of moderately to severely active ulcerative colitis in
adults who have had an inadequate response to...
The FDA has approved the oral Janus kinase (JAK)
inhibitor upadacitinib (Rinvoq – Abbvie) for treatment
of moderately to severely active ulcerative colitis in
adults who have had an inadequate response to or
cannot tolerate one or more tumor necrosis factor
(TNF) inhibitors. Upadacitinib is the second JAK
inhibitor to be approved for this indication; tofacitinib
(Xeljanz) was the first. Upadacitinib is also approved
for treatment of rheumatoid arthritis, psoriatic
arthritis, atopic dermatitis, and ankylosing spondylitis.
Drugs for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • November 15, 2021; (Issue 1637)
Rheumatoid arthritis (RA) is prevalent in 0.5% of
adults in the US; it is about 2.5 times more common
in women than in men. Guidelines for treatment
of RA from the American College of Rheumatology
were...
Rheumatoid arthritis (RA) is prevalent in 0.5% of
adults in the US; it is about 2.5 times more common
in women than in men. Guidelines for treatment
of RA from the American College of Rheumatology
were recently updated. The goal of treatment is to
minimize disease activity and prevent irreversible
joint damage.
Expanded Table: Some Biologic Drugs and JAK Inhibitors for Rheumatoid Arthritis (online only)
The Medical Letter on Drugs and Therapeutics • November 15, 2021; (Issue 1637)
...
View Expanded Table: Some Biologic Drugs and JAK Inhibitors for Rheumatoid Arthritis
Flowchart: Rheumatoid Arthritis Treatment (online only)
The Medical Letter on Drugs and Therapeutics • November 15, 2021; (Issue 1637)
...
View the Flowchart: Rheumatoid Arthritis Treatment
Ozanimod (Zeposia) for Ulcerative Colitis
The Medical Letter on Drugs and Therapeutics • September 20, 2021; (Issue 1633)
The oral sphingosine 1-phosphate (S1P) receptor
modulator ozanimod (Zeposia – Bristol Myers Squibb)
has been approved by the FDA for treatment of adults
with moderately to severely active ulcerative...
The oral sphingosine 1-phosphate (S1P) receptor
modulator ozanimod (Zeposia – Bristol Myers Squibb)
has been approved by the FDA for treatment of adults
with moderately to severely active ulcerative colitis. It
is the first S1P receptor modulator to be approved for
treatment of ulcerative colitis. Ozanimod was approved
in March 2020 for use in adults with relapsing forms of
multiple sclerosis.
Drugs for Psoriatic Arthritis
The Medical Letter on Drugs and Therapeutics • December 30, 2019; (Issue 1588)
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...
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.
Drugs for Psoriasis
The Medical Letter on Drugs and Therapeutics • June 17, 2019; (Issue 1574)
Mild to moderate psoriasis can be treated with topical
drugs or with phototherapy. Patients with moderate to
severe disease generally require systemic...
Mild to moderate psoriasis can be treated with topical
drugs or with phototherapy. Patients with moderate to
severe disease generally require systemic therapy.
Expanded Table: Some Drugs for Psoriasis (online only)
The Medical Letter on Drugs and Therapeutics • June 17, 2019; (Issue 1574)
...
View the Expanded Table: Some Drugs for Psoriasis
Risankizumab (Skyrizi) for Psoriasis
The Medical Letter on Drugs and Therapeutics • June 3, 2019; (Issue 1573)
The FDA has approved the interleukin (IL)-23
antagonist risankizumab-rzaa (Skyrizi – Abbvie) for
treatment of moderate to severe plaque psoriasis in
adults. Risankizumab is the third IL-23 antagonist...
The FDA has approved the interleukin (IL)-23
antagonist risankizumab-rzaa (Skyrizi – Abbvie) for
treatment of moderate to severe plaque psoriasis in
adults. Risankizumab is the third IL-23 antagonist to
be approved for this indication; guselkumab (Tremfya)
and tildrakizumab (Ilumya) were approved earlier.
Tildrakizumab (Ilumya) - Another IL-23 Antagonist for Psoriasis
The Medical Letter on Drugs and Therapeutics • January 14, 2019; (Issue 1563)
Tildrakizumab-asmn (Ilumya – Sun), an interleukin
(IL)-23 antagonist, has been approved by the FDA for
treatment of adults with moderate to severe plaque
psoriasis who are candidates for systemic therapy...
Tildrakizumab-asmn (Ilumya – Sun), an interleukin
(IL)-23 antagonist, has been approved by the FDA for
treatment of adults with moderate to severe plaque
psoriasis who are candidates for systemic therapy or
phototherapy. Tildrakizumab is the second selective
IL-23 antagonist to be approved for this indication;
guselkumab (Tremfya) was the first.
Drugs for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • July 30, 2018; (Issue 1552)
Disease-modifying antirheumatic drugs (DMARDs)
are used for initial treatment of rheumatoid arthritis
(RA) to achieve clinical remission and prevent
irreversible joint damage (see Table 1). DMARDs
generally...
Disease-modifying antirheumatic drugs (DMARDs)
are used for initial treatment of rheumatoid arthritis
(RA) to achieve clinical remission and prevent
irreversible joint damage (see Table 1). DMARDs
generally do not have an immediate analgesic effect,
but over time they can control symptoms and have
been shown to delay and possibly stop progression
of the disease. Methotrexate (Trexall, and others)
is generally the drug of choice; it can be used for
patients with low, moderate, or high disease activity.
For mild disease, some clinicians prefer to start with
hydroxychloroquine (Plaquenil, and generics) and/or
sulfasalazine (Azulfidine, and others).
Drugs for Inflammatory Bowel Disease
The Medical Letter on Drugs and Therapeutics • July 2, 2018; (Issue 1550)
Management of both ulcerative colitis (UC) and Crohn's
disease (CD) is based on disease severity. Disease
location (proctitis, left-sided colitis, or extensive
colitis) also plays a role in drug selection....
Management of both ulcerative colitis (UC) and Crohn's
disease (CD) is based on disease severity. Disease
location (proctitis, left-sided colitis, or extensive
colitis) also plays a role in drug selection. Some
drugs for induction and maintenance of remission of
inflammatory bowel disease (IBD) are listed in Table 1.
Expanded Table: Some Drugs for Inflammatory Bowel Disease (online only)
The Medical Letter on Drugs and Therapeutics • July 2, 2018; (Issue 1550)
...
View Expanded Table: Some Drugs for Inflammatory Bowel Disease
Table: Drugs for Ulcerative Colitis (online only)
The Medical Letter on Drugs and Therapeutics • July 2, 2018; (Issue 1550)
...
View Table: Drugs for Ulcerative Colitis
Table: Drugs for Crohn's Disease (online only)
The Medical Letter on Drugs and Therapeutics • July 2, 2018; (Issue 1550)
...
View Table: Drugs for Crohn's Disease
Table: Safety of Drugs for IBD in Pregnancy (online only)
The Medical Letter on Drugs and Therapeutics • July 2, 2018; (Issue 1550)
...
View Table: Safety of Drugs for IBD in Pregnancy
Guselkumab (Tremfya) for Psoriasis
The Medical Letter on Drugs and Therapeutics • November 6, 2017; (Issue 1533)
The FDA has approved the interleukin (IL)-23 blocker
guselkumab (Tremfya – Janssen) for treatment of
moderate to severe plaque psoriasis in adults who
are candidates for systemic therapy or...
The FDA has approved the interleukin (IL)-23 blocker
guselkumab (Tremfya – Janssen) for treatment of
moderate to severe plaque psoriasis in adults who
are candidates for systemic therapy or phototherapy.
Guselkumab is the first selective IL-23 blocker to
become available in the US.
Sarilumab (Kevzara) for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • August 14, 2017; (Issue 1527)
The FDA has approved the interleukin (IL)-6 inhibitor
sarilumab (Kevzara – Sanofi) for second-line
treatment of adults with moderately to severely
active rheumatoid arthritis (RA). It is the second...
The FDA has approved the interleukin (IL)-6 inhibitor
sarilumab (Kevzara – Sanofi) for second-line
treatment of adults with moderately to severely
active rheumatoid arthritis (RA). It is the second IL-6
inhibitor to be approved for this indication; tocilizumab
(Actemra) was approved earlier.
Brodalumab (Siliq) - Another IL-17A Antagonist for Psoriasis
The Medical Letter on Drugs and Therapeutics • July 17, 2017; (Issue 1525)
The FDA has approved brodalumab (Siliq – Valeant),
an injectable human interleukin (IL)-17A receptor
antagonist, for treatment of adults with moderate to
severe plaque psoriasis who have failed to...
The FDA has approved brodalumab (Siliq – Valeant),
an injectable human interleukin (IL)-17A receptor
antagonist, for treatment of adults with moderate to
severe plaque psoriasis who have failed to respond
to other systemic therapies. Brodalumab is the third
IL-17A antagonist to be approved in the US for this
indication; secukinumab (Cosentyx) and ixekizumab
(Taltz) were approved earlier.
Inflectra - An Infliximab Biosimilar
The Medical Letter on Drugs and Therapeutics • January 30, 2017; (Issue 1513)
The FDA has approved infliximab-dyyb (Inflectra –
Pfizer; marketed as Remsima in some countries), as a
biosimilar of the TNF inhibitor infliximab (Remicade).
Infliximab-dyyb was approved in the European...
The FDA has approved infliximab-dyyb (Inflectra –
Pfizer; marketed as Remsima in some countries), as a
biosimilar of the TNF inhibitor infliximab (Remicade).
Infliximab-dyyb was approved in the European Union
(EU) in 2013 and in Canada in 2014. It is the second
biosimilar to be approved by the FDA. Filgastrim-sndz
(Zarxio), a recombinant human granulocyte colony-stimulating
factor, was the first.
Ustekinumab (Stelara) for Crohn's Disease
The Medical Letter on Drugs and Therapeutics • January 2, 2017; (Issue 1511)
The FDA has approved the human interleukin (IL)-12
and -23 antagonist ustekinumab (Stelara – Janssen
Biotech) for treatment of moderately to severely active
Crohn's disease in adults who were intolerant of...
The FDA has approved the human interleukin (IL)-12
and -23 antagonist ustekinumab (Stelara – Janssen
Biotech) for treatment of moderately to severely active
Crohn's disease in adults who were intolerant of or
whose disease was unresponsive to treatment with immunomodulators
or corticosteroids, or a tumor necrosis
factor (TNF) inhibitor. Ustekinumab was approved earlier
for treatment of psoriasis and psoriatic arthritis.
Ixekizumab (Taltz) - A Second IL-17A Inhibitor for Psoriasis
The Medical Letter on Drugs and Therapeutics • May 9, 2016; (Issue 1494)
The FDA has approved ixekizumab (Taltz – Lilly), an
injectable humanized interleukin (IL)-17A antagonist,
for treatment of adults with moderate to severe plaque
psoriasis who are candidates for systemic...
The FDA has approved ixekizumab (Taltz – Lilly), an
injectable humanized interleukin (IL)-17A antagonist,
for treatment of adults with moderate to severe plaque
psoriasis who are candidates for systemic therapy
or phototherapy. Ixekizumab is the second IL-17A
antagonist to be approved for this indication in the US;
secukinumab (Cosentyx – Novartis) was the first.
Drugs for Psoriasis
The Medical Letter on Drugs and Therapeutics • June 8, 2015; (Issue 1470)
Mild to moderate psoriasis is generally treated with
topical corticosteroids. Vitamin D analogs and tazarotene
are topical alternatives that can be used in combination
with topical corticosteroids....
Mild to moderate psoriasis is generally treated with
topical corticosteroids. Vitamin D analogs and tazarotene
are topical alternatives that can be used in combination
with topical corticosteroids. Phototherapy and systemic
therapy, including biologic agents, are recommended for
patients with moderate to severe disease.
Drugs for Psoriatic Arthritis (online only)
The Medical Letter on Drugs and Therapeutics • June 8, 2015; (Issue 1470)
Psoriatic arthritis is a chronic inflammatory arthropathy
that develops in up to 40% of patients with
psoriasis. Several guidelines for treatment of psoriatic
arthritis have been...
Psoriatic arthritis is a chronic inflammatory arthropathy
that develops in up to 40% of patients with
psoriasis. Several guidelines for treatment of psoriatic
arthritis have been published.
Secukinumab (Cosentyx) for Psoriasis
The Medical Letter on Drugs and Therapeutics • March 30, 2015; (Issue 1465)
Secukinumab (Cosentyx – Novartis), an injectable
human interleukin (IL)-17A antagonist, has been
approved by the FDA for treatment of moderate to
severe plaque psoriasis in adult patients who...
Secukinumab (Cosentyx – Novartis), an injectable
human interleukin (IL)-17A antagonist, has been
approved by the FDA for treatment of moderate to
severe plaque psoriasis in adult patients who are
candidates for systemic therapy or phototherapy.
It is the first IL-17 inhibitor to be approved for any
indication in the US.
Drugs for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • December 22, 2014; (Issue 1458)
For initial treatment of rheumatoid arthritis, most expert clinicians prescribe a disease-modifying antirheumatic drug (DMARD) and add a nonsteroidal anti-inflammatory drug (NSAID) or a corticosteroid to...
For initial treatment of rheumatoid arthritis, most expert clinicians prescribe a disease-modifying antirheumatic drug (DMARD) and add a nonsteroidal anti-inflammatory drug (NSAID) or a corticosteroid to control symptoms. Methotrexate is generally the DMARD of choice...
DMARDs
Disease-modifying antirheumatic drugs (DMARDs) are used early in the treatment of rheumatoid arthritis (RA) to achieve clinical remission, prevent irreversible damage to joints, and minimize toxicity associated with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. DMARDs generally do not have an immediate analgesic effect, but over time can control symptoms and have been shown to delay and possibly stop progression of the disease. Methotrexate (Rheumatrex, and others) is generally the first DMARD prescribed; it can be used to treat mild, moderate, or severe RA. For mild disease, some clinicians prefer to start with hydroxychloroquine (Plaquenil, and generics) and/or sulfasalazine (Azulfidine, and others).
DMARDs
Disease-modifying antirheumatic drugs (DMARDs) are used early in the treatment of rheumatoid arthritis (RA) to achieve clinical remission, prevent irreversible damage to joints, and minimize toxicity associated with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. DMARDs generally do not have an immediate analgesic effect, but over time can control symptoms and have been shown to delay and possibly stop progression of the disease. Methotrexate (Rheumatrex, and others) is generally the first DMARD prescribed; it can be used to treat mild, moderate, or severe RA. For mild disease, some clinicians prefer to start with hydroxychloroquine (Plaquenil, and generics) and/or sulfasalazine (Azulfidine, and others).
Vedolizumab (Entyvio) for Inflammatory Bowel Disease
The Medical Letter on Drugs and Therapeutics • September 15, 2014; (Issue 1451)
The FDA has approved vedolizumab (Entyvio - Takeda),
an intravenous integrin receptor antagonist, for treatment
of moderate to severe ulcerative colitis or Crohn's
disease in adults who have not responded...
The FDA has approved vedolizumab (Entyvio - Takeda),
an intravenous integrin receptor antagonist, for treatment
of moderate to severe ulcerative colitis or Crohn's
disease in adults who have not responded to, lost
response to, or cannot tolerate standard treatment.
Natalizumab (Tysabri), another integrin receptor antagonist,
has been available for several years for treatment
of Crohn's disease and multiple sclerosis.
Drugs for Inflammatory Bowel Disease
The Medical Letter on Drugs and Therapeutics • August 4, 2014; (Issue 1448)
Aminosalicylates are effective for induction and maintenance
of remission in mild to moderate ulcerative
colitis. They are not recommended for treatment of
Crohn's disease.
FORMULATIONS — Oral mesalamine...
Aminosalicylates are effective for induction and maintenance
of remission in mild to moderate ulcerative
colitis. They are not recommended for treatment of
Crohn's disease.
FORMULATIONS — Oral mesalamine is rapidly absorbed in the small intestine and most of the drug does not reach the colon. Pentasa releases mesalamine gradually throughout the gastrointestinal tract. Delzicol, Asacol HD, Lialda, and Apriso delay the release of the drug until it reaches the distal ileum and colon. Sulfasalazine (Azulfidine, and generics), balsalazide (Colazal, and others), and olsalazine (Dipentum) are prodrugs; mesalamine is azo-bonded to a second moiety and released in the colon following bacterial cleavage of the bond. Mesalamine is also available as an enema (Rowasa, and generics) and as a rectal suppository (Canasa).
FORMULATIONS — Oral mesalamine is rapidly absorbed in the small intestine and most of the drug does not reach the colon. Pentasa releases mesalamine gradually throughout the gastrointestinal tract. Delzicol, Asacol HD, Lialda, and Apriso delay the release of the drug until it reaches the distal ileum and colon. Sulfasalazine (Azulfidine, and generics), balsalazide (Colazal, and others), and olsalazine (Dipentum) are prodrugs; mesalamine is azo-bonded to a second moiety and released in the colon following bacterial cleavage of the bond. Mesalamine is also available as an enema (Rowasa, and generics) and as a rectal suppository (Canasa).
Golimumab (Simponi) for Ulcerative Colitis
The Medical Letter on Drugs and Therapeutics • March 31, 2014; (Issue 1439)
The FDA has approved golimumab (Simponi – Janssen),
a fully human monoclonal antibody specific for tumor necrosis
factor (TNF) alpha, for induction and maintenance
of remission in patients with moderate to...
The FDA has approved golimumab (Simponi – Janssen),
a fully human monoclonal antibody specific for tumor necrosis
factor (TNF) alpha, for induction and maintenance
of remission in patients with moderate to severe ulcerative
colitis who do not respond to or cannot tolerate other
therapies or who require continuous treatment with corticosteroids.
Golimumab was approved earlier for treatment
of rheumatoid arthritis, psoriatic arthritis, and ankylosing
spondylitis. It is the third TNF inhibitor to be approved for
use in ulcerative colitis.
Certolizumab Pegol (Cimzia) and Ustekinumab (Stelara) for Psoriatic Arthritis
The Medical Letter on Drugs and Therapeutics • February 3, 2014; (Issue 1435)
Certolizumab pegol (Cimzia – UCB), a tumor necrosis
factor (TNF) inhibitor previously approved for treatment
of Crohn's disease and rheumatoid arthritis,
and ustekinumab (Stelara – Janssen), a human...
Certolizumab pegol (Cimzia – UCB), a tumor necrosis
factor (TNF) inhibitor previously approved for treatment
of Crohn's disease and rheumatoid arthritis,
and ustekinumab (Stelara – Janssen), a human interleukin-12 and -23 antagonist previously approved for
treatment of moderate-to-severe plaque psoriasis,
have now been approved by the FDA for treatment of
active psoriatic arthritis.
TNF Inhibitors for Crohn's Disease: When, Which, and for How Long
The Medical Letter on Drugs and Therapeutics • December 23, 2013; (Issue 1432)
Three tumor necrosis factor (TNF) inhibitors – infliximab
(Remicade), adalimumab (Humira), and certolizumab
pegol (Cimzia) – are approved by the FDA
for treatment of moderately to severely active...
Three tumor necrosis factor (TNF) inhibitors – infliximab
(Remicade), adalimumab (Humira), and certolizumab
pegol (Cimzia) – are approved by the FDA
for treatment of moderately to severely active Crohn’s
disease in adults who have had an inadequate
response to conventional therapy. Infliximab is also
FDA-approved for the same indication in children ≥6
years old and for treatment of fistulas in adults. All 3
TNF inhibitors have been shown to reduce the signs
and symptoms of Crohn's disease in clinical trials.
They have been associated with adverse effects such
as tuberculosis, other serious infections, and lymphoma,
and they are expensive.
Canakinumab (Ilaris) for Systemic Juvenile Idiopathic Arthritis
The Medical Letter on Drugs and Therapeutics • August 19, 2013; (Issue 1423)
The FDA has approved the interleukin-1 (IL-1) beta
inhibitor canakinumab (Ilaris – Novartis) for treatment of
systemic juvenile idiopathic arthritis (sJIA; formerly
called juvenile rheumatoid arthritis or...
The FDA has approved the interleukin-1 (IL-1) beta
inhibitor canakinumab (Ilaris – Novartis) for treatment of
systemic juvenile idiopathic arthritis (sJIA; formerly
called juvenile rheumatoid arthritis or Still’s disease) in
children ≥2 years old. Canakinumab was approved earlier
for treatment of cryopyrin-associated periodic syndromes
(CAPS). Tocilizumab (Actemra), an interleukin-6
(IL-6) inhibitor that has been available since 2010 for
treatment of rheumatoid arthritis in adults, was also
recently approved by the FDA for sJIA. Canakinumab is
the only IL-1 inhibitor approved for this indication.
Tofacitinib (Xeljanz) for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • January 7, 2013; (Issue 1407)
The FDA has approved tofacitinib (toe” fa sye’ ti nib;
Xeljanz – Pfizer), an oral Janus kinase (JAK) inhibitor, for
treatment of adults with moderately to severely active
rheumatoid arthritis (RA) who...
The FDA has approved tofacitinib (toe” fa sye’ ti nib;
Xeljanz – Pfizer), an oral Janus kinase (JAK) inhibitor, for
treatment of adults with moderately to severely active
rheumatoid arthritis (RA) who have had an inadequate
response to or are intolerant of methotrexate. Ruxolitinib
(Jakafi) is the only other JAK inhibitor available in the
US; it is FDA-approved for treatment of myelofibrosis.
Drugs for Acne, Rosacea and Psoriasis
The Medical Letter on Drugs and Therapeutics • January 1, 2013; (Issue 125)
The pathogenesis of acne is multifactorial: follicular
hyperkeratinization, bacteria, sebum production,
androgens, and inflammation all play a role. The gram-positive
microaerophilic bacteria...
The pathogenesis of acne is multifactorial: follicular
hyperkeratinization, bacteria, sebum production,
androgens, and inflammation all play a role. The gram-positive
microaerophilic bacteria Propionibacterium
acnes promote development of acne lesions by secreting
chemotactic factors that attract leukocytes to the
follicle, causing inflammation.
Drugs for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • May 1, 2012; (Issue 117)
Disease-modifying anti-rheumatic drugs (DMARDs)
are now used early in the treatment of rheumatoid
arthritis (RA) to achieve clinical remission, prevent
irreversible damage to joints, and minimize...
Disease-modifying anti-rheumatic drugs (DMARDs)
are now used early in the treatment of rheumatoid
arthritis (RA) to achieve clinical remission, prevent
irreversible damage to joints, and minimize toxicity
associated with nonsteroidal anti-inflammatory drugs
(NSAIDs) and corticosteroids. DMARDs (Table 1)
generally do not have an immediate analgesic effect,
but over time can control symptoms and have been
shown to delay and possibly stop progression of the
disease. NSAIDs have immediate analgesic and antiinflammatory
effects, but may not affect the disease
process. Oral corticosteroids can relieve joint symptoms
and control systemic manifestations, but their
chronic use can cause many complications. Judicious
use of intra-articular corticosteroids can rapidly
decrease inflammation in acute joints with few, if any,
adverse effects.
Drugs for Tuberculosis
The Medical Letter on Drugs and Therapeutics • April 1, 2012; (Issue 116)
Tuberculosis (TB) is still a common cause of death
worldwide, and the prevalence of drug-resistant TB
poses challenges to its treatment and control.
Guidelines with detailed management recommendations
are...
Tuberculosis (TB) is still a common cause of death
worldwide, and the prevalence of drug-resistant TB
poses challenges to its treatment and control.
Guidelines with detailed management recommendations
are available from the American Thoracic
Society, Centers for Disease Control and Prevention
(CDC) and Infectious Diseases Society of America
(IDSA).
Drugs for Inflammatory Bowel Disease
The Medical Letter on Drugs and Therapeutics • March 1, 2012; (Issue 115)
Inflammatory bowel disease (IBD) is generally classified
as either Crohn’s disease (CD) or ulcerative
colitis (UC). More detailed guidelines on their treatment
are available from the American College...
Inflammatory bowel disease (IBD) is generally classified
as either Crohn’s disease (CD) or ulcerative
colitis (UC). More detailed guidelines on their treatment
are available from the American College of
Gastroenterology.
Which TNF Inhibitor for Rheumatoid Arthritis?
The Medical Letter on Drugs and Therapeutics • May 17, 2010; (Issue 1338)
The FDA has approved five tumor necrosis factor (TNF) inhibitors for treatment of moderately to
severely active rheumatoid arthritis (RA). TNF-α is a pro-inflammatory cytokine involved in the...
The FDA has approved five tumor necrosis factor (TNF) inhibitors for treatment of moderately to
severely active rheumatoid arthritis (RA). TNF-α is a pro-inflammatory cytokine involved in the pathogenesis of many systemic inflammatory disorders.
Addendum: Cost of Ustekinumab (Stelara)
The Medical Letter on Drugs and Therapeutics • March 8, 2010; (Issue 1333)
In the Medical Letter article on ustekinumab (Stelara) for psoriasis (2010; 52:7), footnote 2 in table 2 should have included a second sentence: $5595.60 is the cost of one 45-mg...
In the Medical Letter article on ustekinumab (Stelara) for psoriasis (2010; 52:7), footnote 2 in table 2 should have included a second sentence: $5595.60 is the cost of one 45-mg syringe.
Ustekinumab (Stelara) for Psoriasis
The Medical Letter on Drugs and Therapeutics • January 25, 2010; (Issue 1330)
The FDA has approved the use of ustekinumab (Stelara - Centocor Ortho Biotech), an interleukin antagonist given by subcutaneous (SC) injection for treatment of adults with moderate to severe plaque psoriasis....
The FDA has approved the use of ustekinumab (Stelara - Centocor Ortho Biotech), an interleukin antagonist given by subcutaneous (SC) injection for treatment of adults with moderate to severe plaque psoriasis. It is the first agent in its class for this indication; the other biologic agents for psoriasis are Tcell or tumor necrosis factor (TNF) inhibitors.
Drugs for Tuberculosis
The Medical Letter on Drugs and Therapeutics • October 1, 2009; (Issue 86)
Even though the incidence continues to decline in the United States, tuberculosis (TB) is still a common cause of death worldwide, and the prevalence of drug-resistant TB poses severe challenges to its...
Even though the incidence continues to decline in the United States, tuberculosis (TB) is still a common cause of death worldwide, and the prevalence of drug-resistant TB poses severe challenges to its treatment and control. Guidelines with detailed management recommendations are available from the Centers for Disease Control and Prevention (CDC), American Thoracic Society and Infectious Diseases Society of America (IDSA).
Drugs for Inflammatory Bowel Disease
The Medical Letter on Drugs and Therapeutics • September 1, 2009; (Issue 85)
Inflammatory bowel disease (IBD) is either Crohn's disease or ulcerative colitis. Drug selection is guided by disease type (Crohn's versus ulcerative colitis), severity and location and whether the goal is...
Inflammatory bowel disease (IBD) is either Crohn's disease or ulcerative colitis. Drug selection is guided by disease type (Crohn's versus ulcerative colitis), severity and location and whether the goal is induction or maintenance of remission. Table 1 on page 66 lists the drugs used to treat IBD with their formulations and cost. Table 2 on page 68 lists the drugs of choice and their doses for different indications. Table 3 on page 71 lists the drugs' adverse effects and recommendations for monitoring. More detailed guidelines are available from the American College of Gastroenterology.
Golimumab (Simponi) for Inflammatory Arthritis
The Medical Letter on Drugs and Therapeutics • July 13, 2009; (Issue 1316)
Golimumab (Simponi - Centocor), a fully humanized anti-tumor necrosis factor (TNF)-a antibody, has been approved by the FDA for the treatment of: (1) moderate to severe active rheumatoid arthritis (RA) in...
Golimumab (Simponi - Centocor), a fully humanized anti-tumor necrosis factor (TNF)-a antibody, has been approved by the FDA for the treatment of: (1) moderate to severe active rheumatoid arthritis (RA) in combination with methotrexate; (2) active psoriatic arthritis (PsA) alone or in combination with methotrexate; and (3) active ankylosing spondylitis (AS).
Drugs for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • May 1, 2009; (Issue 81)
Disease-modifying anti-rheumatic drugs (DMARDs) are now used early in the treatment of rheumatoid arthritis (RA) to prevent irreversible damage to joints and minimize toxicities associated with nonsteroidal...
Disease-modifying anti-rheumatic drugs (DMARDs) are now used early in the treatment of rheumatoid arthritis (RA) to prevent irreversible damage to joints and minimize toxicities associated with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.
Advertisements for TNF Inhibitors
The Medical Letter on Drugs and Therapeutics • November 17, 2008; (Issue 1299)
Some tumor necrosis factor (TNF) inhibitors are being promoted on the internet directly to the public for use in psoriasis...
Some tumor necrosis factor (TNF) inhibitors are being promoted on the internet directly to the public for use in psoriasis (www.yahoo.com).
Drugs for Acne, Rosacea and Psoriasis
The Medical Letter on Drugs and Therapeutics • November 1, 2008; (Issue 75)
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, bacteria, sebum production, androgens and inflammation all play a role. The gram-positive microaerophilic bacteria Propionibacterium...
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, bacteria, sebum production, androgens and inflammation all play a role. The gram-positive microaerophilic bacteria Propionibacterium acnes promote development of acne lesions by secreting chemotactic factors that attract leukocytes to the follicle, causing inflammation.
Certolizumab (Cimzia) for Crohn's Disease
The Medical Letter on Drugs and Therapeutics • October 20, 2008; (Issue 1297)
The FDA has approved the marketing of certolizumab pegol (Cimzia - UCB), a tumor necrosis factor (TNF) blocker, for treatment of moderate to severe Crohn's disease refractory to conventional treatment. It is...
The FDA has approved the marketing of certolizumab pegol (Cimzia - UCB), a tumor necrosis factor (TNF) blocker, for treatment of moderate to severe Crohn's disease refractory to conventional treatment. It is the third TNF blocker approved for this indication.
Correction: Natalizumab (Tysabri) for Crohn's Disease
The Medical Letter on Drugs and Therapeutics • June 2, 2008; (Issue 1287)
The May 5, 2008 article (Med Lett Drugs Ther 2008; 50:34) on the approval of natalizumab (Tysabri) for treatment of Crohn's disease in the "Adverse Effects" section on page 35 included the statement:...
The May 5, 2008 article (Med Lett Drugs Ther 2008; 50:34) on the approval of natalizumab (Tysabri) for treatment of Crohn's disease in the "Adverse Effects" section on page 35 included the statement: "post-marketing hepatotoxicity, sometimes fatal or requiring liver transplantation, has occurred." Actually, no fatal hepatotoxicity or liver transplantation has been reported to date. The FDA warning about post-marketing hepatotoxicity with Tysabri that was the basis for our statement said: "The combination of transaminase elevations and elevated bilirubin without evidence of obstruction is recognized as an important predictor of severe liver injury that may lead to [emphasis added] death or the need for a liver transplant in some patients." Also, in the last sentence of the Conclusion, we should have said: "Because of the risk of serious hepatic toxicity and the rare but even more serious risk of developing progressive multifocal leukoencephalopathy, it should be used only in patients who have not responded to other drugs, including a TNF inhibitor." The italicized words should be substituted for "it is FDA-approved for use."
Download: U.S. English
Download: U.S. English
Natalizumab (Tysabri) for Crohn's Disease
The Medical Letter on Drugs and Therapeutics • May 5, 2008; (Issue 1285)
Natalizumab (Tysabri - Elan and Biogen) is a monoclonal antibody approved for induction and maintenance treatment of moderate to severe Crohn's disease (CD) refractory to conventional therapies and inhibitors...
Natalizumab (Tysabri - Elan and Biogen) is a monoclonal antibody approved for induction and maintenance treatment of moderate to severe Crohn's disease (CD) refractory to conventional therapies and inhibitors of tumor necrosis factor (TNF). Initially approved in 2004 for the treatment of multiple sclerosis (MS), natalizumab was temporarily withdrawn from the market after 3 patients developed progressive multifocal leukoencephalopathy (PML). It is now available for treatment of both MS and CD through a restricted distribution program.
Abatacept (Orencia) for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • February 27, 2006; (Issue 1229)
Atacept (Orencia - Bristol-Myers Squibb), an inhibitor of T-cell activation, has been approved by the FDA for treatment of moderate to severe rheumatoid arthritis (RA) in patients who have not responded to one...
Atacept (Orencia - Bristol-Myers Squibb), an inhibitor of T-cell activation, has been approved by the FDA for treatment of moderate to severe rheumatoid arthritis (RA) in patients who have not responded to one or more disease-modifying anti-rheumatic drugs (DMARDs).
Drugs for Acne, Rosacea and Psoriasis
The Medical Letter on Drugs and Therapeutics • July 1, 2005; (Issue 35)
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, Propionibacterium acnes bacteria, sebum production, androgens and inflammation have all been implicated. P. acnes, a gram-positive...
The pathogenesis of acne is multifactorial: follicular hyperkeratinization, Propionibacterium acnes bacteria, sebum production, androgens and inflammation have all been implicated. P. acnes, a gram-positive microaerophilic bacterium, plays an important role in the development of acne lesions by secreting chemotactic factors that attract leukocytes to the follicle, causing inflammation.
Drugs for Tuberculosis
The Medical Letter on Drugs and Therapeutics • December 1, 2004; (Issue 28)
Tuberculosis (TB) is still a problem in the United States, even though the incidence continues to decline in most of the country (MMWR Morbid Mortal Wkly Rep 2004; 53:209). Treatment of TB can be divided into...
Tuberculosis (TB) is still a problem in the United States, even though the incidence continues to decline in most of the country (MMWR Morbid Mortal Wkly Rep 2004; 53:209). Treatment of TB can be divided into treatment of latent infection diagnosed by a positive PPD and treatment of active clinical TB. Guidelines with detailed management recommendations are available from the US Centers for Disease Control and Prevention (CDC) (MMWR Morbid Mortal Wkly Rep 2003; 52RR-11:1).
Efalizumab (Raptiva) for Treatment of Psoriasis
The Medical Letter on Drugs and Therapeutics • December 8, 2003; (Issue 1171)
Efalizumab (Raptiva - Genentech/XOMA), a humanized monoclonal antibody that inhibits T-cell activation, has been approved by the FDA for treatment of adults with moderate to severe chronic plaque...
Efalizumab (Raptiva - Genentech/XOMA), a humanized monoclonal antibody that inhibits T-cell activation, has been approved by the FDA for treatment of adults with moderate to severe chronic plaque psoriasis.
Alefacept (Amevive) For Treatment of Psoriasis
The Medical Letter on Drugs and Therapeutics • April 14, 2003; (Issue 1154)
Alefacept (a le' fa sept; Amevive - Biogen) has been approved by the FDA for parenteral treatment of adults with moderate to severe chronic plaque...
Alefacept (a le' fa sept; Amevive - Biogen) has been approved by the FDA for parenteral treatment of adults with moderate to severe chronic plaque psoriasis.
Adalimumab (Humira) For Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • March 31, 2003; (Issue 1153)
Adalimumab (Humira - Abbott), a tumor necrosis factor alpha (TNF-α) inhibitor, has been approved by the FDA for treatment of moderate to severe rheumatoid arthritis (RA). A genetically engineered human...
Adalimumab (Humira - Abbott), a tumor necrosis factor alpha (TNF-α) inhibitor, has been approved by the FDA for treatment of moderate to severe rheumatoid arthritis (RA). A genetically engineered human IgG1 monoclonal antibody, adalimumab is approved for subcutaneous (SC) injection in adults who have failed at least one disease-modifying anti-rheumatic drug (DMARD), for use either alone or with other DMARDs such as methotrexate (Rheumatrex, and others). Two other TNF-α antagonists, etanercept (Enbrel) and infliximab (Remicade), are already on the market for treatment of RA (Treatment Guidelines from The Medical Letter 2003; 1:25).
Anakinra (Kineret) For Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • February 18, 2002; (Issue 1124)
Anakinra (Kineret - Amgen), an interleuken-1 (IL-1) receptor antagonist, has been approved by the FDA for treatment of moderately to severly active rheumatoid arthritis in adults who have failed at least one...
Anakinra (Kineret - Amgen), an interleuken-1 (IL-1) receptor antagonist, has been approved by the FDA for treatment of moderately to severly active rheumatoid arthritis in adults who have failed at least one disease-modifying anti-rheumatic drug(DMARD) such as methotrexate (Medical Letter 2000; 24:57).
Budesonide (Entocort EC) For Crohn's Disease
The Medical Letter on Drugs and Therapeutics • January 21, 2002; (Issue 1122)
Budesonide (Entocort EC — AstraZeneca), a locally active glucocorticosteriod widely used for inhalation treatment of allergic rhinitis and asthma (Medical Letter 2000; 42:19), has been approved for oral...
Budesonide (Entocort EC — AstraZeneca), a locally active glucocorticosteriod widely used for inhalation treatment of allergic rhinitis and asthma (Medical Letter 2000; 42:19), has been approved for oral treatment of mild to moderate active Crohn's disease involving the ileum and/or ascending colon. Both oral budesonide and budesonide enemas have been available for years in Europe and Canada for treatment of inflammatory bowel disease.
New Drugs for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • November 20, 1998; (Issue 1040)
Leflunomide (Arava - Hoechst Marion Roussel), which inhibits pyrimidine synthesis, and etanercept (Enbrel - Immunex/Wyeth-Ayerst), which blocks the action of tumor necrosis factor (TNF), have been approved by...
Leflunomide (Arava - Hoechst Marion Roussel), which inhibits pyrimidine synthesis, and etanercept (Enbrel - Immunex/Wyeth-Ayerst), which blocks the action of tumor necrosis factor (TNF), have been approved by the FDA for treatment of rheumatoid arthritis. A third drug, infliximab (Remicade - Centocor), which also blocks TNF and has been used to treat rheumatoid arthritis, was approved earlier for treatment of Crohn's disease. Its use in Crohn's disease will be reviewed in a future issue.