Matching articles for "prednisone"
Drugs for Gout
The Medical Letter on Drugs and Therapeutics • October 30, 2023; (Issue 1688)
Drugs for gout are used to reduce the pain and
inflammation of acute flares, decrease the frequency
of exacerbations, and lower serum urate levels to
prevent recurrent flares, development of tophi,...
Drugs for gout are used to reduce the pain and
inflammation of acute flares, decrease the frequency
of exacerbations, and lower serum urate levels to
prevent recurrent flares, development of tophi, and
joint damage.
Comparison Table: Some Drugs for Gout (online only)
The Medical Letter on Drugs and Therapeutics • October 30, 2023; (Issue 1688)
...
View the Comparison Table: Some Drugs for Gout
Delandistrogene Moxeparvovec (Elevidys) for Duchenne Muscular Dystrophy
The Medical Letter on Drugs and Therapeutics • October 2, 2023; (Issue 1686)
Delandistrogene moxeparvovec-rokl (Elevidys –
Sarepta), an adeno-associated virus (AAV) vector-based
gene therapy, has received accelerated
approval from the FDA for treatment of ambulatory
children 4-5...
Delandistrogene moxeparvovec-rokl (Elevidys –
Sarepta), an adeno-associated virus (AAV) vector-based
gene therapy, has received accelerated
approval from the FDA for treatment of ambulatory
children 4-5 years old with Duchenne muscular
dystrophy (DMD) who have a confirmed mutation in
the dystrophin gene. It is the first gene therapy to be
approved in the US for treatment of DMD. Accelerated
approval was based on expression of microdystrophin
in skeletal muscle, a surrogate endpoint.
Glofitamab (Columvi) for Diffuse Large B-Cell Lymphoma (online only)
The Medical Letter on Drugs and Therapeutics • August 7, 2023; (Issue 1682)
Glofitamab-gxbm (Columvi – Genentech), a bispecific
CD20-directed CD3 T-cell engager, has received
accelerated approval from the FDA for IV treatment of
relapsed or refractory diffuse large B-cell...
Glofitamab-gxbm (Columvi – Genentech), a bispecific
CD20-directed CD3 T-cell engager, has received
accelerated approval from the FDA for IV treatment of
relapsed or refractory diffuse large B-cell lymphoma
(DLBCL), not otherwise specified, or large B-cell
lymphoma (LBCL) arising from follicular lymphoma
after ≥2 lines of systemic therapy. Accelerated
approval was based on response rates and durability
of response. Glofitamab is the second T-cell-engaging
bispecific antibody to be approved in the US
for treatment of DLBCL; epcoritamab-bysp (Epkinly),
which is given subcutaneously, was approved earlier.
Unlike epcoritamab, glofitamab is not approved for
treatment of high-grade B-cell lymphoma.
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
In Brief: Lisocabtagene Maraleucel (Breyanzi) for Large B-Cell Lymphoma (online only)
The Medical Letter on Drugs and Therapeutics • June 26, 2023; (Issue 1679)
The FDA has approved lisocabtagene maraleucel
(Breyanzi – BMS) for treatment of adults with large
B-cell lymphoma (LBCL), including diffuse large
B-cell lymphoma (DLBCL) not otherwise...
The FDA has approved lisocabtagene maraleucel
(Breyanzi – BMS) for treatment of adults with large
B-cell lymphoma (LBCL), including diffuse large
B-cell lymphoma (DLBCL) not otherwise specified,
high-grade B-cell lymphoma, primary mediastinal
large B-cell lymphoma, or follicular lymphoma
grade 3B who have disease refractory to first-line
chemoimmunotherapy, relapsed within 12 months
of or after first-line chemoimmunotherapy, are not
eligible for hematopoietic stem cell transplantation
due to comorbidities or age, or have relapsed
or refractory disease after ≥2 lines of systemic
therapy. Breyanzi is an individualized cellular
product prepared from the patient's own T cells,
which are genetically modified to express chimeric
antigen receptors (CAR) and then infused back into
the patient. The CAR T-cell products axicabtagene
ciloleucel (Yescarta) and tisagenlecleucel (Kymriah)
are also FDA-approved for treatment of large B-cell
lymphoma.
Epcoritamab (Epkinly) for Diffuse Large B-Cell Lymphoma (DLBCL) (online only)
The Medical Letter on Drugs and Therapeutics • June 12, 2023; (Issue 1678)
Epcoritamab-bysp (Epkinly – Genmab), a bispecific
CD20-directed CD3 T-cell engager, has received
accelerated approval from the FDA for subcutaneous
treatment of relapsed or refractory diffuse large
B-cell...
Epcoritamab-bysp (Epkinly – Genmab), a bispecific
CD20-directed CD3 T-cell engager, has received
accelerated approval from the FDA for subcutaneous
treatment of relapsed or refractory diffuse large
B-cell lymphoma (DLBCL), not otherwise specified,
including DLBCL arising from indolent lymphoma,
and high-grade B-cell lymphoma after ≥2 lines
of systemic therapy. Epcoritamab is the second
T-cell-engaging bispecific antibody to become
available in the US for treatment of non-Hodgkin's
lymphoma; mosunetuzumab-axgb (Lunsumio) was
recently approved for relapsed or refractory follicular
lymphoma, a common subtype of non-Hodgkin's
lymphoma.
Polatuzumab vedotin (Polivy) for Lymphoma (online only)
The Medical Letter on Drugs and Therapeutics • May 29, 2023; (Issue 1677)
Polatuzumab vedotin-piiq (Polivy – Genentech), a
CD79b-directed antibody and microtubule inhibitor
conjugate, has been approved by the FDA for use
in combination with rituximab,...
Polatuzumab vedotin-piiq (Polivy – Genentech), a
CD79b-directed antibody and microtubule inhibitor
conjugate, has been approved by the FDA for use
in combination with rituximab, cyclophosphamide,
doxorubicin, and prednisone (R-CHP) for first-line
treatment of diffuse large B-cell lymphoma
(DLBCL), not otherwise specified (NOS), or high-grade
B-cell lymphoma (HGBL) in adults who have
an International Prognostic Index (IPI) score ≥2. The
drug was previously approved for use in combination
with bendamustine and rituximab for treatment of
patients with relapsed or refactory DLBCL, NOS, who
received at least 2 prior therapies.
A New Indication for Axicabtagene Ciloleucel (Yescarta) (online only)
The Medical Letter on Drugs and Therapeutics • November 14, 2022; (Issue 1663)
The FDA recently approved axicabtagene ciloleucel
(Yescarta – Kite), a CD19-directed genetically
modified cellular product, for treatment of large B-cell
lymphoma that is refractory to first-line...
The FDA recently approved axicabtagene ciloleucel
(Yescarta – Kite), a CD19-directed genetically
modified cellular product, for treatment of large B-cell
lymphoma that is refractory to first-line chemoimmunotherapy
or that relapses within 12 months
of first-line treatment. It was previously approved for
treatment of relapsed or refractory B-cell lymphoma
after ≥2 lines of systemic therapy and for treatment
of relapsed or refractory follicular lymphoma
after ≥2 lines of systemic therapy. Yescarta is an
individualized cellular product prepared from the
patient's own T cells, which are genetically modified
to express chimeric antigen receptors (CAR) and then
infused back into the patient.
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.
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.
Rilonacept (Arcalyst) for Recurrent Pericarditis
The Medical Letter on Drugs and Therapeutics • September 6, 2021; (Issue 1632)
Rilonacept (Arcalyst – Kiniksa), an interleukin-1 (IL-1)
antagonist that has been available for years for
treatment of cryopyrin-associated periodic syndromes,
has now been approved by the FDA for...
Rilonacept (Arcalyst – Kiniksa), an interleukin-1 (IL-1)
antagonist that has been available for years for
treatment of cryopyrin-associated periodic syndromes,
has now been approved by the FDA for treatment
of recurrent pericarditis and prevention of further
recurrences in patients ≥12 years old. It is the first drug
to be approved in the US for this indication. Anakinra
(Kineret), an IL-1 receptor antagonist FDA-approved for
treatment of rheumatoid arthritis, has been used off-label
for years for treatment of recurrent pericarditis.
Teprotumumab (Tepezza) for Thyroid Eye Disease
The Medical Letter on Drugs and Therapeutics • May 31, 2021; (Issue 1625)
Teprotumumab-trbw (Tepezza - Horizon), an insulin-like
growth factor-1 receptor (IGF-1R) inhibitor, has
been approved by the FDA for IV treatment of thyroid
eye disease. It is the first drug to be approved...
Teprotumumab-trbw (Tepezza - Horizon), an insulin-like
growth factor-1 receptor (IGF-1R) inhibitor, has
been approved by the FDA for IV treatment of thyroid
eye disease. It is the first drug to be approved in the US
for this indication.
Drugs for Allergic Rhinitis and Allergic Conjunctivitis
The Medical Letter on Drugs and Therapeutics • April 19, 2021; (Issue 1622)
The choice of drugs for treatment of allergic rhinitis
depends on the severity of symptoms and whether
they are intermittent or persistent (see Table...
The choice of drugs for treatment of allergic rhinitis
depends on the severity of symptoms and whether
they are intermittent or persistent (see Table 1).
Golodirsen (Vyondys 53) for Duchenne Muscular Dystrophy
The Medical Letter on Drugs and Therapeutics • July 27, 2020; (Issue 1603)
Golodirsen (Vyondys 53 — Sarepta), an antisense
oligonucleotide, has received accelerated approval
from the FDA for treatment of Duchenne muscular
dystrophy (DMD) in the ~8% of patients who have
mutations...
Golodirsen (Vyondys 53 — Sarepta), an antisense
oligonucleotide, has received accelerated approval
from the FDA for treatment of Duchenne muscular
dystrophy (DMD) in the ~8% of patients who have
mutations of the dystrophin gene that are amenable
to exon 53 skipping. It is the first drug to be approved
for this indication and the third to be approved for
treatment of DMD; the antisense oligonucleotide
eteplirsen (Exondys 51) and the oral corticosteroid
deflazacort (Emflaza) were approved earlier.
Corticosteroids in Community-Acquired Pneumonia
The Medical Letter on Drugs and Therapeutics • January 13, 2020; (Issue 1589)
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...
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).
OTC Drugs for Seasonal Allergies
The Medical Letter on Drugs and Therapeutics • April 22, 2019; (Issue 1570)
Patients with seasonal allergies often experience
nasal itching and congestion, sneezing, rhinorrhea,
and itchy, watery eyes. Oral, intranasal, and ophthalmic
preparations are widely available over the...
Patients with seasonal allergies often experience
nasal itching and congestion, sneezing, rhinorrhea,
and itchy, watery eyes. Oral, intranasal, and ophthalmic
preparations are widely available over the counter
(OTC) for relief of symptoms. Prescription products for
management of allergic rhinitis and allergic conjunctivitis
are reviewed separately.
Drugs for Gout
The Medical Letter on Drugs and Therapeutics • March 11, 2019; (Issue 1567)
Drugs for gout reduce the pain and inflammation of
acute flares and lower serum urate levels in order to
prevent recurrent flares, development of tophi, and
joint...
Drugs for gout reduce the pain and inflammation of
acute flares and lower serum urate levels in order to
prevent recurrent flares, development of tophi, and
joint damage.
Expanded Table: Some Drugs for Gout (online only)
The Medical Letter on Drugs and Therapeutics • March 11, 2019; (Issue 1567)
...
View the Expanded Table: Some Drugs for Gout
Axicabtagene Ciloleucel (Yescarta) for B-Cell Lymphoma (online only)
The Medical Letter on Drugs and Therapeutics • July 16, 2018; (Issue 1551)
The FDA has approved axicabtagene ciloleucel
(Yescarta – Kite) for treatment of adults with relapsed
or refractory CD19+ large B-cell lymphoma after ≥2
lines of systemic therapy. Yescarta is an...
The FDA has approved axicabtagene ciloleucel
(Yescarta – Kite) for treatment of adults with relapsed
or refractory CD19+ large B-cell lymphoma after ≥2
lines of systemic therapy. Yescarta is an individualized
cellular product prepared from the patient's own T cells,
which are genetically modified to express chimeric
antigen receptors (CAR) and then infused back into
the patient. It is the second CAR T-cell immunotherapy
to become available in the US. Tisagenlecleucel
(Kymriah), a CAR T-cell product previously approved
for treatment of relapsed or refractory B-cell precursor
acute lymphoblastic leukemia (ALL) in patients ≤25
years old, was recently also approved for relapsed or
refractory CD19+ large B-cell lymphoma after ≥2 lines
of systemic therapy.
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
Benralizumab (Fasenra) for Severe Eosinophilic Asthma
The Medical Letter on Drugs and Therapeutics • February 26, 2018; (Issue 1541)
The FDA has approved benralizumab (Fasenra –
AstraZeneca), a humanized monoclonal antibody
selective for the interleukin-5 (IL-5) receptor, for
add-on maintenance treatment of severe asthma in
patients...
The FDA has approved benralizumab (Fasenra –
AstraZeneca), a humanized monoclonal antibody
selective for the interleukin-5 (IL-5) receptor, for
add-on maintenance treatment of severe asthma in
patients ≥12 years old with an eosinophilic phenotype.
Benralizumab is the third anti-IL-5 antibody to be
approved for treatment of severe eosinophilic asthma;
mepolizumab (Nucala) and reslizumab (Cinqair), which
target IL-5 itself, were approved earlier.
Deflazacort (Emflaza) for Duchenne Muscular Dystrophy
The Medical Letter on Drugs and Therapeutics • September 11, 2017; (Issue 1529)
Deflazacort (Emflaza – PTC Therapeutics), an oral
corticosteroid, has been approved by the FDA for
treatment of Duchenne muscular dystrophy (DMD) in
patients ≥5 years old. It has been available...
Deflazacort (Emflaza – PTC Therapeutics), an oral
corticosteroid, has been approved by the FDA for
treatment of Duchenne muscular dystrophy (DMD) in
patients ≥5 years old. It has been available outside
the US for many years. Deflazacort is the second
drug to be approved for treatment of DMD; eteplirsen
(Exondys 51), an antisense oligonucleotide approved
for IV administration in patients with mutations of
the dystrophin gene amenable to exon 51 skipping
(about 13% of DMD cases), was the first.
Drugs for Allergic Disorders
The Medical Letter on Drugs and Therapeutics • May 8, 2017; (Issue 1520)
Allergic rhinitis can be classified as seasonal,
perennial, or episodic. It is often associated with
allergic conjunctivitis, rhinosinusitis, and asthma. H1-ANTIHISTAMINES — Oral – Oral...
Allergic rhinitis can be classified as seasonal,
perennial, or episodic. It is often associated with
allergic conjunctivitis, rhinosinusitis, and asthma.
H1-ANTIHISTAMINES — Oral – Oral second-generation H1-antihistamines are the preferred first-line treatment for relief of the itching, sneezing, and rhinorrhea that characterize mild-to-moderate allergic rhinitis. They are less effective for nasal congestion.
H1-ANTIHISTAMINES — Oral – Oral second-generation H1-antihistamines are the preferred first-line treatment for relief of the itching, sneezing, and rhinorrhea that characterize mild-to-moderate allergic rhinitis. They are less effective for nasal congestion.
ColciGel - A Homeopathic Colchicine Gel for Gout
The Medical Letter on Drugs and Therapeutics • January 4, 2016; (Issue 1485)
Homeopathic drugs characteristically consist of very
large dilutions of "proven" substances. Serial dilutions
of 1:10 are designated by the Roman numeral X.
ColciGel (Gensco), a prescription homeopathic
gel...
Homeopathic drugs characteristically consist of very
large dilutions of "proven" substances. Serial dilutions
of 1:10 are designated by the Roman numeral X.
ColciGel (Gensco), a prescription homeopathic
gel containing a 10,000-fold dilution of colchicine
(colchicinum 4X), is now being marketed for topical
treatment and prophylaxis of gout.
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).
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.
Drugs for Asthma and COPD
The Medical Letter on Drugs and Therapeutics • August 1, 2013; (Issue 132)
INHALATION DEVICES — Metered-dose inhalers
(MDIs) require coordination of inhalation with hand-actuation
of the device. Valved holding chambers
(VHCs) or spacers help some patients, especially
young...
INHALATION DEVICES — Metered-dose inhalers
(MDIs) require coordination of inhalation with hand-actuation
of the device. Valved holding chambers
(VHCs) or spacers help some patients, especially
young children and the elderly, use MDIs effectively.
VHCs have one-way valves that prevent the patient
from exhaling into the device, minimizing the need for
coordinated actuation and inhalation. Spacers are
tubes or chambers placed between the canister and a
face mask or mouthpiece, which also avoids the need
to coordinate actuation and inhalation. Both VHCs
and spacers retain the larger particles emitted from the
MDI, decreasing their deposition in the oropharynx
and leading to a higher proportion of small respirable
particles being inhaled.
Budesonide (Uceris) for Ulcerative Colitis
The Medical Letter on Drugs and Therapeutics • March 18, 2013; (Issue 1412)
The FDA has approved a new extended-release formulation
of the corticosteroid budesonide (Uceris –
Santarus) for induction of remission in patients with
mild to moderate ulcerative...
The FDA has approved a new extended-release formulation
of the corticosteroid budesonide (Uceris –
Santarus) for induction of remission in patients with
mild to moderate ulcerative colitis.
Delayed-Release Prednisone (Rayos)
The Medical Letter on Drugs and Therapeutics • November 26, 2012; (Issue 1404)
The FDA has approved a delayed-release oral formulation
of prednisone (Rayos – Horizon Pharma). Rayos is
not labeled for any specific indication, but the only
published studies of the new product have been...
The FDA has approved a delayed-release oral formulation
of prednisone (Rayos – Horizon Pharma). Rayos is
not labeled for any specific indication, but the only
published studies of the new product have been in
patients with rheumatoid arthritis (RA).
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.
Drugs for Asthma
The Medical Letter on Drugs and Therapeutics • February 1, 2012; (Issue 114)
Inhalation is the preferred route of delivery for most
asthma drugs. Chlorofluorocarbons (CFCs), which
have ozone-depleting properties, are being phased out
as propellants in metered-dose inhalers....
Inhalation is the preferred route of delivery for most
asthma drugs. Chlorofluorocarbons (CFCs), which
have ozone-depleting properties, are being phased out
as propellants in metered-dose inhalers. Non-chlorinated
hydrofluoroalkane (HFA) propellants, which do
not deplete the ozone layer, are being used instead.
Tesamorelin (Egrifta) for HIV-Associated Lipodystrophy
The Medical Letter on Drugs and Therapeutics • May 2, 2011; (Issue 1363)
The FDA has approved tesamorelin (Egrifta – EMD
Serono), an injectable synthetic analog of growth-hormone-
releasing factor (GRF), for reduction of excess
abdominal fat in patients with lipodystrophy...
The FDA has approved tesamorelin (Egrifta – EMD
Serono), an injectable synthetic analog of growth-hormone-
releasing factor (GRF), for reduction of excess
abdominal fat in patients with lipodystrophy associated
with HIV infection. Growth hormone (somatropin –
Serostim; EMD Serono) has been available for years for
treatment of HIV wasting.
Vigabatrin (Sabril) for Epilepsy
The Medical Letter on Drugs and Therapeutics • February 22, 2010; (Issue 1332)
The FDA has approved vigabatrin (vye gá ba trin; Sabril – Lundbeck) for oral use as add-on therapy for complex partial seizures in adults who are refractory to several antiepileptic drugs and as monotherapy...
The FDA has approved vigabatrin (vye gá ba trin; Sabril – Lundbeck) for oral use as add-on therapy for complex partial seizures in adults who are refractory to several antiepileptic drugs and as monotherapy for infantile spasms. Vigabatrin has been available in other countries for many years. Because of its potential for retinal toxicity, it will be available in the US only through a restricted distribution program called SHARE (Support, Help and Resources for Epilepsy). Prescribers and pharmacists distributing the drug must register, and patients must undergo visual field testing.
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.
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.
Drugs That May Cause Psychiatric Symptoms
The Medical Letter on Drugs and Therapeutics • December 15, 2008; (Issue 1301)
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment could also be due to the underlying illness, previously...
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment could also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.
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Drugs for Asthma
The Medical Letter on Drugs and Therapeutics • December 1, 2008; (Issue 76)
No truly new drugs have been approved for treatment of asthma since omalizumab (Xolair) in 2003, but some randomized controlled trials of older drugs have been published, and new guidelines have become...
No truly new drugs have been approved for treatment of asthma since omalizumab (Xolair) in 2003, but some randomized controlled trials of older drugs have been published, and new guidelines have become available.
Ciclesonide (Alvesco) - A New Inhaled Corticosteroid for Asthma
The Medical Letter on Drugs and Therapeutics • September 22, 2008; (Issue 1295)
The FDA has approved the marketing of the corticosteroid ciclesonide (Alvesco - Sepracor) in a hydrofluoroalkane (HFA) metered-dose inhaler formulation for maintenance treatment of asthma in patients >12 years...
The FDA has approved the marketing of the corticosteroid ciclesonide (Alvesco - Sepracor) in a hydrofluoroalkane (HFA) metered-dose inhaler formulation for maintenance treatment of asthma in patients >12 years old. Ciclesonide is also available in the US as a nasal spray for allergic rhinitis (Omnaris), and has been available for asthma in Europe since 2003.
Drugs for Allergic Disorders
The Medical Letter on Drugs and Therapeutics • August 1, 2007; (Issue 60)
Allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria, anaphylaxis and asthma (reviewed in Treatment Guidelines 2005; 3:33 and not included here), are prevalent worldwide, especially in...
Allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria, anaphylaxis and asthma (reviewed in Treatment Guidelines 2005; 3:33 and not included here), are prevalent worldwide, especially in industrialized countries. Pharmacologic treatment of these disorders continues to improve in efficacy and safety. In addition to using drugs to prevent and control the symptoms of their allergic diseases, patients should also be instructed to avoid, if possible, specific allergens and/or environmental conditions that trigger or worsen their symptoms.
Nelarabine (Arranon) for T-Cell Acute Lymphoblastic Leukemia
The Medical Letter on Drugs and Therapeutics • February 13, 2006; (Issue 1228)
Nelarabine (Arranon - GlaxoSmithKline), a prodrug of the deoxyguanosine analog 9-β-D-arabinofuranosylguanine (ara-G), has been approved by the FDA for treatment of patients with T-cell acute lymphoblastic...
Nelarabine (Arranon - GlaxoSmithKline), a prodrug of the deoxyguanosine analog 9-β-D-arabinofuranosylguanine (ara-G), has been approved by the FDA for treatment of patients with T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LBL) that has not responded to, or has relapsed following, treatment with at least two chemotherapy regimens.
Drugs for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • December 1, 2005; (Issue 40)
To prevent irreversible damage to joints and minimize toxicities associated with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, disease modifying anti-rheumatic drugs (DMARDs) are now used...
To prevent irreversible damage to joints and minimize toxicities associated with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, disease modifying anti-rheumatic drugs (DMARDs) are now used early in the treatment of rheumatoid arthritis (RA). The DMARDs listed in the table on page 84 have no immediate analgesic effects, but can control symptoms and have been shown to delay and possibly stop progression of the disease. The NSAIDs listed in the table on page 88 have analgesic and anti-inflammatory effects, but may not affect the disease process. Oral corticosteroids can rapidly relieve joint symptoms and control systemic manifestations, but their chronic use is associated with many complications.
Drugs for Asthma
The Medical Letter on Drugs and Therapeutics • May 1, 2005; (Issue 33)
Patients with mild, infrequent asthma symptoms may require only intermittent, asneeded use of an inhaled short-acting beta2-adrenergic agonist. Use of a short-acting beta2-agonist more than twice weekly, other...
Patients with mild, infrequent asthma symptoms may require only intermittent, asneeded use of an inhaled short-acting beta2-adrenergic agonist. Use of a short-acting beta2-agonist more than twice weekly, other than for exercise-induced bronchospasm, indicates a need for anti-inflammatory treatment. Inhaled corticosteroids are the most effective anti-inflammatory medication; leukotriene modifiers are less effective alternatives. If regular use of an inhaled corticosteroid in a low dose does not prevent symptoms, a long-acting beta2-agonist should be added; addition of a second drug is more effective than raising the dose of the inhaled steroid. A leukotriene modifier can also be used as the second drug. Omalizumab may be considered as adjunctive therapy for patients more than 12 years old who have allergic asthma not controlled by other drugs. A short course of oral corticosteroids may be useful for acute exacerbations. Treatment of acute severe asthma as a medical emergency is not included here; it has been reviewed elsewhere (ER McFadden Jr, Am J Respir Crit Care Med 2003; 168:740).
Drugs for Allergic Disorders
The Medical Letter on Drugs and Therapeutics • November 1, 2003; (Issue 15)
Allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria and anaphylaxis, along with asthma (reviewed in Treatment Guidelines 2002; 1:7 and not included here), have increased in prevalence...
Allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria and anaphylaxis, along with asthma (reviewed in Treatment Guidelines 2002; 1:7 and not included here), have increased in prevalence during the past 30 years and are now epidemic worldwide, especially in industrialized countries. Many safe and effective drugs are currently available for prevention and relief of symptoms in these disorders, but pharmacological treatment alone may not be sufficient. Patients should also be instructed to avoid specific allergens or environmental conditions that trigger their symptoms. Allergen-specific immunotherapy, parenteral administration of gradually increasing doses of the allergen ("allergy shots"), has been effective in allergic rhinitis, allergic conjunctivitis and allergic asthma, and also in prevention of anaphylaxis triggered by stings from bees, yellow jackets, hornets and wasps. It has not been effective in food allergy, atopic dermatitis or urticaria.
Drugs for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • January 1, 2003; (Issue 5)
Many different drugs are now used to treat rheumatoid arthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs), listed in the table on page 26, have analgesic and anti-inflammatory effects, but may not affect...
Many different drugs are now used to treat rheumatoid arthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs), listed in the table on page 26, have analgesic and anti-inflammatory effects, but may not affect the disease process. Corticosteroids can provide rapid relief of joint symptoms and control of systemic manifestations, but chronic use is associated with many complications. The "disease-modifying" anti-rheumatic drugs (DMARDs), listed on page 29, have no immediate analgesic effects, but can control symptoms and may delay progression of the disease (American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines, Arthritis Rheum 2002; 46:328). Interactions of anti-rheumatic drugs with other drugs are listed in The Medical Letter Handbook of Adverse Drug Interactions, 2003.
Drugs for Asthma
The Medical Letter on Drugs and Therapeutics • October 1, 2002; (Issue 2)
New drug formulations continue to be introduced for the treatment of asthma, and new studies on older drugs continue to change our perspectives on the management of this chronic inflammatory disease. Treatment...
New drug formulations continue to be introduced for the treatment of asthma, and new studies on older drugs continue to change our perspectives on the management of this chronic inflammatory disease. Treatment of asthma in the emergency department or hospital is not addressed here. More information on the diagnosis and treatment of asthma is available from Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma (Bethesda:NIH, 1997 and 2002 update; www.nhlbi.nih.gov).
Drugs That May Cause Psychiatric Symptoms
The Medical Letter on Drugs and Therapeutics • July 8, 2002; (Issue 1134)
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment may also be due to the underlying illness, previously...
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment may also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.
Drugs For Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • July 10, 2000; (Issue 1082)
Many different drugs are now used to treat rheumatoid arthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs) have analgesic and anti-inflammatory effects, but may not affect the disease process. The...
Many different drugs are now used to treat rheumatoid arthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs) have analgesic and anti-inflammatory effects, but may not affect the disease process. The "disease-modifying anti-rheumatic"drugs (DMARDs) have no immediate analgesic effects, but can control symptoms and may delay progression of the disease.
Rituximab for Non-Hodgkins Lymphoma
The Medical Letter on Drugs and Therapeutics • June 19, 1998; (Issue 1029)
Rituximab (Rituxan - IDEC Pharmaceutical/Genentech), a monoclonal antibody, has been approved by the FDA for treatment of low-grade B-cell non-Hodgkin's lymphoma. Most low-grade lymphomas are B-cell...
Rituximab (Rituxan - IDEC Pharmaceutical/Genentech), a monoclonal antibody, has been approved by the FDA for treatment of low-grade B-cell non-Hodgkin's lymphoma. Most low-grade lymphomas are B-cell lymphomas.
Immune Globulin IV for Prevention of RH Isoimmunization and for Treatment of ITP
The Medical Letter on Drugs and Therapeutics • January 19, 1996; (Issue 966)
immune globulin (human) has been available for many years in an intramuscular (IM) formulation for prevention of Rh isoimmunization in pregnant Rh-negative women (Medical Letter, 16:3, 1974). Recently, the US...
immune globulin (human) has been available for many years in an intramuscular (IM) formulation for prevention of Rh isoimmunization in pregnant Rh-negative women (Medical Letter, 16:3, 1974). Recently, the US Food and Drug Administration (FDA) approved the first intravenous (IV) immune globulin preparation (WinRho SD - Univax), not only for preventing Rh isoimmunization, but also for treatment of immune thrombocytopenic purpura (ITP) in Rh-positive patients.
Drugs for AIDS and Associated Infections
The Medical Letter on Drugs and Therapeutics • October 13, 1995; (Issue 959)
Results of recently completed clinical trials have led to some changes in recommendation for treatment of human immunodeficiency virus (HIV) and other infections associated with...
Results of recently completed clinical trials have led to some changes in recommendation for treatment of human immunodeficiency virus (HIV) and other infections associated with AIDS.
Pegaspargase for Acute Lymphoblastic Leukemia
The Medical Letter on Drugs and Therapeutics • March 17, 1995; (Issue 944)
Pegaspargase (peg as par jase; PEG-L-asparaginase; Oncaspar - Rh ne-Poulenc Rorer), a polyethylene glycol (PEG) conjugate of L-asparaginase, has been approved by the US Food and Drug Administration for...
Pegaspargase (peg as par jase; PEG-L-asparaginase; Oncaspar - Rh ne-Poulenc Rorer), a polyethylene glycol (PEG) conjugate of L-asparaginase, has been approved by the US Food and Drug Administration for treatment of acute lymphoblastic leukemia (ALL), the most common malignancy of childhood. The new drug is recommended only for patients who have had allergic reactions to asparaginase. Asparaginase is available commercially as Elspar, which is derived from Escherichia coli. A formulation derived from Erwinia chrysanthemi is available on an investigational basis (Ogden Bioservices, 301-762-0069). Some patients who have had allergic reactions to E. coli asparaginase can tolerate Erwinia asparaginase.
Tacrolimus FK506 Organ Transplants
The Medical Letter on Drugs and Therapeutics • September 16, 1994; (Issue 931)
Tacrolimus (Prograf - Fujisawa), previously called FK506 (Medical Letter, 33:94, 1991), has been approved by the US Food and Drug Administration for primary prevention of organ rejection in patients receiving...
Tacrolimus (Prograf - Fujisawa), previously called FK506 (Medical Letter, 33:94, 1991), has been approved by the US Food and Drug Administration for primary prevention of organ rejection in patients receiving liver transplants. The drug has also been used as rescue therapy for organ graft rejection unresponsive to cyclosporine (Sandimmune) and other immunosuppressive drugs.
Drugs for AIDS and Associated infections
The Medical Letter on Drugs and Therapeutics • September 3, 1993; (Issue 904)
Results of recently completed clinical trials have led to some changes in recommendations for treatment of human immunodeficiency virus (HIV) and other infections associted with...
Results of recently completed clinical trials have led to some changes in recommendations for treatment of human immunodeficiency virus (HIV) and other infections associted with AIDS.
Teniposide for Acute Lymphoblastic Leukemia
The Medical Letter on Drugs and Therapeutics • November 13, 1992; (Issue 883)
Teniposide (ten i poe' side; VM 26; Vumon - Bristol), an anticancer drug that has been under investigation in the USA for 20 years, has now been approved for use in combination induction treatment of...
Teniposide (ten i poe' side; VM 26; Vumon - Bristol), an anticancer drug that has been under investigation in the USA for 20 years, has now been approved for use in combination induction treatment of refractory acute lymphoblastic leukemia (ALL) in children. A semisynthetic derivative of podophyllotoxin, teniposide is chemically related to etoposide (VePesid - Medical Letter, 26:48, 1984).
Bone Marrow Transplants for Malignant Diseases
The Medical Letter on Drugs and Therapeutics • August 21, 1992; (Issue 877)
Intensive chemotherapy, with or without total body radiation, followed by bone marrow transplantation is now widely used in the treatment of malignant diseases. The drugs and radiation needed to try to...
Intensive chemotherapy, with or without total body radiation, followed by bone marrow transplantation is now widely used in the treatment of malignant diseases. The drugs and radiation needed to try to eradicate the malignancy unavoidably destroy the bone marrow; intravenous infusion of bone marrow cells restores the marrow by repopulating it. Diseases for which bone marrow transplantation has been used include the leukemias and lymphomas, breast cancer, neuroblastoma, ovarian cancer, germ cell tumors, melanoma, multiple myeloma, and malignant gliomas (NC Gorin, Am J Clin On-col, 14 suppl 1:S5, 1991; Medical Letter, 33:39, 1991; G Gahrton et al, N Engl J Med, 325:1267, 1991).
Drugs For Treatment of Peptic Ulcers
The Medical Letter on Drugs and Therapeutics • November 29, 1991; (Issue 858)
Drugs that accelerate healing and prevent relapse or reurrence of peptic ulcers act either by decreasing gastric acidity or by enhancing mucosal defense mechanisms. Risk factors that may cause breakdown of...
Drugs that accelerate healing and prevent relapse or reurrence of peptic ulcers act either by decreasing gastric acidity or by enhancing mucosal defense mechanisms. Risk factors that may cause breakdown of mucosal defenses include the use of aspirinor other nonsteroidal anti-inflammatory drugs (NSAIDs) and the presence of Helicobacter pylori bacterial in the gastric antrum (AH Soll, Engl J Med, 322:909, 1990; WL Peterson, N Engl J Med, 324:1043, 1991).
Fludarabine
The Medical Letter on Drugs and Therapeutics • September 20, 1991; (Issue 853)
Fludarabine phosphate (Fludara - Berlex), an analog of vidarabine (Vira-A), was recently approved by the U.S. Food and Drug Administration for treatment of patients with refractory chronic lymphocytic...
Fludarabine phosphate (Fludara - Berlex), an analog of vidarabine (Vira-A), was recently approved by the U.S. Food and Drug Administration for treatment of patients with refractory chronic lymphocytic leukemia (CLL). The drug has not yet been marketed but is still available, as it has been for two years, through the National Cancer Institute.
Mesalamine For Ulcerative Colitis
The Medical Letter on Drugs and Therapeutics • May 20, 1988; (Issue 766)
Mesalamine (Rowasa - Reid-Rowell), probably better known as 5-aminosalicylic acid (5-ASA) and also called mesalazine in some other countries, was recently marketed in the USA as an enema for treatment of mild...
Mesalamine (Rowasa - Reid-Rowell), probably better known as 5-aminosalicylic acid (5-ASA) and also called mesalazine in some other countries, was recently marketed in the USA as an enema for treatment of mild to moderate distal ulcerative colitis, including ulcerative proctosigmoiditis and ulcerative proctitis.