June 17th 2021
The COX-2 inhibitor Anjeso, a faster-acting injectable formulation of meloxicam, reduces opioid use after surgery.
November 18th 2014
June 13th 2013
June 12th 2013
Fuzeon (enfuvirtide for injection)
April 1st 2003Enfuvirtide is the first drug to be approved in a new class of anti-HIV drugs known as fusion inhibitors (see "Focus On... Enfuvirtide"). The drug interferes with the entry of HIV-1 into immune cells by inhibiting the fusion of viral and cellular membranes. This occurs when enfuvirtide prevents conformational changes required for the fusion of viral and cellular membranes by binding to the first heptad-repeat (HR1) in the gp41 subunit of the viral envelope glycoprotein. Enfuvirtide, in combination with other antiretroviral agents, is intended for the treatment of HIV-1 infection in treatment-experienced patients with evidence of HIV-1 replication despite ongoing antiretroviral therapy.
Celecoxib shows similar rates of recurrent bleeding to diclofenac plus omeprazole
April 1st 2003Two options are available for patients requiring treatment for arthritis who are at risk for ulcer disease: nonsteroidal anti-inflammatory drugs (NSAIDs) that are selective for cyclooxygenase-2 (COX-2) or the combination of a non-selective NSAID with a proton-pump inhibitor. A recent study of representative members from these therapeutic classes has offered findings that the two alternatives are statistically similar in their efficacy with respect to the prevention of recurrent ulcer bleeding.Celecoxib, a COX-2-selective NSAID, was given to 144 patients through random assignment. Another group of patients (N=143) were randomly assigned to receive a combination of diclofenac (a nonselective NSAID) plus omeprazole (a proton-pump inhibitor) during the 6-month trial.
Enfuvirtide: The first fusion inhibitor for the treatment of patients with HIV-1 infection (PDF)
April 1st 2003Enfuvirtide (Fuzeon, Roche/Trimeris) is the first member of a unique class of antiretrovirals known as the fusion inhibitors to gain FDA approval for the treatment of human immunodeficiency virus type-1 (HIV-1) infection. Enfuvirtide is indicated for use in combination with other antiretroviral agents in the treatment of HIV-1 infection in treatment-experienced patients with evidence of HIV-1 replication despite ongoing antiretroviral therapy. Phase 3 trials demonstrated that adding enfuvirtide 90 mg twice daily to an optimized background regimen chosen with genotypic and phenotypic resistance testing improved the surrogate end points of HIV ribonucleic acid (RNA) levels, CD4 cell counts, and the proportion of patients reaching clinically undetectable HIV RNA levels (<400 and <50 copies/mL) through 24 weeks. Enfuvirtide?s efficacy in treatment-experienced patients when added to an optimized background regimen makes it a promising choice for salvage therapy. Further studies will be required to support enfuvirtide?s use in treatment-naïve patients.
From the literature: Selective serotonin reuptake inhibitors linked to upper GI tract bleeding
March 1st 2003Selective serotonin reuptake inhibitors (SSRIs) experienced increased usage in the 1990s due to their low toxicity and minimal adverse effects. Throughout this period, several clinical reports indicated a link between the use of SSRIs and various bleeding disorders. A recent study published in the Archives of Internal Medicine found a distinct correlation between the use of SSRIs and upper gastrointestinal (GI) tract bleeding. The population-based cohort study was conducted within the 490,000 residents of a northern Denmark county over a five-year period.
New insights into the treatment of pulmonary arterial hypertension (PDF)
March 1st 2003Pulmonary arterial hypertension (PAH) is a progressive, debilitating disorder associated with poor quality of life and shortened life span. For many years, medical therapy consisted of calcium channel blockers, warfarin, supplemental oxygen, and digitalis glycosides. A better understanding of the pathophysiology of PAH has led to the recent development of effective treatments for this disorder. Therapeutic agents target the pathophysiologic mechanisms of PAH: pulmonary vasoconstriction, pulmonary vascular remodeling, and in situ thrombosis. With better understanding of the pathogenesis of PAH, recent advances in pharmacotherapy have been introduced for the treatment of PAH. Data are presented on efficacy and safety of newer approved and investigational agents: prostacyclin analogues, oral endothelin antagonists, and phosphodiesterase 5 inhibitors.
Bush budget outlines healthcare priorities
March 1st 2003The central healthcare initiative in the administration's $2.2 trillion budget proposal for fiscal year 2004 is to establish a Medicare prescription drug benefit. President George W Bush proposes to spend $6 billion as a "down payment" on a $400 billion/10-year Medicare drug benefit and "modernization" plan.
Changes in Congress and FDA shape healthcare policy
February 1st 2003The recent selection of Sen Bill Frist (R-Tenn), MD, to lead Senate Republicans has moved healthcare policy up the priority list in the Senate. As a physician, Dr Frist has played a lead role in assessing federal health programs and policies.
An overview of the pathophysiology and treatment of secondary peritonitis
February 1st 2003Intraabdominal infection was first thoroughly described by Hippocrates. Centuries later, despite advances in surgical and supportive therapies, this disease state continues to be associated with significant morbidity and mortality. This article reviews the literature on intraabdominal infections. It describes the pathophysiology, classification, and etiology of intraabdominal infections, focusing primarily on secondary peritonitis. The bacteriology of the gastrointestinal tract in both the normal and infected host is reviewed. Treatment options, including newly approved antimicrobial agents and agents under clinical investigation, are reviewed.
Incorporating an ethical template into pharmacy benefit decision-making (PDF)
January 1st 2003J Russell Teagarden, MA, RPh, vice president of clinical practices and therapeutics at Medco Health Solutions in Franklin Lakes, NJ, explains how using an ?ethical template? for pharmacy benefit decisions can make those decisions consistent and fair, reducing patient displeasure, conflict, and litigation.
A comparison of the newer treatment options for ADHD (PDF)
January 1st 2003Psychostimulant drugs have consistently demonstrated efficacy in the treatment of attention-deficit/hyperactivity disorder (ADHD). Innovative technology has fueled the development of novel release mechanisms and isolation of active enantiomer components with the hopes of enhancing the duration of action and improving the safety and effectiveness. As a result, several new stimulant agents have recently been added to the arsenal of ADHD treatment options. Formulary selection is complicated by the high costs and small but distinct differences among these agents. The five newest FDA-approved stimulant agents for the treatment of ADHD are detailed, and a brief summary of future treatment options, including a recently approved nonstimulant agent, is provided.
Incorporating an ethical template into pharmacy benefit decision-making
January 1st 2003If asked, could you present the underlying rationale for your pharmacy benefit coverage decisions? When considered from the consumer or employee perspective, why should they consider the payors or providers of their drug benefit legitimate decision-makers in limiting their healthcare policies?
Duloxetine: An antidepressant that inhibits both norepinephrine and serotonin uptake
January 1st 2003Duloxetine is a reuptake inhibitor at serotonergic and noradrenergic neurons and appears to have low affinity for other neurotransmitter systems. In three published clinical trials in patients with MDD, duloxetine was well tolerated and more effective than placebo. Further study is needed to compare its efficacy with that of other antidepressants, to prospectively assess time to onset of antidepressant effect, and to clarify effects on somatic symptoms and potential adverse cardiovascular and sexual effects. Duloxetine is also under investigation for the treatment of stress urinary incontinence in women (trade name to be determined, comarketed by Lilly and Boehringer Ingelheim). Preliminary information suggests that duloxetine therapy reduces the number of incontinence episodes. Duloxetine has been deemed ?approvable? for the treatment of MDD and will be comarketed under the trade name Cymbalta by Eli Lilly and Company and Quintiles.