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Vandetanib oral kinase inhibitor (Vandetanib): Oral kinase inhibitor for the treatment of progressive medullary thyroid cancer in patients with unresectable locally advanced or metastatic disease.
New molecular entity: Vandetanib is a oral kinase inhibitor approved by FDA to treat progressive medullary thyroid cancer in patients with unresectable locally advanced or metastatic disease.
On April 6, 2011, FDA approved vandetanib for the treatment of progressive medullary thyroid cancer in patients with unresectable locally advanced or metastatic disease.
Efficacy. Vandetanib's efficacy was established in a single, double-blind, placebo-controlled study involving 331 patients [vandetanib 300 mg (n=231) versus placebo (n=100)] with unresectable locally advanced or metastatic medullary thyroid cancer. Efficacy was measured by the patients' progression-free survival (PFS). Statistically significant improvements in PFS were observed in patients randomly assigned to vandetanib [59 of 231 (26%)] compared to placebo [41 of 100 (41%)] (HR=0.35; 95% CI, 0.24 to 0.53; P<.0001).
Safety. The most common adverse reactions (occurring in >20%) seen with vandetanib were diarrhea, rash, acne, nausea, hypertension, headache, fatigue, decreased appetite, and abdominal pain. Laboratory abnormalities (occurring in >20%) included decreased calcium, increased ALT, and decreased glucose. The use of vandetanib has resulted in Stevens-Johnson syndrome, interstitial lung disease, ischemic cerebrovascular events, hemorrhage, heart failure, hypothyroidism, and reversible posterior leukoencephalopathy syndrome. In addition, Torsades de pointes, ventricular tachycardia, and sudden death have been reported. QT interval prolongation has been reported in a concentration-dependant manner with the use of vandetanib [~35 ms for the 300-mg dose]. Additionally, 36% of patients receiving vandetanib experienced >60 ms increase in the QT interval, and 4.3% of patients had a QTc >500 ms. Vandetanib treatment should not be started in patients whose QTc interval is >450 ms. If the QTc rises above 500 ms, vandetanib use should be interrupted until QTc returns to <450 ms, then resume at reduced dose. Concomitant use with agents that may prolong QT intervals is not recommended with vandetanib.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
