1
In Brief: Alternatives to Adderall
The Medical Letter on Drugs and Therapeutics • November 28, 2022; (Issue 1664)
The short-acting formulation of mixed amphetamine
salts (Adderall, and generics) FDA-approved for
treatment of attention-deficit hyperactivity disorder
(ADHD) and narcolepsy, is currently in short supply in
the US. Until an adequate supply is restored, patients
may be looking for alternatives.
2
In Brief: A New Non-Small Cell Lung Cancer Indication for Osimertinib (Tagrisso) (online only)
The Medical Letter on Drugs and Therapeutics • November 11, 2024; (Issue 1715)
The oral kinase inhibitor osimertinib (Tagrisso –
AstraZeneca), which has been available for years for
treatment of non-small cell lung cancer (NSCLC) in
adults with epidermal growth factor receptor (EGFR)
exon 19 deletions or exon 21 L858R mutations, has now
been approved for treatment of unresectable stage III
EGFR-mutated NSCLC. About 20-30% of patients with
NSCLC have locally advanced stage III NSCLC, and
60-90% of these patients have unresectable disease.
Osimertinib is the first targeted therapy to be approved
for the new indication.
3
Xanomeline/Trospium (Cobenfy) for Schizophrenia
The Medical Letter on Drugs and Therapeutics • November 11, 2024; (Issue 1715)
The FDA has approved Cobenfy (BMS), an oral
fixed-dose combination of the muscarinic agonist
xanomeline and the peripheral muscarinic antagonist
trospium chloride, for treatment of schizophrenia in
adults. It is the first antipsychotic drug to be approved
in the US for treatment of schizophrenia that does not
block dopamine receptors. This is the first approval
for xanomeline; trospium has been available for many
years for treatment of overactive bladder.
4
In Brief: OTC Ivermectin for Head Lice
The Medical Letter on Drugs and Therapeutics • June 26, 2023; (Issue 1679)
Topical ivermectin lotion 0.5% (Sklice, and generics),
which has been available by prescription since 2012,
is now FDA-approved for sale over the counter (OTC)
for treatment of head lice in patients ≥6 months old.
Ivermectin is also available by prescription as a 1%
cream (Soolantra) approved for topical treatment of
inflammatory lesions of rosacea and in oral tablets
(Stromectol, and generics) for treatment of various
parasitic infections.
5
Eroxon — An OTC Gel for Erectile Dysfunction
The Medical Letter on Drugs and Therapeutics • November 11, 2024; (Issue 1715)
The FDA has authorized over-the-counter (OTC)
sale of a nonmedicated alcohol-based gel (Eroxon –
Futura) for treatment of erectile dysfunction (ED) in
males ≥22 years old. Eroxon is the only FDA-approved
OTC and topical treatment for erectile dysfunction. It
is also available in the UK and the EU.
6
Lebrikizumab (Ebglyss) for Atopic Dermatitis
The Medical Letter on Drugs and Therapeutics • November 11, 2024; (Issue 1715)
The FDA has approved lebrikizumab-lbkz (Ebglyss –
Lilly), a subcutaneously injected interleukin (IL)-13
antagonist, for treatment of moderate to severe
atopic dermatitis that has not been or cannot be
adequately treated with topical therapy in patients ≥12
years old (weight ≥40 kg). Lebrikizumab is the third
subcutaneously injected human IgG4 monoclonal
antibody to be approved in the US for this indication.
Tralokinumab (Adbry), another IL-13 antagonist, is
also approved for use in patients ≥12 years old, and
dupilumab (Dupixent), an IL-4 and IL-13 inhibitor, is
approved for use in patients ≥6 months old.
7
Capvaxive – A 21-Valent Pneumococcal Conjugate Vaccine
The Medical Letter on Drugs and Therapeutics • October 14, 2024; (Issue 1713)
The FDA has licensed Capvaxive (PCV21; Merck),
a 21-valent pneumococcal conjugate vaccine, for
prevention of invasive pneumococcal disease (IPD)
and pneumococcal pneumonia in adults. Four other
pneumococcal vaccines are currently available in the
US: Prevnar 20 (PCV20), Vaxneuvance (PCV15), and
Prevnar 13 (PCV13) are conjugate vaccines licensed
for use in persons ≥6 weeks old, and Pneumovax 23
(PPSV23) is a pneumococcal polysaccharide vaccine
licensed for use in persons ≥2 years old (see Table 1).
8
Inavolisib (Itovebi) for Locally Advanced or Metastatic Breast Cancer (online only)
The Medical Letter on Drugs and Therapeutics • November 11, 2024; (Issue 1715)
Inavolisib (Itovebi – Genentech), an oral kinase
inhibitor, has been approved by the FDA for use in
combination with palbociclib and fulvestrant for
treatment of endocrine-resistant, PIK3CA-mutated,
hormone receptor (HR)-positive, human epidermal
growth factor receptor 2 (HER2)-negative, locally
advanced or metastatic breast cancer. This is the first
approval for Itovebi; palbociclib and fulvestrant have
been available for years for treatment of HR-positive,
HER2-negative breast cancer.
9
Axatilimab (Niktimvo) for Chronic Graft-Versus-Host Disease (online only)
The Medical Letter on Drugs and Therapeutics • November 11, 2024; (Issue 1715)
Axatilimab-csfr (Niktimvo – Incyte), a colony
stimulating factor-1 receptor-blocking antibody, has
been approved by the FDA for intravenous treatment
of chronic graft-versus-host disease (cGVHD) after
failure of at least 2 lines of systemic therapy in patients
weighing ≥40 kg. Corticosteroids are generally the
first-line treatment for cGVHD. The oral kinase
inhibitors ibrutinib (Imbruvica), ruxolitinib (Jakafi),
and belumosudil (Rezurock) are also approved for
treatment of cGVHD. Extracorporeal photopheresis
has been used off-label.
10
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 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.