Matching articles for "methotrexate"
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
Sarilumab (Kevzara) for Polymyalgia Rheumatica
The Medical Letter on Drugs and Therapeutics • May 13, 2024; (Issue 1702)
The FDA has approved the interleukin (IL)-6 inhibitor
sarilumab (Kevzara – Sanofi/Regeneron) for treatment
of polymyalgia rheumatica (PMR) in adults who
had an inadequate response to corticosteroids...
The FDA has approved the interleukin (IL)-6 inhibitor
sarilumab (Kevzara – Sanofi/Regeneron) for treatment
of polymyalgia rheumatica (PMR) in adults who
had an inadequate response to corticosteroids or
cannot tolerate a corticosteroid taper. Sarilumab is
the first biologic drug to be approved for treatment
of PMR; it was previously approved for treatment of
rheumatoid arthritis.
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 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.
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
Table: Safety of Drugs for IBD in Pregnancy (online only)
The Medical Letter on Drugs and Therapeutics • July 10, 2023; (Issue 1680)
...
View the Table: Safety of Drugs for IBD in Pregnancy
Table: Some Drug Interactions with Drugs for IBD (online only)
The Medical Letter on Drugs and Therapeutics • July 10, 2023; (Issue 1680)
...
View the Table: Some Drug Interactions with Drugs for IBD
In Brief: Alternatives to Mifepristone for Medication Abortion
The Medical Letter on Drugs and Therapeutics • June 26, 2023; (Issue 1679)
The possibility that use of mifepristone (Mifeprex,
and generics) may be restricted has led to questions
about alternatives for medication...
The possibility that use of mifepristone (Mifeprex,
and generics) may be restricted has led to questions
about alternatives for medication abortion.
Three Drugs for Atopic Dermatitis (Adbry, Cibinqo, and Rinvoq)
The Medical Letter on Drugs and Therapeutics • April 3, 2023; (Issue 1673)
The subcutaneously injected interleukin-13 (IL-13)
antagonist tralokinumab-ldrm (Adbry – Leo) and
the oral Janus kinase (JAK) inhibitors abrocitinib
(Cibinqo – Pfizer) and upadacitinib (Rinvoq –...
The subcutaneously injected interleukin-13 (IL-13)
antagonist tralokinumab-ldrm (Adbry – Leo) and
the oral Janus kinase (JAK) inhibitors abrocitinib
(Cibinqo – Pfizer) and upadacitinib (Rinvoq – Abbvie)
have been approved by the FDA for treatment of
moderate to severe atopic dermatitis.
Deucravacitinib (Sotyktu) for Plaque Psoriasis
The Medical Letter on Drugs and Therapeutics • February 20, 2023; (Issue 1670)
The FDA has approved deucravacitinib (Sotyktu –
BMS), an oral tyrosine kinase 2 (TYK2) inhibitor, for
once-daily treatment of moderate to severe plaque
psoriasis in adults who are candidates for...
The FDA has approved deucravacitinib (Sotyktu –
BMS), an oral tyrosine kinase 2 (TYK2) inhibitor, for
once-daily treatment of moderate to severe plaque
psoriasis in adults who are candidates for systemic
therapy or phototherapy. Deucravacitinib is the first
selective TYK2 inhibitor to be approved in the US for
any indication.
Dupilumab (Dupixent) for Eosinophilic Esophagitis and Prurigo Nodularis
The Medical Letter on Drugs and Therapeutics • February 6, 2023; (Issue 1669)
The FDA has approved the subcutaneously
injected interleukin (IL)-4 receptor alpha antagonist
dupilumab (Dupixent – Sanofi/Regeneron)
for treatment of eosinophilic esophagitis (EoE)
in patients ≥12...
The FDA has approved the subcutaneously
injected interleukin (IL)-4 receptor alpha antagonist
dupilumab (Dupixent – Sanofi/Regeneron)
for treatment of eosinophilic esophagitis (EoE)
in patients ≥12 years old who weigh ≥40 kg and
treatment of prurigo nodularis in adults. Dupilumab
is the first drug to be approved in the US for each
of these indications. It is also FDA-approved for
treatment of atopic dermatitis, asthma, and chronic
rhinosinusitis with nasal polyposis.
Baricitinib (Olumiant) for Severe Alopecia Areata
The Medical Letter on Drugs and Therapeutics • September 5, 2022; (Issue 1658)
The oral Janus kinase (JAK) inhibitor baricitinib
(Olumiant – Lilly), which was previously approved by
the FDA for treatment of moderately to severely active
rheumatoid arthritis and treatment of COVID-19...
The oral Janus kinase (JAK) inhibitor baricitinib
(Olumiant – Lilly), which was previously approved by
the FDA for treatment of moderately to severely active
rheumatoid arthritis and treatment of COVID-19 in
certain hospitalized adults, has now been approved
for treatment of severe alopecia areata in adults.
Baricitinib is the first systemic treatment to be
approved in the US for this indication.
Flowchart: Rheumatoid Arthritis Treatment (online only)
The Medical Letter on Drugs and Therapeutics • November 15, 2021; (Issue 1637)
...
View the Flowchart: Rheumatoid Arthritis Treatment
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 Conventional DMARDs for Rheumatoid Arthritis (online only)
The Medical Letter on Drugs and Therapeutics • November 15, 2021; (Issue 1637)
...
View Expanded Table: Some Conventional DMARDs for Rheumatoid Arthritis
Anifrolumab (Saphnelo) for Systemic Lupus Erythematosus
The Medical Letter on Drugs and Therapeutics • September 20, 2021; (Issue 1633)
The FDA has approved anifrolumab-fnia (Saphnelo – AstraZeneca), a type I interferon receptor antagonist, for IV treatment of adults with moderate to severe systemic lupus erythematosus (SLE) who are receiving...
The FDA has approved anifrolumab-fnia (Saphnelo – AstraZeneca), a type I interferon receptor antagonist, for IV treatment of adults with moderate to severe systemic lupus erythematosus (SLE) who are receiving standard treatment. Anifrolumab has not been studied in patients with severe active lupus nephritis or severe active CNS lupus. It is the first type I interferon receptor antagonist to become available
in the US.
Drugs for Atopic Dermatitis
The Medical Letter on Drugs and Therapeutics • June 15, 2020; (Issue 1600)
Atopic dermatitis (AD; also known as eczema) is
frequently associated with other atopic disorders
such as allergic rhinitis, asthma, and food allergy. It
commonly presents in infancy and early childhood
and...
Atopic dermatitis (AD; also known as eczema) is
frequently associated with other atopic disorders
such as allergic rhinitis, asthma, and food allergy. It
commonly presents in infancy and early childhood
and has a relapsing course, often improving by
adolescence, but sometimes persisting into (or first
appearing in) adulthood or even old age.
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.
Upadacitinib (Rinvoq) - A New JAK Inhibitor for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • November 18, 2019; (Issue 1585)
The FDA has approved upadacitinib (Rinvoq –
Abbvie), an oral Janus kinase (JAK) inhibitor, for
treatment of adults with moderately to severely
active rheumatoid arthritis (RA) who have had
an inadequate...
The FDA has approved upadacitinib (Rinvoq –
Abbvie), 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 cannot tolerate
methotrexate (Trexall, and others). Upadacitinib is
the third JAK inhibitor to be approved in the US for
treatment of RA; tofacitinib (Xeljanz, Xeljanz XR)
and baricitinib (Olumiant) were approved earlier.
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).
Expanded Table: Conventional DMARDs for Rheumatoid Arthritis (online only)
The Medical Letter on Drugs and Therapeutics • July 30, 2018; (Issue 1552)
...
View Expanded Table: Conventional DMARDs for Rheumatoid Arthritis
Baricitinib (Olumiant) for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • July 16, 2018; (Issue 1551)
The FDA has approved the Janus kinase (JAK) inhibitor
baricitinib (Olumiant – Lilly) for oral treatment of adults
with moderately to severely active rheumatoid arthritis
(RA) that has not responded...
The FDA has approved the Janus kinase (JAK) inhibitor
baricitinib (Olumiant – Lilly) for oral treatment of adults
with moderately to severely active rheumatoid arthritis
(RA) that has not responded adequately to one or more
tumor necrosis factor (TNF) inhibitors. Baricitinib is
the second JAK inhibitor to be approved for treatment
of RA; tofacitinib (Xeljanz, Xeljanz XR) was the first.
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.
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
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
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.
Ocrelizumab (Ocrevus) for MS
The Medical Letter on Drugs and Therapeutics • June 19, 2017; (Issue 1523)
The FDA has approved ocrelizumab (Ocrevus –
Genentech), a humanized anti-CD20 monoclonal
antibody, for treatment of adults with primary
progressive or relapsing multiple sclerosis (MS). It is the
first...
The FDA has approved ocrelizumab (Ocrevus –
Genentech), a humanized anti-CD20 monoclonal
antibody, for treatment of adults with primary
progressive or relapsing multiple sclerosis (MS). It is the
first anti-CD20 monoclonal antibody to be approved for
treatment of MS and the first disease-modifying drug
to be approved in the US for primary progressive MS.
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.
Netupitant/Palonosetron (Akynzeo) for Chemotherapy-Induced Nausea and Vomiting
The Medical Letter on Drugs and Therapeutics • April 27, 2015; (Issue 1467)
The FDA has approved Akynzeo (Helsinn/Eisai), an oral
fixed-dose combination of the substance P/neurokinin
1 (NK1) receptor antagonist netupitant and the
serotonin-3 (5-HT3) receptor antagonist...
The FDA has approved Akynzeo (Helsinn/Eisai), an oral
fixed-dose combination of the substance P/neurokinin
1 (NK1) receptor antagonist netupitant and the
serotonin-3 (5-HT3) receptor antagonist palonosetron,
for prevention of acute and delayed nausea and
vomiting associated with cancer chemotherapy
in adults. Akynzeo is the first product to combine
drugs from these two classes. Palonosetron (Aloxi)
is also available as a single agent for prevention of
chemotherapy-induced and postoperative nausea
and vomiting. Netupitant is the second substance
P/NK1 receptor antagonist to be approved in the US;
aprepitant (Emend) was the first.
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).
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).
Apremilast (Otezla) for Psoriatic Arthritis
The Medical Letter on Drugs and Therapeutics • May 26, 2014; (Issue 1443)
Apremilast (Otezla – Celgene), an oral phosphodiesterase
type-4 (PDE4) inhibitor, has been approved
by the FDA for treatment of active psoriatic arthritis in
adults. It is the fi rst PDE4 inhibitor to be...
Apremilast (Otezla – Celgene), an oral phosphodiesterase
type-4 (PDE4) inhibitor, has been approved
by the FDA for treatment of active psoriatic arthritis in
adults. It is the fi rst PDE4 inhibitor to be approved for this
indication.
In Brief: Otrexup - A Single-Use Auto-Injector Formulation of Methotrexate
The Medical Letter on Drugs and Therapeutics • March 31, 2014; (Issue 1439)
The FDA has approved a new injectable formulation of methotrexate (Otrexup – Antares) for use in rheumatoid arthritis and polyarticular juvenile idiopathic arthritis, and for severe psoriasis in adults. On...
The FDA has approved a new injectable formulation of methotrexate (Otrexup – Antares) for use in rheumatoid arthritis and polyarticular juvenile idiopathic arthritis, and for severe psoriasis in adults. On its web site (www.otrexup.com), the manufacturer states: "Otrexup is the first subcutaneous (SC) methotrexate (MTX) for self-administration delivered once weekly by auto-injector." Methotrexate has been available as a once-weekly injection (IM or SC) for these indications for many years,1 but not specifically for self-administration and not in a single-dose auto-injector. Methotrexate is generally given orally, but injectable formulations may be helpful for patients who have adverse gastrointestinal effects from the oral formulation or lose benefit over time because of poor absorption.
Otrexup auto-injectors are available in strengths of 10, 15, 20, and 25 mg of methotrexate per 0.4 mL. The usual dosage of methotrexate for patients with rheumatoid arthritis ranges from 7.5 to 25 mg once weekly. Otrexup should be administered SC in the abdomen or thigh. Four 25-mg auto-injectors cost $548.00, compared to $5.00 for a single 4-mL vial of generic methotrexate containing 25 mg/mL.2 Nevertheless, some patients with rheumatoid arthritis who find it difficult to draw up methotrexate solution from a vial and inject it with a syringe may prefer Otrexup.
1. Drugs for rheumatoid arthritis. Treat Guidel Med Lett 2012; 10:37.
2. Approximate wholesale acquisition cost (WAC). Source: Analy$ource® Monthly (Selected from FDB MedKnowledge™) March 5, 2014. Reprinted with permission by FDB, Inc. All rights reserved. ©2014. www.fdbhealth.com/policies/drug-pricing-policy. Actual retail prices may be higher.
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Otrexup auto-injectors are available in strengths of 10, 15, 20, and 25 mg of methotrexate per 0.4 mL. The usual dosage of methotrexate for patients with rheumatoid arthritis ranges from 7.5 to 25 mg once weekly. Otrexup should be administered SC in the abdomen or thigh. Four 25-mg auto-injectors cost $548.00, compared to $5.00 for a single 4-mL vial of generic methotrexate containing 25 mg/mL.2 Nevertheless, some patients with rheumatoid arthritis who find it difficult to draw up methotrexate solution from a vial and inject it with a syringe may prefer Otrexup.
1. Drugs for rheumatoid arthritis. Treat Guidel Med Lett 2012; 10:37.
2. Approximate wholesale acquisition cost (WAC). Source: Analy$ource® Monthly (Selected from FDB MedKnowledge™) March 5, 2014. Reprinted with permission by FDB, Inc. All rights reserved. ©2014. www.fdbhealth.com/policies/drug-pricing-policy. Actual retail prices may be higher.
Download complete U.S. English article
Low-Dose Diclofenac (Zorvolex) for Pain
The Medical Letter on Drugs and Therapeutics • March 3, 2014; (Issue 1437)
The FDA has approved Zorvolex (Iroko), a low-dose
oral formulation of the relatively COX-2 selective NSAID
diclofenac, for treatment of mild-to-moderate acute pain
in...
The FDA has approved Zorvolex (Iroko), a low-dose
oral formulation of the relatively COX-2 selective NSAID
diclofenac, for treatment of mild-to-moderate acute pain
in adults.
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.
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.
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 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.
Glucarpidase (Voraxaze) for Methotrexate Toxicity
The Medical Letter on Drugs and Therapeutics • March 5, 2012; (Issue 1385)
The FDA has approved glucarpidase (Voraxaze – BTG
International) for treatment of toxic plasma methotrexate
concentrations (>1 micromole per liter) in patients
with delayed methotrexate clearance due to...
The FDA has approved glucarpidase (Voraxaze – BTG
International) for treatment of toxic plasma methotrexate
concentrations (>1 micromole per liter) in patients
with delayed methotrexate clearance due to impaired
renal function. Glucarpidase has been available in the
US since 2007 under a compassionate use open-label
treatment protocol (Clinical Trials and Consulting
Services, 1-877-398-9829), which will remain in effect
until the drug becomes commercially available later
this year. There is currently a shortage of IV methotrexate
in the US.
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.
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.
Intravenous Ibuprofen (Caldolor)
The Medical Letter on Drugs and Therapeutics • January 11, 2010; (Issue 1329)
An intraveneous (IV) formulation of ibuprofen (Caldolor - Cumberland) was recently approved by the FDA for use in adults. It can be administered alone for treatment of mild to moderate pain or as an adjunct to...
An intraveneous (IV) formulation of ibuprofen (Caldolor - Cumberland) was recently approved by the FDA for use in adults. It can be administered alone for treatment of mild to moderate pain or as an adjunct to opioid analgesics for moderate to severe pain. It is also approved for reduction of fever.
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.
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.
Rituximab (Rituxan) for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • April 24, 2006; (Issue 1233)
Rituximab (Rituxan - Genentech), an anti-CD20 monoclonal antibody already marketed for treatment of B-cell non-Hodgkin's lymphoma, is now FDA-approved for use concurrently with methotrexate to treat moderate to...
Rituximab (Rituxan - Genentech), an anti-CD20 monoclonal antibody already marketed for treatment of B-cell non-Hodgkin's lymphoma, is now FDA-approved for use concurrently with methotrexate to treat moderate to severe rheumatoid arthritis in patients who have had an inadequate response to one or more tumor necrosis factor (TNF) inhibitors. Rituximab selectively depletes CD20+ B cells, which apparently play a role in the autoimmune response and in the chronic synovitis associated with rheumatoid arthritis.
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 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 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.
NSAID Alternatives
The Medical Letter on Drugs and Therapeutics • January 17, 2005; (Issue 1200)
Patients taking nonsteroidal anti-inflammatory drugs (NSAIDs) may be asking their health care providers if they should continue, and some may be asking for alternatives. For most patients taking nonspecific...
Patients taking nonsteroidal anti-inflammatory drugs (NSAIDs) may be asking their health care providers if they should continue, and some may be asking for alternatives. For most patients taking nonspecific NSAIDs, it would be reasonable to continue. For those who are taking the COX-2 selective celecoxib (Celebrex) because they cannot tolerate the gastrointestinal (GI) effects of nonspecific NSAIDs, it seems reasonable to continue at doses no higher than 100 mg b.i.d. or 200 mg once daily; at these dosages cardiovascular risk has been no higher than with placebo. All NSAIDs, including COX-2 inhibitors, can decrease renal blood flow and cause fluid retention, hypertension and renal failure, especially in the elderly and in patients who take diuretics. The unpublished study that led to an FDA alert on an increased cardiovascular risk with naproxen (Naprosyn, and others) was conducted in patients older than 70. See NSAID addendum
Drugs for Breast Cancer
The Medical Letter on Drugs and Therapeutics • January 1, 2005; (Issue 29)
In addition to surgery and radiation therapy, a variety of drugs are used both singly and in combination to treat breast cancer. This article summarizes the principles of adjuvant therapy and treatment for...
In addition to surgery and radiation therapy, a variety of drugs are used both singly and in combination to treat breast cancer. This article summarizes the principles of adjuvant therapy and treatment for metastatic disease. A summary of individual drugs and their adverse effects begins on page 3.
Aprepitant (Emend) for Prevention of Nausea and Vomiting Due to Cancer Chemotherapy
The Medical Letter on Drugs and Therapeutics • August 4, 2003; (Issue 1162)
Aprepitant (Emend - Merck), the first substance P/neurokinin 1 (NK1) receptor antagonist to be approved by the FDA, is now available for oral use with corticosteroids and selective serotonin (5-HT3) receptor...
Aprepitant (Emend - Merck), the first substance P/neurokinin 1 (NK1) receptor antagonist to be approved by the FDA, is now available for oral use with corticosteroids and selective serotonin (5-HT3) receptor antagonists to prevent nausea and vomiting caused by highly emetogenic anticancer drugs such as cisplatin.
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).
Drugs of Choice for Cancer
The Medical Letter on Drugs and Therapeutics • March 1, 2003; (Issue 7)
The tables in this article list drugs used for treatment of cancer in the USA and Canada and their major adverse effects. The choice of drugs in Table I is based on the opinions of Medical Letter consultants....
The tables in this article list drugs used for treatment of cancer in the USA and Canada and their major adverse effects. The choice of drugs in Table I is based on the opinions of Medical Letter consultants. Some drugs are listed for indications for which they have not been approved by the US Food and Drug Administration. In some cases, such as elderly patients or those with many co-morbid illnesses, the regimen of choice might not be suitable. For many of the cancers listed, surgery and/or radiation therapy may be the treatment of choice or may also be part of the management. Anticancer drugs and their adverse effects are listed in Table II on page 46. A partial list of brand names appears on page 52.
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.
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).
Topical Tacrolimus For Treatment of Atopic Dermatitis
The Medical Letter on Drugs and Therapeutics • April 16, 2001; (Issue 1102)
Tacrolimus ointment (Protopic) has been approved by the FDA in 0.03% and 0.1% formulations for treatment of atopic dermatitis. Tacrolimus is used systemically (Prograf) to prevent rejection of organ...
Tacrolimus ointment (Protopic) has been approved by the FDA in 0.03% and 0.1% formulations for treatment of atopic dermatitis. Tacrolimus is used systemically (Prograf) to prevent rejection of organ transplants.
Drugs of Choice For Cancer Chemotherapy (combined issue 1087-1088)
The Medical Letter on Drugs and Therapeutics • September 18, 2000; (Issue 1087)
The tables in this article list drugs used for treatment of cancer in the USA and Canada. The choices of drugs in Table 1 is based on the opinions of Medical Letter consultants. Some drugs are listed for...
The tables in this article list drugs used for treatment of cancer in the USA and Canada. The choices of drugs in Table 1 is based on the opinions of Medical Letter consultants. Some drugs are listed for indications for which they have not been approved by the US Food and Drug Administration. For many of the cancers listed, surgery and/or radiation therapy are also part of the management of the disease.
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.
Meloxicam (Mobic) for Osteoarthritis
The Medical Letter on Drugs and Therapeutics • May 29, 2000; (Issue 1079)
Meloxicam, a nonsteroidal anti-inflammatory drug (NSAID) with some cyclooxygenase-2 (COX-2) selectivity in vitro, has been approved by the FDA for treatment of...
Meloxicam, a nonsteroidal anti-inflammatory drug (NSAID) with some cyclooxygenase-2 (COX-2) selectivity in vitro, has been approved by the FDA for treatment of osteoarthritis.
Epirubicin for Adjuvant Therapy in Node-Positive Breast Cancer
The Medical Letter on Drugs and Therapeutics • February 7, 2000; (Issue 1071)
Epirubicin, an analog of doxorubicin that has been available in Europe and Canada for 15 years, has now been approved by the FDA for adjuvant use after resection of the primary tumor in breast cancer patients...
Epirubicin, an analog of doxorubicin that has been available in Europe and Canada for 15 years, has now been approved by the FDA for adjuvant use after resection of the primary tumor in breast cancer patients with axillary node involvement.
Prosorba Column for Rheumatoid Arthritis
The Medical Letter on Drugs and Therapeutics • July 30, 1999; (Issue 1058)
Prosorba, an antibody-adsorbing column used with plasmapheresis, has been approved by the FDA for treatment of moderate-to-severe rheumatoid arthritis in patients refractory or intolerant to methotrexate and...
Prosorba, an antibody-adsorbing column used with plasmapheresis, has been approved by the FDA for treatment of moderate-to-severe rheumatoid arthritis in patients refractory or intolerant to methotrexate and other disease-modifying anti-rheumatic drugs (DMARDs).
Rofecoxib for Osteoarthritis and Pain
The Medical Letter on Drugs and Therapeutics • July 2, 1999; (Issue 1056)
Rofecoxib, a selective COX-2 inhibitor, has been approved by the FDA for treatment of osteoarthritis, acute pain and menstrual...
Rofecoxib, a selective COX-2 inhibitor, has been approved by the FDA for treatment of osteoarthritis, acute pain and menstrual pain.
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.
Two New Retinoids for Psoriasis
The Medical Letter on Drugs and Therapeutics • November 7, 1997; (Issue 1013)
The US Food and Drug Administration (FDA) has approved two new retinoids for treatment of psoriasis. Tazarotene gel 0.05% and 0.1% (Tazorac - Allergan) is being marketed for topical use in patients with...
The US Food and Drug Administration (FDA) has approved two new retinoids for treatment of psoriasis. Tazarotene gel 0.05% and 0.1% (Tazorac - Allergan) is being marketed for topical use in patients with stable, mild to moderate plaque psoriasis. Acitretin (Soriatane - Roche) is being promoted for systemic use in severe psoriasis.
Drugs of Choice for Cancer Chemotherapy
The Medical Letter on Drugs and Therapeutics • March 14, 1997; (Issue 996)
The tables that follow list drugs used for treatment of cancer in the USA and Canada and their major adverse effects. The choice of drugs in Table I is based on the opinions of Medical Letter consultants....
The tables that follow list drugs used for treatment of cancer in the USA and Canada and their major adverse effects. The choice of drugs in Table I is based on the opinions of Medical Letter consultants. Some drugs are listed for indications for which they have not been approved by the US Food and Drug Administration. For most of the cancers listed, surgery and/or radiation therapy are part of the management of the disease. Anticancer drugs and their adverse effects are listed in Table II.
Methotrexate and Misoprostol for Abortion
The Medical Letter on Drugs and Therapeutics • April 26, 1996; (Issue 973)
Recent articles in the press have suggested that in early pregnancy, an intramuscular (IM) injection of methotrexate (Folex, and others), a folic acid antagonist, and oral or vaginal administration of...
Recent articles in the press have suggested that in early pregnancy, an intramuscular (IM) injection of methotrexate (Folex, and others), a folic acid antagonist, and oral or vaginal administration of misoprostol (Cytotec), a prostaglandin, offers a medical alternative to a surgically induced abortion. Methotrexate is approved by the US Food and Drug Administration for use in rheumatoid arthritis, psoriasis and various types of cancer, including choriocarcinoma, and has also been used to terminate ectopic pregnancies. Misoprostol is approved for prevention of gastric ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs). In France, the United Kingdom and Sweden, misoprostol or another prostaglandin is used with mifepristone (RU486) to induce abortions in early pregnancy (Medical Letter, 32:112, 1990).
Calcipotriene for Psoriasis
The Medical Letter on Drugs and Therapeutics • August 5, 1994; (Issue 928)
Calcipotriene ointment 0.005% (calcipotriol; Dovonex - Westwood Squibb), a synthetic vitamin D 3 analog previously available in Europe and Canada, has now been approved by the US Food and Drug Administration...
Calcipotriene ointment 0.005% (calcipotriol; Dovonex - Westwood Squibb), a synthetic vitamin D 3 analog previously available in Europe and Canada, has now been approved by the US Food and Drug Administration (FDA) for treatment of moderate plaque psoriasis, the most common form of the disease.
Drugs for Vomiting Caused by Cancer Chemotherapy
The Medical Letter on Drugs and Therapeutics • December 24, 1993; (Issue 912)
Several currently available antiemetic drugs can prevent vomiting caused by cancer chemotherapy. Anticancer drugs that cause vomiting are listed in the table...
Several currently available antiemetic drugs can prevent vomiting caused by cancer chemotherapy. Anticancer drugs that cause vomiting are listed in the table below.
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 That Cause Pulmonary Toxicity
The Medical Letter on Drugs and Therapeutics • September 21, 1990; (Issue 827)
Some commonly used systemic drugs that may cause pulmonary toxicity are listed in the table below. These adverse effects may sometimes be difficult to distinguish from the underlying disease (JAD Cooper, Jr...
Some commonly used systemic drugs that may cause pulmonary toxicity are listed in the table below. These adverse effects may sometimes be difficult to distinguish from the underlying disease (JAD Cooper, Jr et al, Am Rev Respir Dis, 133:321, 488, 1986). Pulmonary effects that are part of a generalized reaction or are indirect effects of drugs - on respiratory muscles, for example, or on the immune system - are not included here.
Adjuvant Chemotherapy of Early Breast Cancer
The Medical Letter on Drugs and Therapeutics • May 18, 1990; (Issue 818)
The most important prognostic variable in early breast cancer is axillary lymph node involvement. Based on past experience, after 10 years about 70% of node-negative patients will be alive and apparently free...
The most important prognostic variable in early breast cancer is axillary lymph node involvement. Based on past experience, after 10 years about 70% of node-negative patients will be alive and apparently free of disease; about 30% will have relapsed or died. Patients with positive nodes may have a 30% to 60% relapse rate, depending on the number of positive nodes and other prognostic factors, such as the presence of estrogen receptors (IC Henderson et al, in VT DeVita, Jr et al, eds, Cancer: Principles and Practice of Oncology, 3rd ed, Philadelphia:Lippincott, 1989, p 1197). Which of these patients should receive adjuvant treatment with cytotoxic drugs and/or endocrine therapy is controversial; a National Cancer Institute (NCI) Consensus Conference on this subject is scheduled for June.
Trimetrexate
The Medical Letter on Drugs and Therapeutics • January 27, 1989; (Issue 784)
Trimetrexate glucuronate (Parke-Davis), an investigational drug, is now available in the USA from the National Institute of Allergy and Infectious Diseases (NIAID) for treatment of selected AIDS patients with...
Trimetrexate glucuronate (Parke-Davis), an investigational drug, is now available in the USA from the National Institute of Allergy and Infectious Diseases (NIAID) for treatment of selected AIDS patients with Pneumocystis carinii pneumonia (PCP). For this indication, trimetrexate is always used concurrently with leucovorin (Wellcovorin; and others).
Diclofenac
The Medical Letter on Drugs and Therapeutics • December 2, 1988; (Issue 780)
Diclofenac sodium (Voltaren - Geigy), a nonsteroidal anti-inflammatory drug (NSAID) available in some countries since 1974, was recently introduced in the USA for treatment of rheumatoid arthritis,...
Diclofenac sodium (Voltaren - Geigy), a nonsteroidal anti-inflammatory drug (NSAID) available in some countries since 1974, was recently introduced in the USA for treatment of rheumatoid arthritis, osteoarthritis and ankylosing spondylitis. It is being promoted as 'The number one prescribed antiarthritic in the world.'