This department includes information about new drugs from the perspective of the five attributes to be considered when weighing the advantages of one drug over another: Safety, Tolerability, Effectiveness, Price, and Simplicity.

Oct 15, 2010 Issue
Milnacipran (Savella) for Fibromyalgia
Milnacipran can decrease the overall pain scores and improve symptoms of fibromyalgia. Safety in patients with severe comorbid medical and psychiatric conditions is unknown because these groups of patients were excluded from the study.

Sep 15, 2010 Issue
Methylnaltrexone (Relistor) for Opioid-Induced Constipation
Methylnaltrexone can temporarily relieve opioid-induced constipation in patients with advanced illness who have not responded to laxative treatment. However, it must be given by injection, is expensive, and has been studied only for short-term use.

Jun 15, 2010 Issue
Saxagliptin (Onglyza) for Type 2 Diabetes Mellitus
Saxagliptin lowers A1C levels to a lesser extent and is much more expensive than first-line therapy with metformin. Its ability to decrease diabetes-related complications, including mortality, is not known. It is a DPP-4 inhibitor that has a more significant drug interaction profile than sitagliptin and offers little cost advantage.

May 15, 2010 Issue
Febuxostat (Uloric) for Hyperuricemia and Gout
Febuxostat more effectively lowers serum uric acid to goal levels than does allopurinol; however, this benefit is offset by a slightly higher incidence of adverse effects and treatment discontinuation. Until superiority for patient-oriented outcomes is shown in comparative trials with allopurinol, febuxostat should be reserved for symptomatic patients who do not obtain adequate reduction in serum uric acid levels or are intolerant of allopurinol.

Feb 15, 2010 Issue
Dapsone (Aczone) 5% Gel for the Treatment of Acne
Topical dapsone gel will decrease the percentage of lesions in patients with mild to moderate acne, especially inflammatory lesions. Although not directly compared, dapsone gel has lower response rates than currently available topical treatments that are less expensive.

Dec 15, 2009 Issue
Sinecatechins (Veregen) for External Genital and Perianal Warts
Sinecatechins offers no clear advantage with regard to safety and tolerability. Indirect comparisons with other treatments suggest that sinecatechins may be more effective, with fewer recurrences of warts following successful treatment, but direct comparisons are lacking.

Jun 15, 2009 Issue
Risperidone (Risperdal) for Management of Autistic Disorder
Risperidone does not alter the course of autistic disorder, but is effective for controlling irritability and other associated symptoms. Patients taking risperidone should be appropriately monitored for adverse effects, especially abnormal movements.

Jan 15, 2009 Issue
Tinidazole (Tindamax) for Trichomoniasis and Bacterial Vaginosis
Tinidazole is generally an expensive alternative to metronidazole for the treatment of trichomoniasis and bacterial vaginosis. It offers little, if any, advantage with regard to safety, tolerability, and effectiveness; however, its once-daily dosing and shorter course of therapy may be useful for some patients.

Dec 15, 2008 Issue
Adalimumab (Humira) for the Treatment of Rheumatoid Arthritis
Adalimumab used alone offers little benefit over the traditional first-line agent, methotrexate. However, it increases remission rates when combined with methotrexate in early aggressive rheumatoid arthritis and when combined with traditional DMARDs in those who have not derived benefit from existing regimens. Most patients experience few side effects; however, rare, serious adverse events can occur.

Oct 15, 2008 Issue
Conivaptan (Vaprisol) for the Treatment of Hyponatremia
In most cases, patients with hyponatremia can be adequately managed with fluid restriction alone. However, acutely symptomatic patients may require treatment, such as hypertonic saline. In these situations, conivaptan is an expensive alternative.

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