AFP DEPARTMENT COLLECTION
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.
Aug 15, 2008 Issue
Zoledronic Acid (Reclast) for Osteoporosis
Zoledronic acid, in combination with calcium and vitamin D, will reduce the risk of vertebral fractures, and to a lesser extent, hip fractures in women with osteoporosis. It decreases subsequent fractures and mortality in high-risk patients who have had a hip fracture. Zoledronic acid may be most useful for women who are unable to tolerate, or have difficulty remembering to take, oral bisphosphonates.
Jul 15, 2008 Issue
Becaplermin (Regranex) for Diabetic Foot Ulcers
Although patients treated with becaplermin are more likely to experience complete and faster ulcer healing than patients continuing good wound care alone, the increased risk of cancer mortality and significant cost outweigh the possible benefits in most patients.
Feb 15, 2008 Issue
Selegiline Transdermal Patch (Emsam) for Major Depressive Disorder
Transdermal selegiline is an expensive treatment option for patients with major depressive disorder who have not responded to other antidepressants or who cannot swallow or take oral medications. Based on guidelines from the American Psychiatric Association, MAO inhibitor pharmacotherapy should be reserved for patients with atypical and treatment-resistant depression.
Jan 15, 2008 Issue
Levonorgestrel/Ethinyl Estradiol (Lybrel) for Continuous Contraception
Lybrel appears to be as safe and effective as other combined oral contraceptives; however, at this time, there is little published data about this specific product. Other combined monophasic oral contraceptives, some of which cost less than Lybrel, can be used continuously and have been shown to produce similar results.
Dec 15, 2007 Issue
Telithromycin (Ketek) for Treatment of Community-Acquired Pneumonia
Telithromycin is similar to clarithromycin with regard to dosing, drug interactions, and effectiveness. It has more frequent and severe adverse effects and is more expensive than other macrolides. Telithromycin should only be used in patients with mild to moderate community-acquired pneumonia caused by penicillin- or macrolide-resistant S. pneumoniae.
Nov 15, 2007 Issue
Retapamulin (Altabax) 1% Topical ointment for the Treatment of Impetigo
Retapamulin is an effective alternative to topical mupirocin in the treatment of limited-area impetigo in patients older than nine months. Although it is more expensive, retapamulin does have a dosing advantage over mupirocin; it only requires a twice-a-day application for five days, whereas mupirocin requires application three times a day for 10 to 12 days.
Oct 15, 2007 Issue
Aliskiren (Tekturna) for the Treatment of Hypertension
Aliskiren provides a new pharmacologic approach to treating hypertension; however, short-term studies have not identified a unique role. It is more expensive than commonly used first-line diuretics, and long-term safety has not been demonstrated.
Sep 15, 2007 Issue
Sitagliptin (Januvia) for the Treatment of Patients with Type 2 Diabetes
Sitagliptin may be useful as second-line or third-line therapy in patients with a mildly elevated A1C level (less than 9 percent) who do not reach their A1C goal with first-line therapy (metformin). Sitagliptin will decrease postprandial blood glucose and mildly lower fasting blood glucose for a total A1C reduction around 0.8 percent.
Aug 15, 2007 Issue
Quadrivalent HPV Recombinant Vaccine (Gardasil) for the Prevention of Cervical Cancer
The HPV vaccine is safe and effective in preventing genital warts and cervical changes that may lead to cervical cancer, and it is recommended as part of the vaccination series in females 11 to 12 years of age. It can be given to females as young as 9 or 10 years of age, and catch-up vaccination is recommended for those who are 13 to 26 years of age.
Jul 15, 2007 Issue
Varenicline (Chantix) for Smoking Cessation
For every nine highly-motivated patients who use varenicline instead of placebo, one will not be smoking one year later. Although the cost of therapy is a limitation (total cost is approximately $360 for a three-month course), the easy dosage titration, lack of drug interactions, and favorable side-effect profile make varenicline an appealing alternative to sustained-release bupropion for smoking cessation.