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.
Jul 15, 2006 Issue
Insulin Detemir (Levmir) for Diabetes Mellitus
Insulin detemir is suitable as basal insulin in a basal-bolus regimen. In limited research, it has been shown to cause slightly fewer episodes of minor hypoglycemia and no weight gain in patients with type 1 and 2 diabetes, which is a benefit that must be balanced against its higher price. Insulin detemir has been shown to provide similar glycemic control when compared with NPH insulin.
Jun 15, 2006 Issue
Exenatide Injection (Byetta): Adjunctive Therapy for Glycemic Control
Exenatide is an injectable treatment for type 2 diabetes. Its use requires patient education and strict monitoring of glucose levels because of the difficulty of its administration; therefore, it may not be a safe or practical option for patients who are not willing or able to administer exenatide correctly.
May 15, 2006 Issue
Levonorgestrel-Releasing Intrauterine System (Mirena) for Contraception
The levonorgestrel-releasing intrauterine system is a reliable, reversible, low-maintenance method of long-term contraception. Rates of failure are similar to those of female sterilization, and the risk of expulsion is minimal for most users.
Apr 15, 2006 Issue
Ramelteon (Rozerem) for Insomnia
Ramelteon is safe and effective for decreasing the time to persistent sleep in patients with chronic insomnia. It does not have the potential for abuse or dependence that sedative hypnotics have and is not a controlled substance.
Mar 15, 2006 Issue
Amlodipine/Atorvastin (Caduet) for Preventing Heart Disease
Amlodipine/atorvastatin offers no added benefit in safety, tolerability, or effectiveness over amlodipine and atorvastatin taken separately. It has not been shown to improve mortality or morbidity in patients who have hypertension with or without dyslipidemia. The only potential advantages to amlodipine/atorvastatin therapy are convenience and a single insurance co-pay.
Feb 15, 2006 Issue
Nesiritide (Natrecor) for Acute Decompensated Heart Failure
Nesiritide improves short-term hemodynamics in hospitalized patients with acute decompensated heart failure who have not benefited from aggressive treatment with standard care. However, nesiritide may cause renal function to worsen and may increase the risk of death within 30 days.
Jan 15, 2006 Issue
Ibandronate (Boniva) for Treatment and Prevention of Osteoporosis in Postmenopausal Women
Ibandronate is a bisphosphonate that can be taken daily or monthly. The daily dosage has been shown to decrease vertebral fractures in women with osteoporosis and a history of previous vertebral fractures. Neither formulation has been shown to reduce the risk of hip fracture or other nonvertebral fracture, nor to reduce fractures in women without prior fracture.
Dec 15, 2005 Issue
Rifaximin (Xifaxan) for Traveler's Diarrhea
Rifaximin is safe and effective for treatment in most patients with traveler's diarrhea, but it offers no advantages over ciprofloxacin. At the same cost, it has a less convenient dosage interval than ciprofloxacin and has more limitations.
Nov 15, 2005 Issue
Ezetimibe/Simvastatin (Vytorin) for Hypercholesterolemia
Low doses of ezetimibe/simvastatin provide greater improvements in lipid profile than simvastatin or atorvastatin monotherapy. Ezetimibe/simvastatin may be useful in patients who are unable to tolerate high-dose statin therapy. Combination ezetimibe-simvastatin is less expensive than adding ezetimibe to a statin and more convenient than taking two separate medicines.
Oct 15, 2005 Issue
Topiramate (Topamax) for Migraine Prevention
Topiramate is more effective than placebo for migraine prevention. Its effectiveness appears to be similar to that of other antiepileptic drugs and beta blockers. Because of the high cost of topiramate and the relative frequency of adverse effects, other approaches to migraine prevention, such as beta blockers, tricyclic antidepressants, or riboflavin, should be used first.