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.
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.
Sep 15, 2005 Issue
Duloxetine (Cymbalta) for Treatment of Major Depressive Disorder
Duloxetine is safe and effective for the treatment of major depressive disorder. Because of its expense and the lack of data supporting its superiority over other antidepressants, it should be used as an alternative if other agents are ineffective or are not tolerated.
Aug 15, 2005 Issue
Olmesartan (Benicar) for Hypertension
Olmesartan is a safe and effective antihypertensive agent. There is no evidence that olmesartan is more effective than other ARBs or ACE inhibitors. The longest peer-reviewed studies of olmesartan are of two months’ duration; thus, there is no evidence showing olmesartan’s long-term benefit for cardiovascular or all-cause mortality.
Jul 15, 2005 Issue
Colesevelam (WelChol) for Reduction of LDL Cholesterol
Colesevelam lowers LDL cholesterol levels a small amount (7 to 16 percent) when used alone and provides additional cholesterol lowering when added to statin therapy. It has a slightly beneficial effect on HDL cholesterol levels, has no effect on triglyceride levels, and is well tolerated.
Jun 15, 2005 Issue
Eszopiclone (Lunesta) for Treatment of Transient and Chronic Insomnia
Similar to other hypnotic drugs, eszopiclone treats the symptom of insomnia and not the underlying cause. It offers no advantage over other nonbenzodiazepine hypnotic agents for transient insomnia and it therefore should be considered a second-line agent.
Apr 15, 2005 Issue
Ethinyl Estradiol/Levonorgestrel (Seasonale) for Oral Contraception
Women using ethinyl estradiol/levonorgestrel can expect similar or improved effectiveness and fewer menstrual cycles. Due in part to an increased incidence of unexpected bleeding in the first six months of use, a greater percentage of women will discontinue this regimen than will those using standard oral contraceptives.
Jan 15, 2005 Issue
Omalizumab (Xolair) for Treatment of Asthma
Omalizumab is an immunomodulatory therapy for the control of symptoms in patients with moderate to severe allergic asthma uncontrolled with conventional therapy. Given its high cost, the requirement that it be administered in a physician’s office, and side effects, it is appropriate for use in only a small percentage of patients with asthma.
Dec 15, 2004 Issue
Transdermal Oxybutynin (Oxytrol) for Urinary Incontinence
The transdermal patch of oxybutynin is no more effective than the short- or long-acting oral form. The patch costs more, but causes less dry mouth. Skin reactions will cause about 10 percent of patients to stop using it.
Sep 15, 2004 Issue
Telithromycin (Ketek) for Respiratory Tract Infections
Telithromycin is similar to azithromycin and clarithromycin in side effects, dosing, and cost, but with enhanced activity against S. pneumoniae. Although 30 to 40 percent of S. pneumoniae cases are thought to be resistant to penicillin and/or macrolides, additional clinical trials are needed to determine the clinical relevance of this enhanced activity.
Jul 15, 2004 Issue
Tadalafil (Cialis) for Erectile Dysfunction
Like other PDE5 inhibitors, tadalafil effectively improves the ability of men with erectile dysfunction to achieve an erection and successfully complete intercourse. It is less effective, although still useful, in some men with ED due to diabetes. Its longer duration may require less frequent dosing and may allow the user to take it earlier in the day of planned sexual activity.