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.
Jun 15, 2004 Issue
Tiotropium (Spiriva) for COPD
Tiotropium improves dyspnea, decreases COPD exacerbations and hospitalizations, decreases albuterol use, improves health-related quality of life and increases mean trough FEV1. Tiotropium was more effective than ipratropium and salmeterol in improving TDI scores. It was more effective than ipratropium and equal to salmeterol in decreasing COPD exacerbations.
May 15, 2004 Issue
Ethinyl Estradiol/Drospirenone (Yasmin): A Newer Oral Contraceptive
An effective oral contraceptive, ethinyl estradiol/drospirenone can elevate potassium levels when given in combination with other potassium-elevating agents and offers no advantage over traditional oral contraceptives.
Apr 15, 2004 Issue
Teriparatide (Forteo) for Osteoporosis
Teriparatide increases bone density in men and women with osteoporosis and has reduced the risk of new vertebral fractures in high-risk women. Its role in therapy is not clear. Due to its uncertain safety profile, lack of long-term experience, and high cost, it makes sense to reserve teriparatide for patients with severe osteoporosis who are intolerant or unresponsive to currently approved therapies.
Mar 15, 2004 Issue
Memantine (Namenda) for Moderate to Severe Alzheimer's Disease
Memantine is well tolerated, but its clinical benefits for the treatment of moderate to severe AD appear modest. The reduction in caregiver time requires confirmation in another trial. As with other drugs for AD, memantine does not reverse deterioration.
Feb 15, 2004 Issue
Eplerenone (Inspra) for Hypertension
Compared with other commonly used antihypertensive medications, eplerenone is effective in lowering blood pressure when used alone or as add-on therapy. However, mortality benefits related to antihypertensive treatment have not yet been shown, so it should not be considered a first-line treatment for hypertension.
Jan 15, 2004 Issue
Tegaserod (Zelnorm) for Irritable Bowel Syndrome
Despite design limitations common to drug therapy trials for c-IBS (e.g., subjective outcomes, high placebo response rate), tegaserod is at least somewhat effective at relieving troublesome symptoms in women. Considering the modest benefits and high cost, tegaserod is best used as a short-term, second-line agent for those women who do not respond adequately to changes in diet, to bulk-forming agents like psyllium, or to other interventions.
Dec 15, 2003 Issue
Adefovir (Hepsera) for Chronic Hepatitis B Infection
Adefovir offers an effective first-line alternative for the treatment of chronic hepatitis B. It also may prove to be useful in patients who have failed therapy with lamivudine as well as in patients who have difficulty tolerating interferon alfa-2b. How it compares with other agents or with combination therapy is unknown.
Dec 1, 2003 Issue
Escitalopram (Lexapro) for Depression.
While escitalopram has proved to be an effective treatment for major depression, it has not been shown to be significantly more effective, safer, or better tolerated than citalopram or other antidepressants.
Nov 15, 2003 Issue
Desloratadine for Allergic Rhinitis
Desloratadine is somewhat effective for the treatment of seasonal allergic rhinitis and may decrease nasal congestion. It also is effective for chronic urticaria. Desloratadine is similar in effectiveness to fexofenadine and would be expected to produce results similar to loratadine and other nonsedating antihistamines.
Nov 1, 2003 Issue
Atomoxetine for ADHD
Atomoxetine is more effective than placebo for treating symptoms of ADHD in children and adults, based on short-term studies. Given safety concerns (growth retardation, potential adverse effects in slow metabolizers) and its high cost, atomoxetine should be considered only as an alternative for patients who are intolerant or unresponsive to stimulant medications such as methylphenidate.