July 05, 2007 Archives - Clinical Advisor

Print Issue: July 05, 2007

Drugs in the pipeline

Drug Dependence Nicotine conjugate vaccine (NicVAX, from Nabi Biopharmaceuticals) a vaccine that stimulates the immune system to produce antibodies that bind to nicotine for the treatment of nicotine addiction and prevention of smoking relapse—Phase 2b Musculoskeletal Disorders Bazedoxifene (from Wyeth) a selective estrogen receptor modulator being reviewed for the prevention of postmenopausal osteoporosis—Approvable Editor’s note:…

Altabax- New antibiotic for impetigo

Company: GlaxoSmithKline Pharmacologic class: Antibacterial (pleuromutilin) Active ingredient: Retapamulin 1%; ointment. Indication: Topical treatment of impetigo due to Staphylococcus aureus (methicillin-susceptible isolates only) or Streptococcus pyogenes in patients ≥9 months of age. Pharmacology: Altabax contains retapamulin, a semisynthetic pleuromutilin antibiotic. Each gram of ointment contains 10 mg of retapamulin in white petrolatum. Retapamulin selectively inhibits…

Reclast- Once-a-year therapy for osteoporosis

Company: Novartis Pharmacologic class: Bisphosphonate Active ingredient: Zoledronic acid 5 mg/100 mL bottle; solution for IV infusion. Indication: Treatment of Paget’s disease of bone in men and women. Pharmacology: Paget’s disease of bone is characterized by greatly increased and disorderly bone remodeling. Excessive osteoclastic bone resorption is followed by irregular osteoblastic new bone formation, leading…

Veramyst- New steroid for countering allergic rhinitis

Company: GlaxoSmithKline Pharmacologic class: Corticosteroid Active ingredient: Fluticasone furoate 27.5 µg/spray; alcohol-free. Indication: Seasonal and perennial allergic rhinitis. Pharmacology: Fluticasone furoate is a synthetic trifluorinated corticosteroid with potent anti-inflammatory activity. The exact mechanism by which this corticosteroid exerts its effects in the treatment of allergic rhinitis is unknown. Corticosteroids have a wide range of actions…

Elestrin- Estrogen lotion helps diminish hot flushes

Company: Kenwood Therapeutics Pharmacologic class: Estrogen Active ingredient: Estradiol 0.06%; gel; contains alcohol. Indication: Moderate-to-severe vasomotor symptoms associated with menopause. Pharmacology: The addition of exogenous estrogens, such as Elestrin, helps to alleviate the vasomotor symptoms associated with declining estrogen levels. Elestrin contains 0.06% estradiol in a hydroalcoholic gel base. One pump actuation delivers 0.87 g,…

ESZOPICLONE RELIEVES INSOMNIA AND NOCTURNAL MENOPAUSE SYMPTOMS

Level 1: Likely reliable evidence A randomized trial evaluated the efficacy of eszopiclone (Lunesta) for insomnia in 410 women aged 40-60 years with onset of insomnia temporally associated with transition to menopause (Obstet Gynecol. 2006;108:1402-1410). Women were randomized to eszopiclone 3 mg or placebo nightly for four weeks; they were treated with single-blind placebo for…

INTERVENTIONS THAT LOWER RATE OF PROGRESSION FROM IMPAIRED GLUCOSE TOLERANCE TO DIABETES

Level 1: Likely reliable evidence Impaired glucose tolerance (IGT) has been defined as a two-hour, 75-g oral glucose tolerance test result of 140-199 mg/dL (Diabetes Care. 2003;26:3160-3167; full text available online without charge at: http://care.diabetesjournals.org/cgi/content/full/26/11/3160. Accessed June 12, 2007). In patients with IGT, the effect of interventions on reducing the risk of progression to type…

SSRIS EFFECTIVE AS EARLY AS ONE TO

Level 1: Likely reliable evidence A systematic review of 50 randomized placebo-controlled trials of selective serotonin reuptake inhibitors (SSRIs) evaluated their onset of efficacy in 10,121 adults with unipolar depression (Arch Gen Psychiatry. 2006;63:1217-1223). Included trials evaluated fluoxetine (Prozac), fluvoxamine (Luvox), citalopram (Celexa), escitalopram (Lexapro), sertraline (Zoloft), and paroxetine (Paxil) and reported outcome measures at…

SPECULUM EXAM WITHOUT STIRRUPS REDUCES STRESS…

Level 1: Likely reliable evidence AND MAY NOT AFFECT CERVICAL-SMEAR QUALITY Level 2: Mid-level evidence A randomized trial evaluated the use of stirrups in 197 women undergoing a routine gynecologic exam and cervical smear (BMJ. 2006;333:171; full text available online free of charge at: www.bmj.com/cgi/content. Accessed June 12, 2007). Participants were randomized to an exam…

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