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The investigational inhaled insulin product (Exubera) could prove a boon to patients with diabetes, cutting or eliminating the need for injections. So indicate findings from a phase III trial presented at the annual meeting of the American Association of Clinical Endocrinologists (AACE). For patients with type 1 diabetes, a regimen of inhaled insulin before meals and one injection at night could control blood glucose as well as or possibly better than injections alone. These results add to some phase III data presented last June that showed a small but significant number of patients with type 2 diabetes reached recommended blood glucose levels at 6 months.

In studies reported this month at the European League Against Rheumatism meeting in Stockholm, the anti-TNF antibody adalimumab (D2E7) for rheumatoid arthritis is showing good long-term results, even in patients for whom other disease modifying antirheumatic drugs (DMARDs) have failed.

In this final installment of this series, the authors focus on the use of SSRIs in alcohol dependence, chronic pain, eating disorders, premenstrual dysphoric disorder, and sexual dysfunction. For each condition, the authors examine how well clinical trial evidence supports the application, discuss dosing and safety considerations, and provide their recommendations on preferred and alternative SSRIs, based on the weight of the evidence.

Tadalafil (Cialis) was recently deemed approvable for the treatment of erectile dysfunction (ED). When approved, it will join the widely used PDE5 inhibitor sildenafil citrate as an oral therapy for ED management. Among tadalafil?s characteristics are its rapid onset of action, a duration of action of up to 24 hours, and lack of food influence on the drug?s pharmacokinetics. In this Focus article, the pharmacologic, pharmacokinetic, and therapeutic aspects of tadalafil are reviewed and compared, when possible, with sildenafil and another investigational agent, vardenafil.

Leflunomide, etanercept, infliximab, and anakinra represent the four latest additions to the therapeutic armamentarium for rheumatoid arthritis. All four of these DMARDs have demonstrated clinical and radiographic evidence of efficacy that is changing the therapeutic approach to treatment. The authors of this article summarize the pivotal clinical trial and efficacy data up through the perimarketing period, provide the latest efficacy and safety update on these agents, discuss the financial implications of their use, and offer insights into their place in therapy.

Moxifloxacin (Avelox®) is a relatively new fluoroquinolone available in both oral and intravenous formulations. Extensive clinical analysis and postmarketing surveys suggest that moxifloxacin is safe and well tolerated.

This article reviews the efficacy of fluoroquinolones for treating community-acquired pneumonia (CAP) and discusses clinical advantages of fluoroquinolones relative to other drug classes. Of 19 randomized, controlled trials comparing a fluoroquinolone with another agent or combination of agents in CAP, 6 trials have demonstrated superiority of the fluoroquinolone with respect to clinical and/or bacteriologic efficacy.

The emergence of antibiotic resistance to Streptococcus pneumoniae and other bacterial pathogens is, in part, responsible for the increase in infectious-disease–related mortality occurring between 1980 and 1992.

Pharmacokinetic and pharmacodynamic parameters serve as guidelines for selecting antimicrobial agents and dose regimens that will maximize efficacy and suppress resistance.