Formulary Watch |

Statin therapy reduces severity of second ischemic stroke in patients with no history of coronary heart disease

A secondary analysis of data from the Stroke Prevention with Aggressive Reduction in Cholesterol Levels (SPARCL) trial demonstrated that statin treatment can significantly reduce the severity of a second ischemic stroke in patients who had no history of coronary heart disease. With statin treatment, there were fewer fatal and severe strokes, fewer moderate and mild strokes, fewer transient ischemic attacks (TIAs), and more patients who had no events, said Larry B. Goldstein, MD, at the American Neurological Association (ANA) 131st Annual Meeting.

Studies of famotidine demonstrate improvement in cardiac symptoms of chronic heart failure

Two studies of the effects of famotidine in patients with chronic heart failure (CHF) have demonstrated that the treatment improves cardiac symptoms of CHF, including ventricular remodeling. Famotidine has not been approved by FDA for treatment of CHF.

Inhaled corticosteroids administered within 90 days of discharge reduce mortality rate in COPD patients

Administration of inhaled corticosteroids (ICS) within 90 days of hospital discharge is effective in reducing mortality in chronic obstructive pulmonary disease (COPD) patients, especially among those aged 35 to 64 years, according to a recent study published in the journal Chest.

Celecoxib demonstrates benefit in preventing premalignant colorectal adenomas, but cardiovascular risk raises concerns

Although use of the cyclooxygenase (COX)-2 inhibitor celecoxib has demonstrated benefit in preventing premalignant colorectal adenomas, generally the agent should not be recommended for this purpose due to the risk of cardiovascular events, according to 1 recent trial. In a second study of celecoxib use and adenomas, treatment with celecoxib 400 mg/d markedly lowered the incidence of colorectal adenomas within 2 years after the removal of polyps.

Diabetes associations develop consensus algorithm for the management of hyperglycemia in type 2 diabetes

The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) have developed a consensus algorithm for the management of hyperglycemia in type 2 diabetes. The statement, published in the August issue of Diabetes Care, was created for several reasons.

DREAM trial: Rosiglitazone reduces the incidence of new-onset diabetes

In a randomized, double-blind, placebo-controlled trial recently published in Lancet, the thiazolidinedione (or "glitazone") rosiglitazone statistically significantly reduced the incidence of new-onset diabetes when given to patients diagnosed with prediabetes but lacking a prior history of cardiovascular disease. The benefits of using thiazolidinediones in the treatment of patients with diabetes are well known, but the current finding that thiazolidinediones can prevent prediabetics from progressing to diabetes is novel.

DREAM trial: Ramipril fails to reduce the incidence of new-onset diabetes or death

In a randomized, double-blind, placebo-controlled trial, the angiotensin-converting enzyme (ACE) inhibitor ramipril, when administered to patients with prediabetes but no previous cardiovascular disease, failed to demonstrate a statistically significant reduction in the primary composite end point of new-onset diabetes or death.

Long-term use of hormone replacement therapy may be associated with increased risk of ovarian cancer

According to a new study published in the Journal of the National Cancer Institute, menopausal women who use long-term hormone replacement therapy (unopposed estrogen or estrogen in combination with progestin) may have up to a 3-fold increased risk of developing ovarian cancer compared with women who do not use hormone replacement therapy.

Early, intensive statin therapy reduces risk of death and cardiac events in patients hospitalized for ACS

Intensive statin therapy administered to patients within 14 days of hospitalization for acute coronary syndrome (ACS) can reduce the risk of death and certain cardiovascular events by nearly 20%, according to a meta-analysis by Eddie Hulten, MD, MPH, and colleagues recently published in Archives of Internal Medicine.

Focus on 2006: A year of novel pharmacologic agents in review

So far this year, Formulary has examined 10 newly approved or investigational drugs of interest to pharmacy and therapeutics committee members through our "Focus on" articles. Because many readers have expressed that this information is useful when making formulary decisions for their hospitals, health systems, or managed care organizations, Formulary has compiled this late-year review of these new and emerging agents, along with updates on the regulatory status of each.

FDA advises about potential attenuation of anti-platelet effect of low-dose aspirin with concomitant use of ibuprofen

FDA recently released an information sheet advising healthcare professionals about a potential pharmacodynamic interaction between low-dose aspirin (81 mg/d) and ibuprofen 400 mg when they are dosed concomitantly. This interaction may attenuate aspirin's anti-platelet cardioprotective effect in patients taking aspirin for secondary prevention of myocardial infarction.

Rimonabant: A novel CB1 receptor antagonist for the treatment of obesity

Obesity is on the rise in the United States, with 60.5% of the adult population overweight and 23.9% obese as of 2005. Up to 10% of an industrialized country's healthcare budget often can be spent on obesity and associated comorbidities.

New meta-analyses evaluate effect of COX-2 inhibitors on renal and CV events, including arrhythmia

Two recent analyses published in the Journal of the American Medical Association (JAMA) evaluating the adverse risks of cyclooxygenase-2 (COX-2) inhibitors offered continued support for the 2004 decision to remove rofecoxib from world markets. The research also demonstrated a lack of association between celecoxib and adverse cardiovascular and renal effects.

Pipeline Preview (November 2006)

Lisdexamfetamine (NRP104, Shire/New River Pharmaceuticals) for the treatment of pediatric attention-deficit/hyperactivity disorder (ADHD)

FDA Actions in Brief

FDA granted 2 additional indications for rituximab (Rituxan, Genentech/Biogen Idec) in the treatment of patients with CD-20-positive, B-cell non-Hodgkin's lymphoma (NHL). The agent is now approved as first-line treatment of previously untreated patients with follicular NHL in combination with cyclophosphamide, vincristine, and prednisolone (CVP) chemotherapy, and in the treatment of patients with low-grade NHL with stable disease, or in those with partial or complete response following first-line treatment with CVP chemotherapy.

First-time generic approvals (November 2006)

Levonorgestrel and ethinyl estradiol tablets, 0.15/0.03 mg (equiv to Seasonale tablets)

Infliximab

Infliximab acts through the inhibition of tumor necrosis factor (TNF)-alpha, which is responsible for the induction of inflammatory cytokines, the enhancement of leukocyte migration, and the activation of neutrophil and eosinophil functional activity. Infliximab was approved on September 27, 2006, for the treatment of adult patients with chronic severe (ie, extensive and/or disabling) plaque psoriasis who are candidates for systemic therapy and when other systemic therapies are medically less appropriate.

Vorinostat

This agent targets the overexpression of histone deacetylase (HDAC) or the aberrant recruitment of HDACs to oncogenic transcription factors in cancer cells. Vorinostat was approved on October 6, 2006, for the treatment of cutaneous manifestations in patients with cutaneous T-cell lymphoma (CTCL) who have progressive, persistent, or recurrent disease following 2 systemic therapies.

Von Eschenbach a step closer to confirmation

Von Eschenbach a step closer to confirmation

Chicago dining guide

Chicago Dining Guide

AMCP images

Images for AMCP show daily

Faculty scheduled to attend AMCP Educational Conference, Oct. 2006

Faculty scheduled to attend AMCP Educational Conference, Oct. 2006

Tips can aid Medicare beneficiaries in 'doughnut hole'

Recent reports of Medicare Part D beneficiaries who have been caught in the doughnut hole have related how some have cut back on medications.

Pharmacy benefit trends, other industry topics to be explored at AMCP Educational Conference

The Academy of Managed Care Pharmacy's (AMCP) 2006 Educational Conference begins at noon Oct. 4 at the Hyatt Regency, Chicago. Attendees from healthcare organizations, government agencies, academia and the pharmacy industry will be exploring the fast-changing issues driving pharmacy benefit design.

Less CABG bleeding observed with enoxaparin compared with unfractionated heparin after PCI

A 0.5-mg/kg dose of a low molecular weight heparin, enoxaparin, resulted in less non-coronary-artery bypass grafting (CABG) bleeding compared with unfractionated heparin in the first 48 hours after elective percutaneous coronary intervention (PCI), according to a prospective, open-label, multicenter, randomized trial reported in the New England Journal of Medicine.

High-dose statin therapy displays benefit in preventing cardiovascular events compared with standard doses

Intensive lipid lowering with high-dose 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) provides a significant benefit over standard-dose statin therapy in preventing nonfatal cardiovascular outcomes and also may reduce the incidence of cardiovascular death, according to results of a meta-analysis published in the Journal of the American College of Cardiology.

High-dose statin therapy displays benefit in preventing cardiovascular events compared with standard doses

Intensive lipid lowering with high-dose 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) provides a significant benefit over standard-dose statin therapy in preventing nonfatal cardiovascular outcomes and also may reduce the incidence of cardiovascular death, according to results of a meta-analysis published in the Journal of the American College of Cardiology.

Valsartan appears more effective than amlodipine in preventing HF, diabetes in patients with hypertension

An angiotensin receptor blocker (ARB) valsartan-based regimen offered advantages over a calcium channel blocker (CCB) amlodipine-based regimen in preventing heart failure (HF) and diabetes in patients with hypertension, according to results of an analysis published in Hypertension.

Oral isotretinoin therapy linked to abnormalities in serum lipid, transaminase levels

Abnormality of triglyceride values was most severe in patients during treatment compared with baseline measures.

Infliximab

TNF inhibitor approved for inhibiting joint damage, improving physical function in psoriatic arthritis