Voriconazole: A novel azole antifungal agent (PDF)
August 1st 2002In late May, voriconazole (Vfend) received approval for the treatment of invasive aspergillosis and as salvage therapy for treatment of Scedosporium apiospermum and Fusarium infections. In addition to these infections, voriconazole has excellent invitro activity against both Candida and Aspergillus species, including good activity against fluconazole- and itraconazole-resistant species. This Focus article reviews the antifungal's pharmacology, pharmacokinetics, efficacy in clinical trials, safety, dosing, price, and place in therapy.
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Understanding the costs and treatments of alcohol abuse and dependence (PDF)
August 1st 2002Effective decision-making in benefit management requires an understanding of the economic burden of an illness - in this case, the economic burden and treatment of alcoholism. This article provides an understanding of the true costs of the disease, what has been found to be effective in its treatment, and what treatments may lessen the economic burden of the disease.
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Finding optional ways to manage patients with chronic obstructive pulmonary disease (COPD) - the fourth leading cause of death in the US became a priority for this large mid-western collaborative of health care organizations. This this end, a guideline was developed to help clinicians identify, evaluate and manage COPD. This article provides an overview of the guideline development process and implementation approach, key guideline components, and the step-by-step pharmacologic treatment strategy.
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Did naproxen's cardioprotective effect skew safety data on rofecoxib?
July 1st 2002Three case-controlled studies published in the Archives of Internal Medicineshow naproxen sodium has cardioprotective effects that other NSAIDs don't.An accompanying editorial says that no evidence indicates that the COX-2inhibitor rofecoxib increases (or decreases) MI risk. It simply fell victimto being compared with the only NSAID (ie, naproxen) shown to have a cardioprotectivebenefit. (None of these new studies directly compared non-naproxen NSAIDswith COX-2 inhibitors.)
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Multiple studies show eplerenone to be a potent antihypertensive agent
July 1st 2002Eplerenone, a selective aldosterone inhibitor in phase III clinical trials,is an effective agent for reducing blood pressure in a variety of patientswith hypertension, including African-Americans, said presenters at the 17thannual scientific meeting of the American Society of Hypertension in NewYork City.
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The six-step process for conducting outcomes analyses using administrative databases (PDF)
July 1st 2002Administrative databases are a potentially useful source of data for conducting retrospective studies. Information in such a database can be used to evaluate the effects of organizational policy changes, new programs, or pharmaceutical therapies. This month?s column reviews the six essential steps required for conducting a simple database analysis. An example involving sepsis is used to further illustrate key points.
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Alefacept: A T-cell-specific immunosuppressant to treat moderate to severe plaque psoriasis (PDF)
July 1st 2002Alefacept (Amevive) is the first immunosuppressive agent directed specifically at inhibiting the activation of, and possibly killing, T cells, which are involved in the cascade of events leading to psoriatic plaque formation and inflammation. In May, an FDA advisory committee recommended alefacept for approval as a first-line therapy against moderate to severe plaque psoriasis. The authors of this Focus article review the clinical characteristics of alefacept as well as make comparisons with other systemic drugs currently used to treat chronic psoriasis and the likely biologic competitors etanercept and infliximab.
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The evidence supporting a role for the angiotensin II receptor blockers (ARBs) in patients with nephropathy and/or heart failure continues to evolve. Currently, the FDA is in late-stage review of the first ARB for a heart failure indication and is reviewing another ARB for a diabetic nephropathy indication. The authors of this article present and interpret the clinical evidence for ARB use in these two disease states. Included in their discussion are the most recent recommendations on ARBs’ place in therapy according to the American Diabetes Association, the American College of Cardiology, and the American Heart Association.
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Anoka Regional Treatment Facility, Anoka, MN-This 150-bed regional treatment facility was spending over half its annual budget on atypical antipsychotic medications. In an effort to better control rising drug class costs, a market share shift analysis of the products currently in use at the facility was conducted.
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The ruckus over designer babies, human cloning and genetic discrimination has colored much of the debate and perception of genetic services, but the discipline is gaining momentum as research propels new tests to determine the susceptibility to more common diseases, as well as a slew of rare ones.
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Inhaled insulin regimen looks equal to or better than shots alone for type 1 diabetes
June 1st 2002The 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.
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