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The FDA has granted approval for Otsuka Pharmaceutical’s brexpiprazole as the first drug to treat agitation in patients with Alzheimer’s disease. Agitation is a common symptom in Alzheimer’s patients, characterized by extreme aggression, restlessness, and anxiety. Previously, non-pharmacological strategies were used initially, followed by off-label use of antipsychotics and anti-depressants in severe cases. The decision to approve brexpiprazole was based on two late-stage studies demonstrating its effectiveness in calming agitated patients with Alzheimer’s, compared to a placebo. The drug was already approved for the treatment of major depressive disorder and schizophrenia in adults. This approval addresses an unmet need in the management of agitation in Alzheimer’s patients and provides healthcare professionals with a new pharmacological option. Brexpiprazole has shown significant improvement in calming agitated patients, offering a potential solution to help alleviate symptoms associated with the disease. The drug’s approval was supported by sufficient data and endorsement from an advisory panel, reinforcing its benefits outweigh the associated risks.
Neurology May 17th 2023
The United States is currently experiencing a shortage of Adderall, a medication used to treat attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) and narcolepsy. The FDA, in frequent communication with manufacturers, has not provided a clear timeline for when the shortage will be resolved. The shortage is attributed to various factors. The demand for Adderall has increased significantly, with a 10% rise in prescriptions filled in 2021 compared to the previous year. The US Drug Enforcement Agency’s efforts to combat prescription drug misuse have also played a role in limiting production. Furthermore, the pandemic led to the emergence of telemedicine startups, making it easier for individuals to obtain Adderall prescriptions, sometimes inaccurately. While waiting for the supply to be restored, healthcare professionals can consider alternative therapies such as dexmethylphenidate, methylphenidate, and dextroamphetamine.
Clinical Pharmacology May 17th 2023
Recent draft guidelines from the United States Preventive Services Task Force (USPSTF) propose a change in routine screening mammography recommendations. The new guidelines suggest that women should begin undergoing regular mammograms 10 years earlier than previously advised, starting at the age of 40. This recommendation applies to all individuals assigned female at birth. Simultaneously, FDA has made updates to federal mammography regulations, with a particular focus on reporting requirements related to breast density. These regulatory changes are motivated by studies indicating that approximately half of women over the age of 40 have dense breast tissue in concordance with the high prevalence of breast cancer in the population.
Obstetrics & Gynecology May 16th 2023
Oncology News Central (ONC)
During its April 28 meeting, the FDA’s Oncologic Drugs Advisory Committee (ODAC) voted 11-1 on whether access to the combination should be limited to patients whose tumors carry BRCA mutations. The majority of members shared the FDA reviewers’ concerns regarding clinical trial results and uncertainty about whether people without the BRCA mutation would benefit from the regimen. The FDA argued that the results of the phase 3 PROpel clinical trial could not be applied to patients who had not had their BRCA or HRR mutation status determined. As a result, the FDA contended that the PROpel intention-to-treat (ITT) group was heterogeneous, complicating the interpretation and application of the trial’s results to unselected patients.
Oncology, Medical May 8th 2023
Medical Professionals Reference (MPR)
The FDA has authorized the use of the mRNA bivalent COVID-19 vaccine (Moderna and Pfizer-BioNTech) for all doses administered to individuals 6 months of age and older. The monovalent vaccines are no longer authorized for use in the US. This simplifies the vaccination schedule and encourages future vaccination. For child vaccination, unvaccinated children may receive a 2-dose series of the Moderna bivalent vaccine (6 months through 5 years) or a 3-dose series of the Pfizer-BioNTech bivalent vaccine (6 months through 4 years). Children who are 5 years old may receive 2 doses of Moderna bivalent vaccine or a single dose of Pfizer-BioNTech bivalent vaccine. For immunocompromised children 6 months through 4 years, eligibility depends on the vaccine previously received. For individuals 5 years of age and older with certain kinds of immunocompromise, a single additional dose of bivalent vaccine may be administered at least 2 months following the initial dose of a bivalent vaccine. Additional doses may be administered at the discretion of the health care provider, taking into consideration the individual’s clinical circumstances.
All Specialties April 24th 2023
The FDA’s Oncologic Drugs Advisory Committee (ODAC) has voted to support the use of polatuzumab vedotin-piiq (Polivy) in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone (Pola+R-CHP) for the first-line treatment of patients with previously untreated large B-cell lymphoma (LBCL). The committee voted 11-2 in favour of the drug following the confirmatory POLARIX trial, a double-blind, placebo-controlled, phase 3 study, which enrolled 879 patients with LBCL, including diffuse large B-cell lymphoma (DLBC), not otherwise specified (NOS). Although concerns were raised about modest benefits in progression-free survival (PFS) and similar overall survival (OS) between Pola+R-CHP and the standard treatment R-CHOP, ODAC member Neil Vasan, MD, PhD, said that the benefits outweighed the risks and Pola+R-CHP should be an option for first-time treatment of DLBCL with curative intent, as it could spare patients from more toxic and complicated salvage therapies.
Hematology April 24th 2023