1
Resmetirom (Rezdiffra) for Metabolic Dysfunction-Associated Steatohepatitis
The Medical Letter on Drugs and Therapeutics • April 29, 2024; (Issue 1701)
Resmetirom (Rezdiffra – Madrigal), a thyroid hormone
receptor-beta agonist, has received accelerated
approval from the FDA for treatment of noncirrhotic
nonalcoholic steatohepatitis (NASH) with moderate
to advanced fibrosis in adults. NASH has recently
been renamed metabolic dysfunction-associated
steatohepatitis (MASH). Resmetirom is the first drug
to be approved in the US for this indication.
2
Antibiotic Prophylaxis for Dental Procedures
The Medical Letter on Drugs and Therapeutics • April 29, 2024; (Issue 1701)
Since 2007, antimicrobial prophylaxis for dental
procedures has been recommended to prevent
viridans group streptococcal infective endocarditis
only for patients at highest risk of an adverse
outcome. Limiting use to such patients does not
appear to have led to an increased incidence of
infective endocarditis or increased mortality due to
infective endocarditis.
3
A New Indication for Semaglutide (Wegovy)
The Medical Letter on Drugs and Therapeutics • April 29, 2024; (Issue 1701)
The injectable glucagon-like peptide-1 (GLP-1)
receptor agonist semaglutide (Wegovy) has been
approved by the FDA to reduce the risk of major
adverse cardiovascular events (MACE) in adults with
established cardiovascular disease (CVD) and either
obesity or overweight. Semaglutide is the first drug
to be approved for cardiovascular risk reduction in
this population. It is also approved in a lower-dose
injectable formulation as Ozempic and in an oral
formulation as Rybelsus (see Table 1).
4
Intravenous Acetaminophen/Ibuprofen (Combogesic IV)
The Medical Letter on Drugs and Therapeutics • April 29, 2024; (Issue 1701)
The FDA has approved Combogesic IV (Hikma), an IV
solution containing acetaminophen and ibuprofen, to
treat mild to moderate pain (alone) or moderate to
severe pain (in combination with an opioid) in adults
when IV analgesia is considered clinically necessary.
Single-drug IV solutions containing ibuprofen
(Caldolor) and acetaminophen have been available in
the US for years.
5
iDose TR — A Travoprost Implant for Glaucoma
The Medical Letter on Drugs and Therapeutics • April 29, 2024; (Issue 1701)
The FDA has approved iDose TR (Glaukos), an
intracameral implant containing the prostaglandin
analog (PGA) travoprost, for reduction of intraocular
pressure (IOP) in patients with open-angle glaucoma
or ocular hypertension. Travoprost is also available
as a topical ophthalmic solution (Travatan Z, and
generics) for the same indication. iDose TR is the
second ocular implant to become available in the US
for this indication; Durysta, an intracameral implant
containing the prostaglandin analog bimatoprost,
was the first.
6
In Brief: Alternatives to Adderall
The Medical Letter on Drugs and Therapeutics • November 28, 2022; (Issue 1664)
The short-acting formulation of mixed amphetamine
salts (Adderall, and generics) FDA-approved for
treatment of attention-deficit hyperactivity disorder
(ADHD) and narcolepsy, is currently in short supply in
the US. Until an adequate supply is restored, patients
may be looking for alternatives.
7
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • June 12, 2023; (Issue 1678)
An oral nonopioid analgesic is often sufficient for
acute treatment of mild to moderate migraine pain
without severe nausea or vomiting. A triptan is the
drug of choice for treatment of moderate to severe
migraine in most patients without vascular disease.
Treatment of pain when it is still mild to moderate in
intensity improves headache response and reduces
the risk of recurrence.
8
Airsupra: An Inhaled Albuterol/Budesonide Combination for Asthma
The Medical Letter on Drugs and Therapeutics • March 18, 2024; (Issue 1698)
The FDA has approved Airsupra (AstraZeneca), a
metered-dose inhaler containing the short-acting
beta2-agonist (SABA) albuterol and the inhaled
corticosteroid (ICS) budesonide, for use as needed for
treatment or prevention of bronchoconstriction and to
reduce the risk of exacerbations in patients ≥18 years
old with asthma. Airsupra is the first combination of
a SABA and an ICS to become available in the US. It is
not approved for use as maintenance therapy.
9
In Brief: Fexofenadine (Allegra) and Fruit Juice
The Medical Letter on Drugs and Therapeutics • May 30, 2011; (Issue 1365)
Fexofenadine (Allegra, and others) is the most recent second-generation H1-antihistamine to become available over the counter (OTC). Cetirizine (Zyrtec, and others) and loratadine (Claritin, and others) are already available OTC. Cetirizine can be sedating in usual doses. Loratadine can be sedating in higher-than-usual doses. Fexofenadine remains nonsedating even in higher doses.
10
Treatment of Common Respiratory Tract Infections
The Medical Letter on Drugs and Therapeutics • April 17, 2023; (Issue 1674)
Most respiratory tract infections are caused by
viruses. Bacterial respiratory tract infections are
usually treated empirically with antibiotic therapy
that targets the most probable causative pathogens.
Recommended antibiotic regimens for outpatient
treatment of some common respiratory tract
infections are listed in Table 1 for adults and Table 2
for children.