1
In Brief: New Warning for the RSV Vaccines Arexvy and Abrysvo
The Medical Letter on Drugs and Therapeutics • January 10, 2025; (Issue 5095)
The FDA has required a new warning in the labels of the
recombinant respiratory syncytial virus (RSV) vaccines
Arexvy (GSK) and Abrysvo (Pfizer) about an increased
risk of Guillain-Barré syndrome (GBS) within 42 days
of administration of either vaccine. Both vaccines
are FDA-approved to prevent lower respiratory tract
disease (LRTD) caused by RSV in adults.Abrysvo is
also approved for use in pregnant women at 32-36
weeks' gestation to prevent RSV-associated LRTD in
their infants from birth through 6 months of age.
2
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.
3
Drugs for Age-Related Macular Degeneration
The Medical Letter on Drugs and Therapeutics • January 6, 2025; (Issue 1719)
Age-related macular degeneration (AMD) has two
major forms: dry or non-neovascular (~90% of
patients) and wet or neovascular (~10% of patients).
4
Vyalev — Foscarbidopa/Foslevodopa Subcutaneous Infusion for Parkinson's Disease
The Medical Letter on Drugs and Therapeutics • January 6, 2025; (Issue 1719)
Vyalev (Abbvie), a solution for continuous subcutaneous
infusion containing the prodrugs foscarbidopa
and foslevodopa, has been approved by the FDA
for treatment of motor fluctuations in adults with
advanced Parkinson's disease (PD). Vyalev is the first
subcutaneously administered product to become
available in the US for treatment of PD symptoms. Duopa,
a carbidopa/levodopa enteral suspension infused via a
nasojejunal tube or percutaneous gastrostomy, was
approved in for the same indication 2015.
5
Qlosi — Pilocarpine 0.4% Ophthalmic Solution for Presbyopia
The Medical Letter on Drugs and Therapeutics • January 6, 2025; (Issue 1719)
The FDA has approved pilocarpine 0.4% preservativefree
ophthalmic solution (Qlosi – Orasis) for treatment
of presbyopia in adults. Pilocarpine 1.25% ophthalmic
solution (Vuity) was approved in 2021 for the same
indication. Pilocarpine 1%, 2%, and 4% ophthalmic
solutions (Isopto Carpine, and others) have been
available for years for treatment of glaucoma, but
local (e.g., blurry vision and instillation-site pain)
and systemic (e.g., sweating and GI disturbances)
adverse effects have limited their use.
6
Revumenib (Revuforj) for Acute Leukemia (online only)
The Medical Letter on Drugs and Therapeutics • January 6, 2025; (Issue 1719)
Revumenib (Revuforj – Syndax), an oral menin
inhibitor, has been approved by the FDA for treatment
of relapsed or refractory acute leukemia in patients
≥1 year old with a lysine methyltransferase 2A gene
(KMT2A) translocation. It is the first menin inhibitor to
be approved in the US.
7
Influenza Vaccine for 2024-2025
The Medical Letter on Drugs and Therapeutics • September 16, 2024; (Issue 1711)
Annual vaccination in the US against influenza A and
B viruses is recommended for everyone ≥6 months
old without a contraindication. Influenza vaccines
available in the US for the 2024-2025 season are
listed in Table 2.
8
Valeda Light Delivery System for Age-Related Macular Degeneration
The Medical Letter on Drugs and Therapeutics • January 20, 2025; (Issue 1720)
The FDA has authorized use of the Valeda Light
Delivery System (LumiThera), a multiwavelength
photobiomodulation (PBM) device, to improve visual
acuity in patients with dry age-related macular
degeneration (AMD) who have best-corrected visual
acuity (BCVA) of 20/32 to 20/70.
9
Drugs for Irritable Bowel Syndrome
The Medical Letter on Drugs and Therapeutics • February 3, 2025; (Issue 1721)
Irritable bowel syndrome (IBS) is a common disorder
characterized by recurrent abdominal pain and altered
bowel habits, often accompanied by bloating. IBS
is classified by its predominant bowel symptom:
constipation (IBS-C), diarrhea (IBS-D), mixed type
(IBS-M), or unclassified (IBS-U). Since the exact cause
of IBS is unknown, the goal of treatment is symptom
control. Some over-the-counter (OTC) products and
prescription drugs for IBS are listed in Tables 1-4. The
safety of these drugs during pregnancy and lactation
is described in Table 5 (online only).
10
In Brief: OTC Ivermectin for Head Lice
The Medical Letter on Drugs and Therapeutics • June 26, 2023; (Issue 1679)
Topical ivermectin lotion 0.5% (Sklice, and generics),
which has been available by prescription since 2012,
is now FDA-approved for sale over the counter (OTC)
for treatment of head lice in patients ≥6 months old.
Ivermectin is also available by prescription as a 1%
cream (Soolantra) approved for topical treatment of
inflammatory lesions of rosacea and in oral tablets
(Stromectol, and generics) for treatment of various
parasitic infections.