There are three links in this article to the original comparative effectiveness review, a clinician guide, and a consumer guide.
Good training stuff for your newbies.
pharmaceutical
Scary Chart of the Day – 08.19.10
Pretty ugly looking trend
From 1999 to 2007, the number of U.S. poisoning deaths involving any opioid analgesic (e.g., oxycodone, methadone, or hydrocodone) more than tripled, from 4,041 to 14,459, or 36% of the 40,059 total poisoning deaths in 2007. In 1999, opioid analgesics were involved in 20% of the 19,741 poisoning deaths. During 1999–2007, the number of poisoning deaths involving specified drugs other than opioid analgesics increased from 9,262 to 12,790, and the number involving nonspecified drugs increased from 3,608 to 8,947.
Arava (leflunomide) – Watch Those Liver Enzymes
The FDA has expanded the black box warning to the label of the rheumatoid arthritis drug leflunomide (Arava) to include possible fatal liver damage.
The agency received 49 adverse event reports — including instances of jaundice, coagulopathy, encephalopathy, and 14 fatalities — about the drug from August 2002 to May 2009. Of the patients reporting adverse events, 36 were hospitalized.
Metformin May Lower Mortality in T2DM Patients
Medical News: ADA: Mortality Lower with Metformin – in Meeting Coverage, ADA from MedPage Today
A large, multicenter trial found a 24% reduced risk of all-cause mortality among patients on the drug, compared with those not taking it, according to Ronan Roussel, MD, PhD, of Groupe Hospitalier Bichat-Claude Bernard in Paris, and colleagues.
Right or Wrong? Part Deux
Right or Wrong?
BBC News – Insulin giant pulls medicine from Greece over price cut
Before you formulate an opinion, make sure to read the last sentence in this article.
By way of compensation, he said the company would make available an insulin product called glucagen, free of charge.
Anticonvulsant Meds and Suicide Risk
Results: The study identified 26 completed suicides, 801 attempted suicides, and 41 violent deaths in 297 620 new episodes of treatment with an anticonvulsant (overall median follow-up, 60 days). The incidence of the composite outcomes of completed suicides, attempted suicides, and violent deaths for anticonvulsants used in at least 100 treatment episodes ranged from 6.2 per 1000 person-years for primidone to 34.3 per 1000 person-years for oxcarbazepine. The risk of suicidal acts was increased for gabapentin (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.11-1.80), lamotrigine (HR, 1.84; 95% CI, 1.43-2.37), oxcarbazepine (HR, 2.07; 95% CI, 1.52-2.80), tiagabine (HR, 2.41; 95% CI, 1.65-3.52), and valproate (HR, 1.65; 95% CI, 1.25-2.19), compared with topiramate. The analyses including violent death produced similar results. Gabapentin users had increased risk in subgroups of younger and older patients, patients with mood disorders, and patients with epilepsy or seizure when compared with carbamazepine.
Conclusion: This exploratory analysis suggests that the use of gabapentin, lamotrigine, oxcarbazepine, and tiagabine, compared with the use of topiramate, may be associated with an increased risk of suicidal acts or violent deaths.
Combination Therapy for Crohn’s
Better Treatment Found for Crohn’s Disease – BusinessWeek
The international trial included 508 people with Crohn’s disease who had never been treated with immunosuppressive drugs. One-third were given infliximab alone, one-third received only azathioprine and one-third were treated with both. The trial was funded by Centocor Ortho Biotech, which markets infliximab, and Schering-Plough.
After 26 weeks, 56.8 percent of those getting combination therapy had complete remission of symptoms, compared to 44.4 percent of those getting only infliximab and 30 percent of those getting only azathioprine.
Generic NTG Lacks FDA Approval
After reading this article I remain in a state of disbelief.
F.D.A. Says Millions Got Unapproved Nitroglycerin – NYTimes.com
The problem of the unapproved tablets stems from a longstanding ambiguity about the rules for drugs whose use predates the establishment of the F.D.A. in 1938. Only one brand of nitroglycerin pills is federally approved: Nitrostat, made by Pfizer, on the market since 2000.
Don’t Take Plavix if You Are a Poor Metabolizer
A “poor metabolizer” does not effectively convert Plavix to its active form because of low CYP 2C19 activity.
How does someone figure out they are a “poor metabolizer”?
Read the FDA communication if you’re seriously interested in the answer to this question.
The U.S. Food and Drug Administration (FDA) has added a Boxed Warning to the label for Plavix, the anti-blood clotting medication. The Boxed Warning is about patients who do not effectively metabolize the drug (i.e. “poor metabolizers”) and therefore may not receive the full benefits of the drug.
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