Healthcare Traveler - March 2009 - (Page 38)

Drug Update T H E L AT E S T D E V E LO PM EN T S I N R E SE A RCH researcher Edward S. Kim, MD. Gefitinib can no longer be prescribed to new patients in the U.S., but Kim believes the findings should support the use of erlotinib (Tarceva), which hits similar targets. Committee recommends dropping some asthma meds EurekAlert. “Iressa proves just as effective as chemotherapy for lung cancer.” 2008. http://www.eurekalert.org/pub_releases/ 2008-11/uotm-ipj112008.php (20 Nov. 2008). The randomized study involved 628 children who were still symptomatic after receiving optimized doses of inhaled corticosteroid therapy. Omalizumab currently is approved for people 12 and older with moderate-to-severe persistent asthma who have a positive skin test or in vitro reaction to a perennial aerial allergen, and whose symptoms are inadequately controlled with inhaled corticosteroids. It works by blocking immunoglobulin E. News-Medical.net (2008). “Xolair (Omalizumab) shows promise in treating allergic asthma inadequately controlled by inhaled corticosteroid.” http://www.news-medical.net/?id=42667 (10 Nov. 2008). A n FDA committee recommended in mid-December that beta-2 agonists salmeterol xinafoate (Serevent) and formoterol fumarate (Foradil) no longer be used to treat asthma. The committee later recommended that the combination drugs fluticasone propionate and salmeterol (Advair) along with budesonide/formoterol fumarate dihydrate (Symbicort)—two products that combine a long-acting beta-2 agonist with a corticosteroid—remain available. Two allergist groups—the American College of Allergy, Asthma and Immunology and the American Academy of Allergy, Asthma and Immunology—presented a statement supporting the efficacy and safety of the combination drugs, when used as recommended. Medical News Today (2008). “Allergists Respond to FDA Committee Recommendation on Asthma Medication, Encourage Patients with Questions to Contact Physicians.” http://www.medicalnews today.com/articles/133012.php (15 Dec. 2008). Drug shows promise in childhood asthma Photo: Getty Images/Stockbyte A recent trial showed omalizumab (Xolair) for subcutaneous use significantly reduced asthma attacks in children ages six through 11 with moderate or severe persistent allergic asthma that is not adequately controlled with inhaled corticosteroids. The Phase III study showed that at 24 weeks, children treated with omalizumab had a 31% reduction in clinically significant asthma exacerbations, compared with those treated with a placebo. After a year, the omalizumab group had a 43% reduction in such episodes. Hepatitis drug combo approved for children T he FDA has approved a two-drug combination as the first long-acting treatment for hepatitis C in children. Peginterferon alfa-2a (PEG-Intron)—a genetically engineered version of immune-system protein interferon— Problem Rx Rheumatoid arthritis patient’s respiratory distress Oral pill matches chemo for lung cancer Q N 38 ew testing by researchers at the University of Texas M.D. Anderson Cancer Center has found that gefitinib (Iressa) has proven as effective as chemotherapy as a second-line treatment for non-smallcell lung cancer. The study showed, however, there was no additional survival benefit for patients who expressed an elevated level of the epidermal growth factor receptor mutation. It marks the first time an oral pill has proven as effective as chemotherapy in treating lung cancer in a head-to-head trial, according to lead Healthcare Traveler March 2009 A 66-year-old woman with severe rheumatoid arthritis (RA) presents to the hospital emergency department with shortness of breath and a dry cough. She has been treated for six months with abatacept (Orencia) infusions at her doctor’s office with improved physical function and reduced symptoms. Her RA had not responded to treatment with etanercept (Enbrel). Her history is positive for hypertension, diabetes, and bronchitis. Her bronchitis had been in complete remission for one year. Her lung sounds revealed diffuse wheezing. Her oxygen saturation was 94% on room air. The patient was admitted to the inpatient service. What is the probable cause of the patient’s respiratory distress? A Respiratory complications are common in patients with RA. However, this patient’s bronchitis has been in complete remission prior to abatacept infusions. It is well-documented that patients with pre-existing chronic obstructive pulmonary disease have an increased risk of respiratory adverse events on abatacept therapy. The patient was stabilized and discharged home. Her scheduled abatacept infusions were canceled. She had a follow-up appointment with her rheumatologist. LINDA M. PORTERFIELD, RN, PhD, is a clinical pharmacologist and director of cardiovascular research at Arrhythmia Consultants PC in Memphis, TN, and professor of medicine at the University of Tennessee. www.healthcaretraveler.com http://www.eurekalert.org/pub_releases/2008-11/uotm-ipj112008.php http://www.eurekalert.org/pub_releases/2008-11/uotm-ipj112008.php http://www.News-Medical.net http://www.news-medical.net/?id=42667 http://www.medicalnewstoday.com/articles/133012.php http://www.medicalnewstoday.com/articles/133012.php http://www.healthcaretraveler.com

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Healthcare Traveler - March 2009 Editor’s Desk Contents Paws for Thought Field Notes Company Corner In a Flash Rural ORs Balancing Act Clinical Highlights Drug Update On Assignment Cityscape Name It Tax Facts Big Deals Advertisers’ Index Going the Distance Contest Rules Allied Corner Classifieds Tales from the Road

Healthcare Traveler - March 2009

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