Clinical Trials versus Real Life

The next issue of The Medical Letter (December 22, 2014) will be on Drugs for Rheumatoid Arthritis. In the course of preparing that issue, we were faced with a dilemma. One of our senior reviewers with a long history of treating patients with rheumatoid arthritis asked us to omit the results of a published clinical […]

Edoxaban: Comparative Effectiveness and the FDA

The October 27, 2014 issue of The Medical Letter on Antithrombotic Drugs included, on the advice of its reviewers, edoxaban (Savaysa – Daichhi Sankyo) among the new oral anticoagulants competing with warfarin for use in nonvalvular atrial fibrillation or venous thromboembolism, even though it had not yet been approved for any indication by the FDA. […]

Do Incretin-Based Drugs for Diabetes Cause Pancreatitis?

Both GLP-1 receptor agonists such as exenatide (Byetta, Bydureon) and DPP-4 inhibitors such as sitagliptin (Januvia) lower blood glucose as a result of their effects on incretin hormones, and both have been implicated in post-marketing reports of pancreatitis occurring in patients being treated for type 2 diabetes. Post-marketing reports by themselves cannot prove cause and […]

Treatment of Influenza with Antiviral Drugs

An upcoming issue of The Medical Letter will include an article on antiviral drugs for influenza. Current recommendations for their use are probably broader than the common practice in the US or Canada. Readers will be reminded that even healthy people with uncomplicated influenza can benefit from treatment with antiviral drugs. Starting a neuraminidase inhibitor […]

Testosterone for Old Men

There is a lot that we don’t know about testosterone replacement therapy for older men. We know only a little about its efficacy, and almost nothing about its safety. Not surprisingly then, we don’t know the effective dosage or safe duration of use. And it’s not entirely clear whether it’s FDA-approved. The labeling says testosterone […]

Why Influenza Vaccine?

An upcoming issue of The Medical Letter (October 13, 2014) includes an article on the new influenza vaccine for the 2014-2015 season. We live in a time when many of our patients are suspicious of vaccines. Failure to be vaccinated against flu threatens not only the well-being of the individual patient, but also, when viewed […]

Osteoporosis: A Big Problem

The next issue of The Medical Letter (September 29, 2014) will feature an article on Drugs for Postmenopausal Osteoporosis. In anticipation, it might be worthwhile to consider the scope of the problem, which may be the most common of all those we write about. The numbers here come from guidelines published by the American Association […]

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