Underuse of Paxlovid

The combination of the oral antiviral nirmatrelvir and the protease inhibitor ritonavir (Paxlovid – Pfizer) has been available in the US since late December, 2021.  In the clinical trial that led to the Emergency Use Authorization for Paxlovid, the drug decreased hospitalization or death, compared to placebo, by 88%.1 US COVID-19 deaths in 2022 averaged […]

TV Drug Ads

One of the many unsolicited messages that I receive daily on my computer screen informed me recently that Rinvoq has retaken the crown for top drug ad spender ($55.8 million in November) from Dupixent. I recall seeing unwanted TV ads for both drugs, but I had no idea that I was being visited by TV […]

Respiratory Syncytial Virus Infection

Health authorities are warning of a looming triad this winter: COVID-19, influenza, and respiratory syncytial virus infections. Their emphasis has been on encouraging vaccination against COVID-19 and influenza. No vaccine is available for prevention of RSV infection, but one monoclonal antibody is available, and several vaccines and more monoclonal antibodies are in development.1 Most children […]

USPSTF Indications for Statins for Primary Prevention of CV Disease

Statins are recommended for virtually all patients who have atherosclerotic cardiovascular disease (ASCVD), but the indications for prevention of ASCVD are less clear. The US Preventive Services Task Force (USPSTF) recommendation statement on statin use for primary prevention of cardiovascular disease was recently published in the Journal of the American Medical Association.1 The USPSTF lists […]

Vitamin D Supplements

The July 28th issue of The New England Journal of Medicine included results from a large, randomized, placebo-controlled trial of vitamin D supplementation to lower the risk of fractures in middle-aged and older adults who were not selected based on gender, vitamin D deficiency, low bone mass, or osteoporosis. Supplementation with vitamin D3 2000IU/day did […]

Mifepristone

The recent Supreme Court decision overturning Roe v. Wade has heightened interest in the use of the oral antiprogestin mifepristone (Mifeprex) for termination of intrauterine pregnancies. Mifepristone binds to progesterone receptors and increases prostaglandin levels by inhibiting prostaglandin dehydrogenase; both actions stimulate uterine contractility. It is generally used with the prostaglandin analog misoprostol (Cytotec, and […]

Overdose-Prevention Centers

The May 26 issue of The New England Journal of Medicine includes 2 articles on a subject that deserves more attention than it has received from us.1,2 Drug overdose deaths rose above 100,000 annually during the Covid-19 pandemic in the US, fueled at least partly by purposeful fentanyl contamination of illicit drugs. Naloxone is widely […]