Suvorexant (Belsomra) for Insomnia: One Difficult Sentence

The next issue of The Medical Letter (March 2, 2015) leads off with an article on a new drug with a new mechanism of action for treatment of insomnia. Suvorexant (Belsomra – Merck) is the first orexin receptor antagonist. Signaling of orexin neuropeptides sustains wakefulness; suvorexant promotes sleep by blocking orexin neuropeptides from binding to […]

Lifestyle Intervention for Weight Loss

According to a recent Gallup poll, 36% of US adults believe that they are overweight, and 26% are actively trying to lose weight. So the next issue of The Medical Letter (February 16, 2015), which will be devoted entirely to Diet, Drugs, and Surgery for Weight Loss, should be helpful in dealing with this common […]

Opioid Dependence

The next issue of The Medical Letter (February 2, 2015) includes an article on a new combination of the partial opioid agonist buprenorphine and the opioid antagonist naloxone for treatment of opioid dependence. The same 2 drugs are available generically and in 2 other brand name formulations for the same indication, which suggests that opioid […]

Hepatitis C Drug Cost

Hepatitis C is not a rare disease. It is common. As we wrote in our last summary article on Drugs for Hepatitis C (October 15, 2012), the CDC estimates that 3.25% of US adults born between 1945 and 1965 have antibodies against the virus, and many of them have chronic hepatitis C virus (HCV) infection. […]

Oritavancin (Orbactiv): Another Long-Acting Antibiotic for MRSA

Purulent skin and soft-tissue infections are now mostly caused by methicillin-resistant staph aureus (MRSA) that are resistant not only to methicillin, but also to all other penicillins and all but one cephalosporin. When these infections appear to be serious, they are generally treated in a hospital with vancomycin IV twice a day for 7-14 days. […]

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. […]


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