Put Statins in the Water?

An article later this year will update our 2014 article on Drugs for Lipids, and there is plenty of updating to do. Our 2014 article was published shortly after the American College of Cardiology and the American Heart Association recommended using risk factors rather than specific cholesterol targets as indications for statins. There is general […]

Generic Drugs

An article published online on May 9, 2016 in JAMA Internal Medicine (ME Johansen and C Richardson. Estimation of potential savings through therapeutic substitution.) presented estimates of “excess expenditure due to branded drug overuse when a lower-cost generic in the same class with the same indication was available” between 2010 and 2012. The “excess expenditure” […]

Statin Intolerance

The effectiveness of statins in lowering the risk of cardiovascular events in patients with elevated LDL-C is well established now, but muscle-related symptoms, often without increases in serum creatine kinase levels, have limited their use. An interesting study (SE Nissen et al) designed to ameliorate this problem was published in the April 19th issue of […]

NSAIDs Are Not So Safe Either

It’s hard to believe that opioid overdose now kills more people than car accidents in the US, but we’ve been told this so often that it must be true. Pressure is building on prescribers to use something else to treat most patients with chronic pain, and in many cases that something else will probably be […]

More Testosterone

As promised in this space 2 years ago, a well-designed, randomized, placebo-controlled clinical trial on the effects of testosterone treatment in older men has been published (NEJM 2016; 374:611) . The Medical Letter will try to keep pace by publishing an article in our next issue (1490; March 14) on the safety of testosterone replacement […]

Why Not Screen for Melanoma?

We will soon publish our tenth article in the last 4 years on yet another drug for the treatment of unresectable or metastatic melanoma. All of these drugs are obscenely expensive. None of them cures the disease. Melanoma detected early is nearly 100% curable. Unresectable or metastatic melanoma is usually fatal. Early detection of melanoma […]

Beefed-Up Flu Vaccine for Seniors

The current issue of The Medical Letter (1486; January 18, 2016) includes an article on Fluad, an adjuvanted seasonal flu vaccine for older adults that will become available in the US later this year for use in the 2016-2017 influenza season. Fluad has been available in Europe since 1997 for persons >65 years old, so […]