An update on oral contraceptive options (PDF)
February 1st 2004The oral contraceptive marketplace has undergone evolutionary changes over the years. Early oral contraceptive formulations contained higher doses of estrogen and progestin, which were associated with several safety concerns. Consequently, scientists returned to the laboratories to develop lower-dose formulations that would minimize risk without compromising efficacy. To date, numerous formulations have entered the marketplace that allow for tailored dosing to meet a woman?s clinical and individual needs. In order to provide additional treatment options and create more convenient oral contraceptive regimens, monophasic, multiphasic, extended-cycle, progestin-only, and chewable regimens have emerged. This article will review the main health risks and benefits of oral contraceptives, the concept of extended-cycle regimens, and the financial implications associated with oral contraceptive use.
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Extended-release formulation of oxymorphone effective for pain relief in osteoarthritis
February 1st 2004The opioid oxymorphone (Numorphan, Endo) delivered in a new extended-release (ER) formulation significantly improves standard measures of pain and physical function in osteoarthritis (OA) patients, researchers reported at the American College of Rheumatology 67th Annual Scientific Meeting.
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Memantine: An oral NMDA antagonist for the treatment of moderate-to-severe Alzheimer?s disease
February 1st 2004Memantine (Namenda, Forest) is the newest medication to receive FDA approval for the treatment of Alzheimer?s disease and the first to be approved with a moderate-to-severe indication. All previously approved Alzheimer?s disease treatments belong to the cholinesterase inhibitor class and are approved with a mild-to-moderate indication. Memantine has been used for more than 10 years in Germany and features a novel mechanism of action: N-methyl-d-aspartate (NMDA) antagonism. It has been shown to be effective in double-blind, placebo-controlled trials as monotherapy and in combination therapy with the cholinesterase inhibitor donepezil in patients with moderate-to-severe Alzheimer?s disease.
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Thinking in terms of patient management
February 1st 2004Prior to the massive financial woes that helped "The Governator" take office in California, one of the state's most talked-about stories was a universal healthcare coverage proposal from Bruce Bodaken, chairman, CEO and president of Blue Shield of California (BSC). Other states, such as neighboring Oregon, have considered universal coverage plans in the past, but to date none have been implemented. Due to California's severe economic crisis, Bodaken's plan has been put on the back burner too. But it's still a much-discussed proposal in the state's healthcare circles, and once Gov. Schwarzenegger gets acclimated to his responsibilities and finds a way to stem the state's financial bleeding, it is expected to take center stage once again.
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Efalizumab: A new biologic therapy for the control of chronic plaque psoriasis
January 4th 2004Efalizumab (Raptiva, Genentech/Xoma) is a humanized monoclonal antibody of CD11a that exerts its effect through the blockade of the interaction between leukocyte function-associated antigen-1 (LFA-1) and intercellular adhesion molecule-1 (ICAM-1). FDA recently granted approval for efalizumab in the treatment of chronic moderate-to-severe plaque psoriasis in adults aged 18 years and older. Efalizumab does not achieve clinical response rates equal to cyclosporine or methotrexate, but it lacks the systemic organ toxicities of these agents and is associated with a more rapid onset of action (significant improvements in Psoriasis Area and Severity Index [PASI] response after 2 doses). In addition, efalizumab will likely compete with another approved biologic, alefacept, and off-label use of 2 other biologics currently on the market, etanercept and infliximab. At this time, until further studies comparing efalizumab to other drugs indicated for the treatment of psoriasis are completed and post-marketing surveillance is conducted, the agent?s place on the formulary remains unclear.
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Docetaxel/platinum combinations are efficacious in treatment of NSCLC
January 1st 2004A regimen of docetaxel and cisplatin offers better survival and response rates than a combination of vinorelbine and cisplatin in the treatment of advanced non-small-cell lung cancer, according to a phase 3 study published in the online version of the Journal of Clinical Oncology. In addition, the findings demonstrated that docetaxel is as effective as vinorelbine/cisplatin when combined with another platinum, carboplatin.
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