Lucas Franki is an associate editor for MDedge News, and has been with the company since 2014. He has a BA in English from Penn State University and is an Eagle Scout.

FDA reapproves gemtuzumab ozogamicin for CD33-positive AML treatment

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The Food and Drug Administration has approved gemtuzumab ozogamicin (Mylotarg) for the treatment of newly diagnosed CD33-positive acute myeloid leukemia in adults, according to a press release.

Approval was based on results from three clinical trials. In the first, newly diagnosed AML patients who received gemtuzumab ozogamicin plus chemotherapy had significantly longer event-free survival than did patients who received chemotherapy alone. In a second trial, patients who received gemtuzumab ozogamicin alone had better overall survival compared to those who received only best supportive care. In the third clinical trial, 26% of patients who had experienced a relapse and received gemtuzumab ozogamicin experienced a remission.

Initial approval for gemtuzumab ozogamicin was granted in May 2000 as a stand-alone treatment for CD33-positive AML in older patients, but was withdrawn from the market after clinical trials failed to find any benefit and health concerns were noted. The current approval is based on a lower dosage, a more expansive patient population, and a schedule in combination with chemotherapy.

Common side effects of gemtuzumab ozogamicin include fever, nausea, infection, vomiting, bleeding, thrombocytopenia, stomatitis, constipation, rash, headache, elevated liver function tests, and neutropenia; it is not recommended for women who are pregnant or breastfeeding.

Gemtuzumab ozogamicin was also approved to treat patients older than 2 years old who have experienced a relapse or have not responded to initial treatment.

“Mylotarg’s history underscores the importance of examining alternative dosing, scheduling, and administration of therapies for patients with cancer, especially in those who may be most vulnerable to the side effects of treatment,” Richard Pazdur, MD, director of the FDA’s Oncology Center of Excellence, said in the press release.

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The Food and Drug Administration has approved gemtuzumab ozogamicin (Mylotarg) for the treatment of newly diagnosed CD33-positive acute myeloid leukemia in adults, according to a press release.

Approval was based on results from three clinical trials. In the first, newly diagnosed AML patients who received gemtuzumab ozogamicin plus chemotherapy had significantly longer event-free survival than did patients who received chemotherapy alone. In a second trial, patients who received gemtuzumab ozogamicin alone had better overall survival compared to those who received only best supportive care. In the third clinical trial, 26% of patients who had experienced a relapse and received gemtuzumab ozogamicin experienced a remission.

Initial approval for gemtuzumab ozogamicin was granted in May 2000 as a stand-alone treatment for CD33-positive AML in older patients, but was withdrawn from the market after clinical trials failed to find any benefit and health concerns were noted. The current approval is based on a lower dosage, a more expansive patient population, and a schedule in combination with chemotherapy.

Common side effects of gemtuzumab ozogamicin include fever, nausea, infection, vomiting, bleeding, thrombocytopenia, stomatitis, constipation, rash, headache, elevated liver function tests, and neutropenia; it is not recommended for women who are pregnant or breastfeeding.

Gemtuzumab ozogamicin was also approved to treat patients older than 2 years old who have experienced a relapse or have not responded to initial treatment.

“Mylotarg’s history underscores the importance of examining alternative dosing, scheduling, and administration of therapies for patients with cancer, especially in those who may be most vulnerable to the side effects of treatment,” Richard Pazdur, MD, director of the FDA’s Oncology Center of Excellence, said in the press release.

 

The Food and Drug Administration has approved gemtuzumab ozogamicin (Mylotarg) for the treatment of newly diagnosed CD33-positive acute myeloid leukemia in adults, according to a press release.

Approval was based on results from three clinical trials. In the first, newly diagnosed AML patients who received gemtuzumab ozogamicin plus chemotherapy had significantly longer event-free survival than did patients who received chemotherapy alone. In a second trial, patients who received gemtuzumab ozogamicin alone had better overall survival compared to those who received only best supportive care. In the third clinical trial, 26% of patients who had experienced a relapse and received gemtuzumab ozogamicin experienced a remission.

Initial approval for gemtuzumab ozogamicin was granted in May 2000 as a stand-alone treatment for CD33-positive AML in older patients, but was withdrawn from the market after clinical trials failed to find any benefit and health concerns were noted. The current approval is based on a lower dosage, a more expansive patient population, and a schedule in combination with chemotherapy.

Common side effects of gemtuzumab ozogamicin include fever, nausea, infection, vomiting, bleeding, thrombocytopenia, stomatitis, constipation, rash, headache, elevated liver function tests, and neutropenia; it is not recommended for women who are pregnant or breastfeeding.

Gemtuzumab ozogamicin was also approved to treat patients older than 2 years old who have experienced a relapse or have not responded to initial treatment.

“Mylotarg’s history underscores the importance of examining alternative dosing, scheduling, and administration of therapies for patients with cancer, especially in those who may be most vulnerable to the side effects of treatment,” Richard Pazdur, MD, director of the FDA’s Oncology Center of Excellence, said in the press release.

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Austedo approved for treatment of tardive dyskinesia

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The Food and Drug Administration has approved deutetrabenazine (Austedo) for the treatment of tardive dyskinesia in adults, according to an announcement from Teva Pharmaceutical Industries.

The agency’s approval of Austedo was based on results from two phase 3 clinical trials in which the drug was shown to be safe and effective at reducing involuntary movements collectively termed tardive dyskinesia, a debilitating and sometimes irreversible movement disorder which affects about 500,000 people in the United States. Austedo was first approved in April 2017 to treat chorea associated with Huntington’s disease.

Courtesy Wikimedia Commons/FitzColinGerald/Creative Commons License
The most common side effects of Austedo in tardive dyskinesia patients are nasopharyngitis and insomnia. People who have hepatic impairment, are taking tetrabenazine (Xenazine) or valbenazine (Ingrezza), or are taking or have recently taken monoamine oxidase inhibitors or reserpine should not be prescribed Austedo.

“Physicians treating tardive dyskinesia will appreciate the therapy’s dosing flexibility and the ability to focus on directly treating the movement disorder and not disrupt the ongoing treatment for the underlying condition,” Michael Hayden, MD, PhD, President of Global R&D and Chief Scientific Officer at Teva, said in the announcement.

The full prescribing information can be viewed here.

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The Food and Drug Administration has approved deutetrabenazine (Austedo) for the treatment of tardive dyskinesia in adults, according to an announcement from Teva Pharmaceutical Industries.

The agency’s approval of Austedo was based on results from two phase 3 clinical trials in which the drug was shown to be safe and effective at reducing involuntary movements collectively termed tardive dyskinesia, a debilitating and sometimes irreversible movement disorder which affects about 500,000 people in the United States. Austedo was first approved in April 2017 to treat chorea associated with Huntington’s disease.

Courtesy Wikimedia Commons/FitzColinGerald/Creative Commons License
The most common side effects of Austedo in tardive dyskinesia patients are nasopharyngitis and insomnia. People who have hepatic impairment, are taking tetrabenazine (Xenazine) or valbenazine (Ingrezza), or are taking or have recently taken monoamine oxidase inhibitors or reserpine should not be prescribed Austedo.

“Physicians treating tardive dyskinesia will appreciate the therapy’s dosing flexibility and the ability to focus on directly treating the movement disorder and not disrupt the ongoing treatment for the underlying condition,” Michael Hayden, MD, PhD, President of Global R&D and Chief Scientific Officer at Teva, said in the announcement.

The full prescribing information can be viewed here.

 

The Food and Drug Administration has approved deutetrabenazine (Austedo) for the treatment of tardive dyskinesia in adults, according to an announcement from Teva Pharmaceutical Industries.

The agency’s approval of Austedo was based on results from two phase 3 clinical trials in which the drug was shown to be safe and effective at reducing involuntary movements collectively termed tardive dyskinesia, a debilitating and sometimes irreversible movement disorder which affects about 500,000 people in the United States. Austedo was first approved in April 2017 to treat chorea associated with Huntington’s disease.

Courtesy Wikimedia Commons/FitzColinGerald/Creative Commons License
The most common side effects of Austedo in tardive dyskinesia patients are nasopharyngitis and insomnia. People who have hepatic impairment, are taking tetrabenazine (Xenazine) or valbenazine (Ingrezza), or are taking or have recently taken monoamine oxidase inhibitors or reserpine should not be prescribed Austedo.

“Physicians treating tardive dyskinesia will appreciate the therapy’s dosing flexibility and the ability to focus on directly treating the movement disorder and not disrupt the ongoing treatment for the underlying condition,” Michael Hayden, MD, PhD, President of Global R&D and Chief Scientific Officer at Teva, said in the announcement.

The full prescribing information can be viewed here.

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Clinical trial: Sinai Robotic Surgery Trial in HPVOPC

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The Sinai Robotic Surgery Trial in HPV Positive Oropharyngeal Squamous Cell Carcinoma is an interventional trial currently recruiting patients with early to intermediate stage HPVOPC.

People with HPVOPC are generally curable, are young, and will live for extended periods of time, and are also at high risk for long-term toxicity and morbidity from chemotherapy and radiation. The study will explore the necessity of additional intervention in HPVOPC after surgery, and it is estimated that more than half of patients will not require additional therapy.

The trial will have three study groups. Patients with a good prognosis at low risk of recurrence will undergo surgery but no radiotherapy or chemoradiotherapy. Patients at intermediate risk of recurrence will undergo surgery and receive radiotherapy, and patients at high risk of recurrence will undergo surgery and receive chemoradiotherapy.

Patients are eligible for the study if they have stage 1, 2, 3, or early- to mid-stage 4a resectable primary squamous cell carcinoma of the oropharynx that is HPV positive. Patients must be at least 18; cannot be pregnant; cannot have active alcohol addiction or tobacco usage; must have adequate bone marrow, hepatic, and renal functions; have an ECOG performance status of 0 or 1; have a limiting serious illness; and have had no previous surgery, radiation therapy, or chemotherapy for squamous cell carcinoma other than biopsy or tonsillectomy.

The primary outcome measures of the study are disease-free survival and local regional control after 3 and 5 years. Second study outcome measures include overall survival, toxicity rates, and quality of life outcomes after 3 and 5 years, and local regional control after 5 years.

Recruitment for the study ends in March 2019. About 200 people are expected to be included in the final analysis.

Find more information at the study page on Clinicaltrials.gov.

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The Sinai Robotic Surgery Trial in HPV Positive Oropharyngeal Squamous Cell Carcinoma is an interventional trial currently recruiting patients with early to intermediate stage HPVOPC.

People with HPVOPC are generally curable, are young, and will live for extended periods of time, and are also at high risk for long-term toxicity and morbidity from chemotherapy and radiation. The study will explore the necessity of additional intervention in HPVOPC after surgery, and it is estimated that more than half of patients will not require additional therapy.

The trial will have three study groups. Patients with a good prognosis at low risk of recurrence will undergo surgery but no radiotherapy or chemoradiotherapy. Patients at intermediate risk of recurrence will undergo surgery and receive radiotherapy, and patients at high risk of recurrence will undergo surgery and receive chemoradiotherapy.

Patients are eligible for the study if they have stage 1, 2, 3, or early- to mid-stage 4a resectable primary squamous cell carcinoma of the oropharynx that is HPV positive. Patients must be at least 18; cannot be pregnant; cannot have active alcohol addiction or tobacco usage; must have adequate bone marrow, hepatic, and renal functions; have an ECOG performance status of 0 or 1; have a limiting serious illness; and have had no previous surgery, radiation therapy, or chemotherapy for squamous cell carcinoma other than biopsy or tonsillectomy.

The primary outcome measures of the study are disease-free survival and local regional control after 3 and 5 years. Second study outcome measures include overall survival, toxicity rates, and quality of life outcomes after 3 and 5 years, and local regional control after 5 years.

Recruitment for the study ends in March 2019. About 200 people are expected to be included in the final analysis.

Find more information at the study page on Clinicaltrials.gov.

 

The Sinai Robotic Surgery Trial in HPV Positive Oropharyngeal Squamous Cell Carcinoma is an interventional trial currently recruiting patients with early to intermediate stage HPVOPC.

People with HPVOPC are generally curable, are young, and will live for extended periods of time, and are also at high risk for long-term toxicity and morbidity from chemotherapy and radiation. The study will explore the necessity of additional intervention in HPVOPC after surgery, and it is estimated that more than half of patients will not require additional therapy.

The trial will have three study groups. Patients with a good prognosis at low risk of recurrence will undergo surgery but no radiotherapy or chemoradiotherapy. Patients at intermediate risk of recurrence will undergo surgery and receive radiotherapy, and patients at high risk of recurrence will undergo surgery and receive chemoradiotherapy.

Patients are eligible for the study if they have stage 1, 2, 3, or early- to mid-stage 4a resectable primary squamous cell carcinoma of the oropharynx that is HPV positive. Patients must be at least 18; cannot be pregnant; cannot have active alcohol addiction or tobacco usage; must have adequate bone marrow, hepatic, and renal functions; have an ECOG performance status of 0 or 1; have a limiting serious illness; and have had no previous surgery, radiation therapy, or chemotherapy for squamous cell carcinoma other than biopsy or tonsillectomy.

The primary outcome measures of the study are disease-free survival and local regional control after 3 and 5 years. Second study outcome measures include overall survival, toxicity rates, and quality of life outcomes after 3 and 5 years, and local regional control after 5 years.

Recruitment for the study ends in March 2019. About 200 people are expected to be included in the final analysis.

Find more information at the study page on Clinicaltrials.gov.

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FDA grants Priority Review to Gazyva for follicular lymphoma

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Gazyva (obinutuzumab) has been granted a Priority Review by the Food and Drug Administration for the treatment of previously untreated follicular lymphoma, according to a press release from Genentech.

FDA approval was based on results from the GALLIUM study, a phase 3 trial comparing Gazyva to Rituxan (rituximab). Patients who received Gazyva plus chemotherapy followed by Gazyva therapy alone for 2 years had a 32% improvement in progression-free survival during the 41.1 month follow-up period, compared with the patient group who received Rituxan plus chemotherapy followed by 2 years of Rituxan therapy alone. Median progression-free survival has not been reached in either arm of the study.

Courtesy Wikimedia Commons/FitzColinGerald/Creative Commons License
In two separate phase 3 trials, Gazyva also was shown to be effective in treating previously untreated chronic lymphocytic leukemia indolent non-Hodgkin lymphoma who experience disease progression during or within 6 months of prior Rituxan-based therapy.

The most common adverse events that occurred more often in the Gazyva arm of the study were low white blood cell count, infections, infusion-related reactions, low platelet count, new tumors, and cardiac events.

“Based on the GALLIUM study, Gazyva-based treatment significantly improved progression-free survival over the current standard of care, and we are committed to bringing this potential new option to patients as soon as possible,” Dr. Sandra Horning, chief medical officer and head of Genentech’s Global Product Development said in the press release.

The FDA is expected to make a decision on approval under Priority Review by Dec. 23, 2017.

Find the full press release on the Genentech website.

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Gazyva (obinutuzumab) has been granted a Priority Review by the Food and Drug Administration for the treatment of previously untreated follicular lymphoma, according to a press release from Genentech.

FDA approval was based on results from the GALLIUM study, a phase 3 trial comparing Gazyva to Rituxan (rituximab). Patients who received Gazyva plus chemotherapy followed by Gazyva therapy alone for 2 years had a 32% improvement in progression-free survival during the 41.1 month follow-up period, compared with the patient group who received Rituxan plus chemotherapy followed by 2 years of Rituxan therapy alone. Median progression-free survival has not been reached in either arm of the study.

Courtesy Wikimedia Commons/FitzColinGerald/Creative Commons License
In two separate phase 3 trials, Gazyva also was shown to be effective in treating previously untreated chronic lymphocytic leukemia indolent non-Hodgkin lymphoma who experience disease progression during or within 6 months of prior Rituxan-based therapy.

The most common adverse events that occurred more often in the Gazyva arm of the study were low white blood cell count, infections, infusion-related reactions, low platelet count, new tumors, and cardiac events.

“Based on the GALLIUM study, Gazyva-based treatment significantly improved progression-free survival over the current standard of care, and we are committed to bringing this potential new option to patients as soon as possible,” Dr. Sandra Horning, chief medical officer and head of Genentech’s Global Product Development said in the press release.

The FDA is expected to make a decision on approval under Priority Review by Dec. 23, 2017.

Find the full press release on the Genentech website.

 

Gazyva (obinutuzumab) has been granted a Priority Review by the Food and Drug Administration for the treatment of previously untreated follicular lymphoma, according to a press release from Genentech.

FDA approval was based on results from the GALLIUM study, a phase 3 trial comparing Gazyva to Rituxan (rituximab). Patients who received Gazyva plus chemotherapy followed by Gazyva therapy alone for 2 years had a 32% improvement in progression-free survival during the 41.1 month follow-up period, compared with the patient group who received Rituxan plus chemotherapy followed by 2 years of Rituxan therapy alone. Median progression-free survival has not been reached in either arm of the study.

Courtesy Wikimedia Commons/FitzColinGerald/Creative Commons License
In two separate phase 3 trials, Gazyva also was shown to be effective in treating previously untreated chronic lymphocytic leukemia indolent non-Hodgkin lymphoma who experience disease progression during or within 6 months of prior Rituxan-based therapy.

The most common adverse events that occurred more often in the Gazyva arm of the study were low white blood cell count, infections, infusion-related reactions, low platelet count, new tumors, and cardiac events.

“Based on the GALLIUM study, Gazyva-based treatment significantly improved progression-free survival over the current standard of care, and we are committed to bringing this potential new option to patients as soon as possible,” Dr. Sandra Horning, chief medical officer and head of Genentech’s Global Product Development said in the press release.

The FDA is expected to make a decision on approval under Priority Review by Dec. 23, 2017.

Find the full press release on the Genentech website.

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FDA approves second adalimumab biosimilar for multiple conditions

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The Food and Drug Administration has approved Cyltezo (adalimumab-adbm) for multiple conditions.

Cyltezo is an injectable tumor necrosis factor blocker, and is a biosimilar to adalimumab (Humira). The drug is indicated to treat moderate to severe active rheumatoid arthritis, active psoriatic arthritis, active ankylosing spondylitis, moderate to severe active Crohn’s disease, moderate to severe active ulcerative colitis, moderately to severely active polyarticular juvenile idiopathic arthritis in patients 4 years of age and older, and moderate to severe plaque psoriasis.

The most common side effects are injection site infections, infection, rash, and headache. There is an increased risk of serious infection and malignancies such as lymphoma, and patients with active infections should not be started on Cyltezo.

Find the Cyltezo labeling information here.

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The Food and Drug Administration has approved Cyltezo (adalimumab-adbm) for multiple conditions.

Cyltezo is an injectable tumor necrosis factor blocker, and is a biosimilar to adalimumab (Humira). The drug is indicated to treat moderate to severe active rheumatoid arthritis, active psoriatic arthritis, active ankylosing spondylitis, moderate to severe active Crohn’s disease, moderate to severe active ulcerative colitis, moderately to severely active polyarticular juvenile idiopathic arthritis in patients 4 years of age and older, and moderate to severe plaque psoriasis.

The most common side effects are injection site infections, infection, rash, and headache. There is an increased risk of serious infection and malignancies such as lymphoma, and patients with active infections should not be started on Cyltezo.

Find the Cyltezo labeling information here.

 

The Food and Drug Administration has approved Cyltezo (adalimumab-adbm) for multiple conditions.

Cyltezo is an injectable tumor necrosis factor blocker, and is a biosimilar to adalimumab (Humira). The drug is indicated to treat moderate to severe active rheumatoid arthritis, active psoriatic arthritis, active ankylosing spondylitis, moderate to severe active Crohn’s disease, moderate to severe active ulcerative colitis, moderately to severely active polyarticular juvenile idiopathic arthritis in patients 4 years of age and older, and moderate to severe plaque psoriasis.

The most common side effects are injection site infections, infection, rash, and headache. There is an increased risk of serious infection and malignancies such as lymphoma, and patients with active infections should not be started on Cyltezo.

Find the Cyltezo labeling information here.

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Liraglutide approved for cardiovascular event reduction

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The type 2 diabetes treatment Victoza (liraglutide) has been approved by the Food and Drug Administration for a new indication – to reduce the risk of several adverse cardiovascular events, according to a press release from Novo Nordisk.

FDA approval was based on results from the LEADER (NCT01179048) trial, where people with type 2 diabetes who received liraglutide were 13% less likely to experience cardiovascular death, nonfatal heart attack, or nonfatal stroke then type 2 diabetes patients who received a placebo, with an absolute risk reduction of 1.9%. Notably, risk of cardiovascular death was reduced by 22% in the liraglutide group, compared with the control group, and all-cause death was reduced by 15%.

Victoza, an injectable human glucagon-like peptide-1 (GLP-1) analog, received FDA approval on Jan. 25, 2010 as a supplement to proper diet and exercise to improve glycemic control in adults with type 2 diabetes. The most common adverse events associated with Victoza are nausea, diarrhea, vomiting, decreased appetite, indigestion, and constipation.

“Today’s news is significant for millions of Americans living with type 2 diabetes because, even when controlled, diabetes puts patients at a greater risk for cardiovascular events. More treatment options like Victoza that address critical aspects of diabetes care beyond glucose lowering are essential to confront this pervasive issue,” Steve Marso, MD, medical director at the Cardiovascular Services HCA Midwest Health Heart and Vascular Institute and one of the primary investigators in LEADER said in the press release.

Find the full press release on the Novo Nordisk website.

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The type 2 diabetes treatment Victoza (liraglutide) has been approved by the Food and Drug Administration for a new indication – to reduce the risk of several adverse cardiovascular events, according to a press release from Novo Nordisk.

FDA approval was based on results from the LEADER (NCT01179048) trial, where people with type 2 diabetes who received liraglutide were 13% less likely to experience cardiovascular death, nonfatal heart attack, or nonfatal stroke then type 2 diabetes patients who received a placebo, with an absolute risk reduction of 1.9%. Notably, risk of cardiovascular death was reduced by 22% in the liraglutide group, compared with the control group, and all-cause death was reduced by 15%.

Victoza, an injectable human glucagon-like peptide-1 (GLP-1) analog, received FDA approval on Jan. 25, 2010 as a supplement to proper diet and exercise to improve glycemic control in adults with type 2 diabetes. The most common adverse events associated with Victoza are nausea, diarrhea, vomiting, decreased appetite, indigestion, and constipation.

“Today’s news is significant for millions of Americans living with type 2 diabetes because, even when controlled, diabetes puts patients at a greater risk for cardiovascular events. More treatment options like Victoza that address critical aspects of diabetes care beyond glucose lowering are essential to confront this pervasive issue,” Steve Marso, MD, medical director at the Cardiovascular Services HCA Midwest Health Heart and Vascular Institute and one of the primary investigators in LEADER said in the press release.

Find the full press release on the Novo Nordisk website.

The type 2 diabetes treatment Victoza (liraglutide) has been approved by the Food and Drug Administration for a new indication – to reduce the risk of several adverse cardiovascular events, according to a press release from Novo Nordisk.

FDA approval was based on results from the LEADER (NCT01179048) trial, where people with type 2 diabetes who received liraglutide were 13% less likely to experience cardiovascular death, nonfatal heart attack, or nonfatal stroke then type 2 diabetes patients who received a placebo, with an absolute risk reduction of 1.9%. Notably, risk of cardiovascular death was reduced by 22% in the liraglutide group, compared with the control group, and all-cause death was reduced by 15%.

Victoza, an injectable human glucagon-like peptide-1 (GLP-1) analog, received FDA approval on Jan. 25, 2010 as a supplement to proper diet and exercise to improve glycemic control in adults with type 2 diabetes. The most common adverse events associated with Victoza are nausea, diarrhea, vomiting, decreased appetite, indigestion, and constipation.

“Today’s news is significant for millions of Americans living with type 2 diabetes because, even when controlled, diabetes puts patients at a greater risk for cardiovascular events. More treatment options like Victoza that address critical aspects of diabetes care beyond glucose lowering are essential to confront this pervasive issue,” Steve Marso, MD, medical director at the Cardiovascular Services HCA Midwest Health Heart and Vascular Institute and one of the primary investigators in LEADER said in the press release.

Find the full press release on the Novo Nordisk website.

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Axial SpA features don’t guarantee its diagnosis in chronic back pain

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The manifestation of multiple features of spondyloarthritis (SpA) in patients with chronic back pain is not sufficient for a diagnosis of axial spondyloarthritis, according to a report from Zineb Ez-Zaitouni and associates.

In a group of 250 people with chronic back pain who were not diagnosed with axial SpA, the most common alternative diagnosis was nonspecific back pain, followed by mechanical back pain, degenerative disc disease, and myalgia/fibromyalgia. Sacroiliitis on either radiographs or MRI and HLA-B27 was uncommon, and HLA-B27 positivity was also infrequent.

A total of 18 patients within the study group had at least four features of SpA but did not have axial SpA. Within this group, the most common SpA features were inflammatory back pain, a positive family history of SpA, a good response to nonsteroidal anti-inflammatory drugs, elevated C-reactive protein or erythrocyte sedimentation rate, and enthesitis. No patients had positive imaging, and only four were positive for HLA-B27.

“These findings show that rheumatologists in clinical practice rightly dispute a diagnosis of axSpA even when there is a high number of SpA features, especially when imaging is normal and patients are negative for HLA-B27,” the investigators concluded.

Find the full report in Annals of the Rheumatic Diseases (doi: 10.1136/annrheumdis-2017-212175)

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The manifestation of multiple features of spondyloarthritis (SpA) in patients with chronic back pain is not sufficient for a diagnosis of axial spondyloarthritis, according to a report from Zineb Ez-Zaitouni and associates.

In a group of 250 people with chronic back pain who were not diagnosed with axial SpA, the most common alternative diagnosis was nonspecific back pain, followed by mechanical back pain, degenerative disc disease, and myalgia/fibromyalgia. Sacroiliitis on either radiographs or MRI and HLA-B27 was uncommon, and HLA-B27 positivity was also infrequent.

A total of 18 patients within the study group had at least four features of SpA but did not have axial SpA. Within this group, the most common SpA features were inflammatory back pain, a positive family history of SpA, a good response to nonsteroidal anti-inflammatory drugs, elevated C-reactive protein or erythrocyte sedimentation rate, and enthesitis. No patients had positive imaging, and only four were positive for HLA-B27.

“These findings show that rheumatologists in clinical practice rightly dispute a diagnosis of axSpA even when there is a high number of SpA features, especially when imaging is normal and patients are negative for HLA-B27,” the investigators concluded.

Find the full report in Annals of the Rheumatic Diseases (doi: 10.1136/annrheumdis-2017-212175)

 

The manifestation of multiple features of spondyloarthritis (SpA) in patients with chronic back pain is not sufficient for a diagnosis of axial spondyloarthritis, according to a report from Zineb Ez-Zaitouni and associates.

In a group of 250 people with chronic back pain who were not diagnosed with axial SpA, the most common alternative diagnosis was nonspecific back pain, followed by mechanical back pain, degenerative disc disease, and myalgia/fibromyalgia. Sacroiliitis on either radiographs or MRI and HLA-B27 was uncommon, and HLA-B27 positivity was also infrequent.

A total of 18 patients within the study group had at least four features of SpA but did not have axial SpA. Within this group, the most common SpA features were inflammatory back pain, a positive family history of SpA, a good response to nonsteroidal anti-inflammatory drugs, elevated C-reactive protein or erythrocyte sedimentation rate, and enthesitis. No patients had positive imaging, and only four were positive for HLA-B27.

“These findings show that rheumatologists in clinical practice rightly dispute a diagnosis of axSpA even when there is a high number of SpA features, especially when imaging is normal and patients are negative for HLA-B27,” the investigators concluded.

Find the full report in Annals of the Rheumatic Diseases (doi: 10.1136/annrheumdis-2017-212175)

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FROM ANNALS OF THE RHEUMATIC DISEASES

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Clinical trial: Use of robotics for cholecystectomy

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The Use of Robotics for Cholecystectomy study is a retrospective review currently recruiting patients who underwent robotic-assisted laparoscopic cholecystectomy from June 2004 through May 2015.

Several methods are considered standard of care for the surgical treatment of cholecystitis, including open surgery, laparoscopic, and robotic-assisted laparoscopic surgery. This study, a retrospective analysis of charts, operating room notes, and operating room documentation of procedures, will review intraoperative and postoperative clinical outcomes of robotic-assisted laparoscopic cholecystectomy.

Patients are eligible for the study if they underwent robotic-assisted laparoscopic cholecystectomy during the study period at UC Davis Medical Center and were between the ages of 18 and 65. Patients who did not choose to have surgery or who were under the age of 18 when surgery was performed are excluded.

The intent of the study is to establish the role of robotics in laparoscopic surgery and to assess the learning curve for surgeons. Primary outcomes will be to compare hernia rates between multiport and single-port approaches, and to compare multiport against single-port approaches through the standard of care model of normal postsurgery follow-ups, along with additional follow-ups if complications are seen.

Recruitment for the study ends in May 2019. About 500 people are expected to be included in the final analysis.

Find more information at the study page on Clinicaltrials.gov.

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The Use of Robotics for Cholecystectomy study is a retrospective review currently recruiting patients who underwent robotic-assisted laparoscopic cholecystectomy from June 2004 through May 2015.

Several methods are considered standard of care for the surgical treatment of cholecystitis, including open surgery, laparoscopic, and robotic-assisted laparoscopic surgery. This study, a retrospective analysis of charts, operating room notes, and operating room documentation of procedures, will review intraoperative and postoperative clinical outcomes of robotic-assisted laparoscopic cholecystectomy.

Patients are eligible for the study if they underwent robotic-assisted laparoscopic cholecystectomy during the study period at UC Davis Medical Center and were between the ages of 18 and 65. Patients who did not choose to have surgery or who were under the age of 18 when surgery was performed are excluded.

The intent of the study is to establish the role of robotics in laparoscopic surgery and to assess the learning curve for surgeons. Primary outcomes will be to compare hernia rates between multiport and single-port approaches, and to compare multiport against single-port approaches through the standard of care model of normal postsurgery follow-ups, along with additional follow-ups if complications are seen.

Recruitment for the study ends in May 2019. About 500 people are expected to be included in the final analysis.

Find more information at the study page on Clinicaltrials.gov.

 

The Use of Robotics for Cholecystectomy study is a retrospective review currently recruiting patients who underwent robotic-assisted laparoscopic cholecystectomy from June 2004 through May 2015.

Several methods are considered standard of care for the surgical treatment of cholecystitis, including open surgery, laparoscopic, and robotic-assisted laparoscopic surgery. This study, a retrospective analysis of charts, operating room notes, and operating room documentation of procedures, will review intraoperative and postoperative clinical outcomes of robotic-assisted laparoscopic cholecystectomy.

Patients are eligible for the study if they underwent robotic-assisted laparoscopic cholecystectomy during the study period at UC Davis Medical Center and were between the ages of 18 and 65. Patients who did not choose to have surgery or who were under the age of 18 when surgery was performed are excluded.

The intent of the study is to establish the role of robotics in laparoscopic surgery and to assess the learning curve for surgeons. Primary outcomes will be to compare hernia rates between multiport and single-port approaches, and to compare multiport against single-port approaches through the standard of care model of normal postsurgery follow-ups, along with additional follow-ups if complications are seen.

Recruitment for the study ends in May 2019. About 500 people are expected to be included in the final analysis.

Find more information at the study page on Clinicaltrials.gov.

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SUMMARY FROM CLINICALTRIALS.GOV

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FDA approves first spironolactone oral suspension

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The Food and Drug Administration has approved CaroSpir, the first oral suspension form of spironolactone, the aldosterone antagonist that was first approved in 1960, according to an announcement from CMP Pharma.

CaroSpir is intended for the treatment of New York Heart Association class III-IV heart failure and reduced ejection fraction, usually in combination with other treatments. CaroSpir is also indicated as an add-on medication for the treatment of hypertension, and for the treatment of edema in cirrhotic patients who have not adequately responded to fluid and sodium restriction.

CaroSpir is contraindicated for patients who have hyperkalemia or Addison’s disease, or who are currently using eplerenone. The most common adverse events associated with CaroSpir are hyperkalemia, hypotension, and worsening renal function; electrolyte and metabolic abnormalities; gynecomastia; and impaired neurological function/coma in patients with hepatic impairment, cirrhosis, and ascites.

“CaroSpir provides a stable, ready to use, and consistent liquid treatment option for adult patients. Up until now, these patients have been prescribed a pharmacy-compounded liquid form of spironolactone. The dosing inconsistencies of compounded liquids have long been a persistent challenge for physicians,” Gerald Sakowski, CEO at CMP Pharma, said in the press release.

Find the full press release on the CMP Pharma website.

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The Food and Drug Administration has approved CaroSpir, the first oral suspension form of spironolactone, the aldosterone antagonist that was first approved in 1960, according to an announcement from CMP Pharma.

CaroSpir is intended for the treatment of New York Heart Association class III-IV heart failure and reduced ejection fraction, usually in combination with other treatments. CaroSpir is also indicated as an add-on medication for the treatment of hypertension, and for the treatment of edema in cirrhotic patients who have not adequately responded to fluid and sodium restriction.

CaroSpir is contraindicated for patients who have hyperkalemia or Addison’s disease, or who are currently using eplerenone. The most common adverse events associated with CaroSpir are hyperkalemia, hypotension, and worsening renal function; electrolyte and metabolic abnormalities; gynecomastia; and impaired neurological function/coma in patients with hepatic impairment, cirrhosis, and ascites.

“CaroSpir provides a stable, ready to use, and consistent liquid treatment option for adult patients. Up until now, these patients have been prescribed a pharmacy-compounded liquid form of spironolactone. The dosing inconsistencies of compounded liquids have long been a persistent challenge for physicians,” Gerald Sakowski, CEO at CMP Pharma, said in the press release.

Find the full press release on the CMP Pharma website.

 

The Food and Drug Administration has approved CaroSpir, the first oral suspension form of spironolactone, the aldosterone antagonist that was first approved in 1960, according to an announcement from CMP Pharma.

CaroSpir is intended for the treatment of New York Heart Association class III-IV heart failure and reduced ejection fraction, usually in combination with other treatments. CaroSpir is also indicated as an add-on medication for the treatment of hypertension, and for the treatment of edema in cirrhotic patients who have not adequately responded to fluid and sodium restriction.

CaroSpir is contraindicated for patients who have hyperkalemia or Addison’s disease, or who are currently using eplerenone. The most common adverse events associated with CaroSpir are hyperkalemia, hypotension, and worsening renal function; electrolyte and metabolic abnormalities; gynecomastia; and impaired neurological function/coma in patients with hepatic impairment, cirrhosis, and ascites.

“CaroSpir provides a stable, ready to use, and consistent liquid treatment option for adult patients. Up until now, these patients have been prescribed a pharmacy-compounded liquid form of spironolactone. The dosing inconsistencies of compounded liquids have long been a persistent challenge for physicians,” Gerald Sakowski, CEO at CMP Pharma, said in the press release.

Find the full press release on the CMP Pharma website.

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Study finds secukinumab effective for moderate to severe scalp psoriasis

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Secukinumab is a safe and effective treatment option for patients with moderate to severe scalp psoriasis, according to Dr. Jerry Bagel of the Psoriasis Treatment Center of Central New Jersey, and his associates.

After 12 weeks of treatment with 300 mg of secukinumab, administered subcutaneously, 52.9% of the 50 patients who received secukinumab achieved a 90% reduction in their Psoriasis Scalp Severity Index score, and 35.3% achieved complete clearance of scalp psoriasis. Only 2% of the 47 patients in the placebo group achieved PSSI 90, and no one achieved complete clearance, in the phase 3b study.

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The most common adverse events in patients who received secukinumab, an interleukin-17A antagonist, were nasopharyngitis, upper respiratory tract infection, cough, and contact dermatitis. No serious adverse events occurred in patients receiving secukinumab; however, two patients who were initially in the study and receiving secukinumab discontinued because of moderate upper abdominal pain and mild psoriasis.

“These promising results demonstrate the possibility of establishing PSSI 90 as a new benchmark for scalp psoriasis treatment outcome,” the investigators noted. Secukinumab (Cosentyx) is approved for moderate to severe plaque psoriasis, active psoriatic arthritis, and in adult patients who are candidates for systemic therapy or phototherapy, and ankylosing spondylitis.

Find the study in the Journal of the American Academy of Dermatology (doi: 10.1016/j.jaad.2017.05.033).

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Secukinumab is a safe and effective treatment option for patients with moderate to severe scalp psoriasis, according to Dr. Jerry Bagel of the Psoriasis Treatment Center of Central New Jersey, and his associates.

After 12 weeks of treatment with 300 mg of secukinumab, administered subcutaneously, 52.9% of the 50 patients who received secukinumab achieved a 90% reduction in their Psoriasis Scalp Severity Index score, and 35.3% achieved complete clearance of scalp psoriasis. Only 2% of the 47 patients in the placebo group achieved PSSI 90, and no one achieved complete clearance, in the phase 3b study.

copyright eenevski/Thinkstock
The most common adverse events in patients who received secukinumab, an interleukin-17A antagonist, were nasopharyngitis, upper respiratory tract infection, cough, and contact dermatitis. No serious adverse events occurred in patients receiving secukinumab; however, two patients who were initially in the study and receiving secukinumab discontinued because of moderate upper abdominal pain and mild psoriasis.

“These promising results demonstrate the possibility of establishing PSSI 90 as a new benchmark for scalp psoriasis treatment outcome,” the investigators noted. Secukinumab (Cosentyx) is approved for moderate to severe plaque psoriasis, active psoriatic arthritis, and in adult patients who are candidates for systemic therapy or phototherapy, and ankylosing spondylitis.

Find the study in the Journal of the American Academy of Dermatology (doi: 10.1016/j.jaad.2017.05.033).

 

Secukinumab is a safe and effective treatment option for patients with moderate to severe scalp psoriasis, according to Dr. Jerry Bagel of the Psoriasis Treatment Center of Central New Jersey, and his associates.

After 12 weeks of treatment with 300 mg of secukinumab, administered subcutaneously, 52.9% of the 50 patients who received secukinumab achieved a 90% reduction in their Psoriasis Scalp Severity Index score, and 35.3% achieved complete clearance of scalp psoriasis. Only 2% of the 47 patients in the placebo group achieved PSSI 90, and no one achieved complete clearance, in the phase 3b study.

copyright eenevski/Thinkstock
The most common adverse events in patients who received secukinumab, an interleukin-17A antagonist, were nasopharyngitis, upper respiratory tract infection, cough, and contact dermatitis. No serious adverse events occurred in patients receiving secukinumab; however, two patients who were initially in the study and receiving secukinumab discontinued because of moderate upper abdominal pain and mild psoriasis.

“These promising results demonstrate the possibility of establishing PSSI 90 as a new benchmark for scalp psoriasis treatment outcome,” the investigators noted. Secukinumab (Cosentyx) is approved for moderate to severe plaque psoriasis, active psoriatic arthritis, and in adult patients who are candidates for systemic therapy or phototherapy, and ankylosing spondylitis.

Find the study in the Journal of the American Academy of Dermatology (doi: 10.1016/j.jaad.2017.05.033).

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FROM THE JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

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