Pain MedicineOnce-Daily Extended-Release Morphine Sulfate Beneficial for Low Back Pain

Speaker: Richard L. Rauck, MD, Medical Director, The Center for Clinical Research, LLC; Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina

Once-daily extended-release (ER) morphine sulfate (Avinza, Ligand) proved superior to twice-a-day, controlled-release oxycodone HCl (OxyContin, Purdue Pharma) for chronic, moderate-to-severe low back pain in patients naive to sustained-release opioids.

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Digestive DiseaseUlcerative Colitis The Mesalamine Study

A formulation of mesalamine generic designed to provide both sustained and late release in the colon may increase compliance and thus promote better outcomes compared with existing 5-aminosalicylic acid (5-ASA) therapies. William J. Sandborn, MD, Professor of Medicine at the Mayo Clinic in Rochester, Minnesota, noted that existing 5-ASA formulations require inconvenient multiple-daily dosing with high pill burdens, which are known to be a factor in noncompliance, leading to relapse.

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Gastroduodenal and Esophageal Ulceration

The ASTERIX study showed that both gastroduodenal ulcers and esophageal ulcers occur less often in at-risk patients who add esomeprazole (Nexium drug, AstraZeneca) to low-dose aspirin than in those who add placebo. Low-dose aspirin reduces recurrent events in patients with cardiovascular or cerebrovascular disease, but it is also associated with an 11% prevalence of gastroduodenal ulcer, said Angel Lanas, MD, from Clinical University Hospital in Zaragoza, Spain.

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HDL also seems to be more quickly hydrolyzed in patients with insulin resistance, leading to lower HDL levels. Statins can reduce LDL levels by 18% to 55% and triglycerides by 7% to 30%; they can also increase HDL levels by 5% to 15%.

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Diabetes MellitusThe number of people living with diabetes mellitus in the U.S. has crossed the 20 million mark, with 1.5 million cases having been diagnosed in 2005 alone. Because nearly 65% of this population will suffer from heart disease or stroke, it is crucial for health care professionals to continually investigate the efficacy of current diabetes treatment regimens.

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Arformoterol Tartrate Inhalation Solution (Brovana)

Manufacturer: Sepracor, Inc., Marlborough, MA

Indication: Arformoterol solution is indicated for the long-term maintenance treatment of bronchoconstriction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. COPD is a slowly progressive disease of the airways that is characterized by a gradual loss of lung function.

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Pharmaceutical Approval Update

Manufacturer: Alcon Laboratories, Inc., Fort Worth, TX Indication: Travoprost Z is indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension who are intolerant of, or insufficiently responsive to, other IOP-lowering medications.

Drug Class: This agent is a synthetic prostaglandin F2a (PGF2a) analogue. Its chemical name is isopropyl (Z)-7-[(1 R, 2 R ,3 R ,5 S )-3,5-dihydroxy-2-[(1 E ,3 R )-3-hydroxy-4-[(a,a,a-trifluoro-m-tolyl)oxy]-1-butenyl]cyclopentyl]-5-heptenoate.

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