Lecanemab-irmb (Leqembi™) for Treatment of Alzheimer's Disease.

Lecanemab-irmb (Leqembi™) is an amyloid beta-directed antibody indicated for the treatment of Alzheimer's disease (AD). AD is an irreversible and progressive neurodegenerative disorder affecting more than 6.5 million Americans 65 years of age and older and it is projected to rise to 14 million by 2060. As the disease progresses, it deteriorates short-term memory and thinking skills and, eventually, the ability to perform simple tasks of daily living. The cost of care for AD patients in the United States is estimated at more than $183 billion every year.

New Drugs: Faricimab-svoa (Vabysmo™) for Macular Degeneration and Diabetic Macular Edema and Omidenepag Isopropyl (Omlonti™) for Glaucoma and Ocular Hypertension.

Two drugs are covered in this quarterly column. Faricimab-svoa (Vabysmo™) for Macular Degeneration and Diabetic Macular Edema and Omidenepag Isopropyl (Omlonti™) for Glaucoma and Ocular Hypertension.

New Drug: Tirzepatide (Mounjaro™).

Type 2 diabetes mellitus (T2DM) is the most common form of diabetes and is a chronic and progressive illness. Millions of Americans have T2DM and many patients do not achieve the recommended blood glucose levels. Glucagon-like peptide 1 (GLP-1) based therapy is an established treatment for the management of T2DM and is recommended early in the treatment algorithm. GLP-1 therapy is associated with better glycemic control, weight reduction, and favorable cardiovascular outcomes. Tirzepatide (Mounjaro™) is a novel dual glucose-dependent insulinotropic polypeptide (GIP) receptor and GLP-1 receptor agonist. Evidence from five SURPASS clinical trials has demonstrated that tirzepatide has potent glucose lowering and weight loss with adverse effects comparable to GLP-1 receptor agonists. This paper gives an overview of tirzepatide and SURPASS clinical trials.

New Drugs Update: Three Novel Treatments for SARS-CoV-2.

Coronavirus disease 2019 (COVID-19) cases were first reported in China in December 2019. As of June 4, 2022, more than 530 million cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections have been reported globally, including more than 6.2 million deaths.1 People of all ages are at risk for SARS-CoV-2 infection and severe illness; however, the probability of serious COVID-19 disease is higher in people 60 years of age or older, those living in a nursing facility or long-term care facility, and people with chronic medical conditions. Mortality is highest in patients older than 70 years of age, regardless of the presence of chronic medical conditions.² In the last two years, in addition to emergence of COVID-19 testing and vaccines, several antiviral treatments and monoclonal antibodies (mAbs) became available and can be used to reduce their chances of being hospitalized or dying from the disease.

New Drugs Update: Finerenone, Difelikefalin, and Avacopan.

Three drugs are discussed in this article: finerenone, difelikefalin, and avacopan. Finerenone (Kerendia™) is FDA-indicated to reduce the risk of sustained estimated glomerular filtration rate (eGFR) decline, end stage kidney disease (ESKD), cardiovascular (CV) death, non-fatal myocardial infarction (MI), and hospitalization for heart failure (HF) in adult patients with chronic kidney disease (CKD) associated with type 2 diabetes (T2D). Difelikefalin (Korsuva™) is FDA-indicated for the treatment of moderate-to-severe pruritus associated with chronic kidney disease (CKD-aP) in adults undergoing hemodialysis (HD). Avacopan (Tavneos™) is FDA-indicated as an adjunctive treatment of adult patients with severe active anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (granulomatosis with polyangiitis [GPA] and microscopic polyangiitis [MPA]) in combination with standard therapy including glucocorticoids.

New Drug Update: Dostarlimab, Loncastuximab Tesirine, and Aducanumab.

Three new drugs are presented: dostarlimab, loncastuximab tesirine, and aducanumab. Product information, clinical trials, and recommendations are provided. Dostarlimab (Jemperli®) is FDA-indicated for the treatment of adult patients with mismatch repair deficient (dMMR - an abnormality that affects DNA repair) recurrent or advanced endometrial cancer (EC). Loncastuximab tesirine (Zynlonta®) is FDA-indicated for the treatment of adult patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy, including diffuse large B-cell lymphoma (DLBCL) not otherwise specified, DLBCL arising from low grade lymphoma, and high-grade B-cell lymphoma. Aducanumab (Aduhelm®) is FDA-indicated for the treatment of Alzheimer's disease. It is an amyloid beta-directed antibody developed by Biogen of Cambridge, Massachusetts. This indication was approved on June 7, 2021, under the accelerated approval based on the reduction in amyloid beta plaques in patients treated with the drug.

New Drugs.

The manuscript contains description of three new medications (vericiguat, tepotinib, tivozanib) which were approved by the US Federal Drug Administration in 2021 and can be used in older populations.

Descriptive Analysis of Acceptance by Prescribers and Economic Benefit of Pharmacist Recommended Interventions in a Critical Care Unit.

BACKGROUND: Pharmacist clinical intervention is defined as the action that identifies and prevents medication-related problems and optimizes patient's medication therapy in cooperation with other healthcare professionals. Types of clinical interventions may vary, but each is patient specific. Few studies have focused on clinical pharmacists interventions in a critical care setting at a rural hospital. OBJECTIVES: The purpose of this study was to assess physician acceptance rate of pharmacist-recommended interventions in the critical care unit (CCU) at a rural hospital over five years and to evaluate the economic benefit of accepted pharmacist-recommended interventions over a one-year time period. METHODS: This study was a retrospective chart review over a five-year time period. Each intervention was categorized and analyzed for acceptance or non-acceptance by the treating physician. Evaluation of economic benefit, cost saving and cost avoidance, for a one-year time period was performed. RESULTS: A total of 1275 interventions were documented during study period. The average acceptance rate for documented interventions was 56%. The acceptance rate by physicians increased over the study period; with the acceptance rate in 2013 being statistically significantly higher than any other years. The overall cost saving for selected interventions was $432 for the one year. The overall cost avoidance of all accepted interventions for the one year was $453,339.36-$468,327.62. CONCLUSION: Clinical pharmacists provide various types of interventions to improve patient care. The analysis of potential cost saving and cost avoidance of selected interventions illustrated a positive economic outcome.