Drugs
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Sumatriptan nasal powder delivered by a breath powered delivery device (ONZETRA® Xsail®) is indicated for the acute treatment of migraine with or without aura in adults. This narrative review discusses the clinical use of sumatriptan nasal powder in this population and summarizes its pharmacological properties. In migraineurs, sumatriptan nasal powder treatment was associated with significantly greater rates of pain relief than placebo from 0.5-2 h postdose after a single treatment in the phase 3 TARGET trial, with these benefits sustained at 24 and 48 h postdose. ⋯ Sumatriptan nasal powder was generally well tolerated, with the majority of adverse events administration-site related and mild or moderate in severity. In conclusion, sumatriptan nasal powder is an effective and generally well tolerated treatment of migraine. With its novel breath powered nasal delivery resulting in a faster onset of action than oral sumatriptan, sumatriptan nasal powder provides a useful new option for the acute treatment of migraine with and without aura in adults.
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Apixaban (Eliquis®) is an oral, direct factor Xa inhibitor that is available for use in the treatment and secondary prevention of venous thromboembolism (VTE). Like other direct oral anticoagulants (DOACs), apixaban has generally predictable pharmacological properties and does not require routine anticoagulation monitoring. ⋯ Similarly, in Japanese adults with acute VTE (AMPLIFY-J), apixaban was associated with a significantly lower risk of major or CRNM bleeding than unfractionated heparin plus warfarin, and no cases of recurrent VTE or VTE-related death over 24 weeks. Thus, apixaban is useful therapeutic alternative for the management of adults with VTE.
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Pixantrone (Pixuvri®) is an aza-anthracenedione with a novel mode of action that is conditionally approved in the EU for use as monotherapy in adult patients with multiply relapsed or refractory aggressive B-cell non-Hodgkin's lymphoma (NHL). In the randomized, open-label, multinational, phase 3 PIX301 trial in patients with multiply relapsed or refractory aggressive NHL, the complete response (CR) plus unconfirmed CR (uCR) rate at the end of treatment (primary endpoint) was significantly higher with intravenous pixantrone monotherapy than with a single-agent comparator (vinorelbine, oxaliplatin, ifosfamide, etoposide, mitoxantrone or gemcitabine). ⋯ In conclusion, pixantrone is a useful option in patients with multiply relapsed or refractory aggressive B-cell NHL. Further results examining the use of pixantrone in combination with rituximab in patients previously treated with rituximab-containing regimens are awaited with interest.