Fungal diseases of the nail bed (onychomycosis) and epidermis are recurrent illnesses in the elderly and immunocompromised patients, which have few efficacious treatment options. Current treatment options for onychomycosis are limited to topical agents, laser treatment, and oral antifungals. Previous generations of topical agents were not efficacious, owing to poor penetration of the nail bed. Oral antifungal drugs, such as itraconazole, terbinafine, and fluconazole, not only give better response rates but also inhibit a host of CYP450 enzymes. Oral antifungals can exacerbate drug-drug interactions for patients taking other medications concurrently. Newer topical agents might recognize improved efficacy and provide therapeutic alternatives when the use of oral antifungal agents is contraindicated. Recently, the Food and Drug Administration (FDA) approved efinaconazole and tavaborole for the treatment of onychomycosis. Additionally, the FDA approved luliconazole for the treatment of tinea pedis, tinea cruris, and tinea corporis. This review examines the mechanism of action, spectrum of activity, pharmacokinetics, and clinical trials data and considers the place in therapy for these 3 new antimycotic agents.
This article gives a practical review of the pharmacology, clinical efficacy, safety, dosing, cost, and place in therapy for oral antihyperglycemic agents used in the treatment of type 2 diabetes mellitus. There are 5 classes of oral antihyperglycemic agents available in the United States: sulfonylurea secretagogues, biguanides, alpha-glucosidase inhibitors, thiazolidinediones, and nonsulfonylurea secretagogues. These agents have distinct characteristics that help in their selection for the treatment of type 2 diabetes.
Objectives
Home-based rapid diagnostic testing can play an integral role in controlling the spread of COVID-19. This review aimed to identify and compare at-home diagnostic tests that have been granted Emergency Use Authorizations (EUA) and convey details about COVID-19 diagnostic tests, including regulatory information, pertinent to pharmacy practice.
Methods
Food and Drug Administration (FDA) online resources pertaining to COVID-19 tests, EUAs, and medical devices were consulted, as well as linked resources from the FDA’s webpages. Homepages of the 9 COVID-19 home tests with EUAs were comprehensively reviewed. PubMed literature searches were performed, most recently in May 2021, to locate literature about the identified home tests, as were searches of Google Scholar, medRxiv, and bioRxiv.
Literature Selection
Studies were included if they were performed at home or were self-collected (or collected by a parent or guardian for patients under 18 years of age), and evaluated the positive percent agreement (PPA) and negative percent agreement (NPA) for the clinical diagnosis of SARS-CoV-2 virus.
Results
Limited data has been published for these home tests given that they are available through EUAs that do not require clinical trials. Fifteen studies were located from searching the literature, but only 2 met the inclusion criteria. Review of the home-tests' websites yielded a single study for each test with the 3 BinaxNow platforms using the same study for their EUAs. The 9 COVID-19 home tests with EUAs as of May 7, 2021 include 3 molecular tests and 6 antigen tests. These tests had similar performance based on positive percent agreement ranging from 83.5% to 97.4% and negative percent agreement ranging from 97% to 100%.
Conclusions
The 9 SARS-CoV-2 home tests demonstrated satisfactory performance in comparison to laboratory real time reverse-transcription polymerase chain reaction (RT-PCR) tests. The convenience and ease of use of these tests make them well-suited for home-based rapid SARS-CoV-2 testing.
Objective To summarize the current literature for Food and Drug Administration (FDA)-approved monoclonal antibodies used as add-on maintenance therapy in uncontrolled eosinophilic asthma. Data Sources PubMed was searched on December 17, 2018 using keywords: asthma, eosinophilic asthma, omalizumab, reslizumab, mepolizumab, benralizumab, and dupilumab. Study Selection Studies evaluating safety and efficacy of monoclonal antibodies for treatment of severe or eosinophilic asthma were included. Results Twenty-one randomized, double-blind, placebo-controlled trials evaluating the current FDA-approved monoclonal antibodies (omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab) for the treatment of uncontrolled eosinophilic asthma were included. The studies demonstrated clinically significant reductions in asthma exacerbations, symptoms, emergency room visits, eosinophil counts, and improvements in pulmonary function and asthma-related quality of life. Conclusion Five monoclonal antibodies are available for uncontrolled eosinophilic asthma. Choice depends on patient factors. Future studies should focus on cost-effectiveness of treatment, drug-drug comparisons, and long-term efficacy and safety.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.