Since 2003, the number of adult antidiabetic drug users increased by 42.9% to 18.8 million in 2012. Metformin use increased by 97.0% to 60.4 million prescriptions dispensed in retail pharmacies in 2012. Among antidiabetic drugs newly approved for marketing between 2003 and 2012, the dipeptidyl peptidase-4 (DPP-4) inhibitor sitagliptin had the largest share with 10.5 million prescriptions in 2012. Rosiglitazone use plummeted to <13,000 prescriptions dispensed in retail or mail-order pharmacies in 2012. Concomitancy analyses showed that 44.9% of metformin use was for monotherapy. Between 33.4 and 48.1% of sulfonylurea, DPP-4 inhibitor, thiazolidinedione, and glucagon-like peptide 1 analog use was not accompanied by metformin. CONCLUSIONSThe antidiabetic drug market is characterized by steady increases in volume, and newly approved drugs experienced substantial uptake, especially DPP-4 inhibitors. The use of rosiglitazone has been negligible since restrictions were put in place in 2011. Further study is needed to understand why one-third to one-half of other noninsulin antidiabetic drug use was not concomitant with metformin use despite guidelines recommending that metformin be continued when other agents are added to treatment.In 2010, 18.8 million adults in the U.S. had been diagnosed with diabetes mellitus, 7.0 million additional Americans were affected by undiagnosed diabetes, and an estimated 1.9 million adults received a new diagnosis of diabetes during that year (1). The number of Americans with diabetes who have or have not received a diagnosis is expected to increase to 44

Study Objective-To examine national trends in prescription antiobesity drug use in the United States. Design-Data analysis. Data Source-The IMS Health Vector One National and Total Patient Tracker and EncuityResearch Treatment Answers databases, the Source Healthcare Analytics Source Lx database, and IMS Life-Link database. Measurements and MainResults-National drug use estimates from 1991-2011 were extracted from the IMS Health Vector One National database, and patient characteristics from 2008-2011 were extracted from the Vector One Total Patient Tracker and Encuity Research Treatment Answers databases. The Source Healthcare Analytics Source Lx database was used to examine duration of antiobesity drug use from 2002-2011, with a sensitivity analysis performed using the IMS LifeLink database. In 2011, approximately 2.74 million patients used antiobesity drugs, predominantly phentermine (2.43 million patients). The use of prescription orlistat and sibutramine was relatively uncommon. Eighty-five percent of antiobesity drug users were female, 62% were aged 17-44 years, and 4.5% had a body mass index of ≤ 24.9 kg/m 2 . Duration of use was generally short and most patients only had one episode of antiobesity drug use during the observation period. The longest episode of use was 30 days or less in 47-58% of patients. Approximately one quarter of the patients used antiobesity drugs for longer than 90 days, including phentermine and other amphetamine congeners whose labels recommend short-term use, * Address for correspondence: Christian Hampp, Division of Epidemiology-I, Office of Pharmacovigilance and Epidemiology, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993; Christian.hampp@fda.hhs.gov. This article reflects the views of the authors, and it should not be construed to represent the United States Food and Drug Administration's views or policies.Christian Hampp had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Supporting InformationThe following supporting information is available in the online version of this paper: Besides lifestyle interventions and surgery, pharmacologic treatment options are available to combat obesity for patients with a body mass index (BMI) of 30 kg/m 2 or more, or in some instances for patients with a BMI of 27 kg/m 2 or more along with additional weight-related risk factors (Table S1). After more than a decade since the last market introduction of a prescription weight-loss drug in the United States (orlistat, 1999), the United States Food and Drug Administration (FDA) has approved two new products: lorcaserin in June 2012 and a phentermine-topiramate combination product in July 2012. 6 Other weight-loss options include the amphetamine congeners benzphetamine, desoxyephedrine (methamphetamine), diethylpropion, phendimetrazine, and phentermine, which were approved more than 50 years ago. 7 Few patien...

While linezolid may be used to treat serious infections often needing extended courses of therapy, potential safety concerns should be kept in mind. In the circumstance of prolonged use of linezolid in children, it is likely that more cases of neuropathy may occur.