ausdoc . |
com . au |
X MONTH library at www . ausdoc . com . au / therapy-update |
2022 |
Kemal Atlay PATIENTS with contraindications to
daily oral HIV pre-exposure prophylaxis
could soon access a PBS-subsidised
long-acting injectable .
Following its September meeting
, the PBAC has recommended a streamlined authority listing for long-acting cabotegravir ( Apretude ) as an HIV pre-exposure prophylaxis ( PrEP ) alternative .
The antiviral , which was approved by the TGA in 2022 , is an integrase strand transfer inhibitor
|
that disrupts the HIV replication cycle .
Patients must have a documented negative HIV test before starting treatment and weigh at least 35kg , according to the product information .
It is contraindicated in those with positive or unknown HIV status , known hypersensitivity to cabotegravir or any excipients and in those who are using rifampicin , rifapentine , phenytoin , phenobarbital , carbamazepine or oxcarbazepine .
The PBAC deferred a decision
|
earlier this year “ to allow further deliberation on the population who should be eligible … and the associated PBS restrictions ”.
“ The PBAC noted the submission requested a listing … only for people who are contraindicated or intolerant to or were repeatedly non-adherent to oral [ tenofovir disoproxil with emtricitabine ] to the extent efficacy and safety were compromised ,” it said at the time . Following the meeting in July , sponsor ViiV Healthcare revised its price offer and proposed criteria .
|
The revised proposals offered “ simpler ” eligibility assessment with “ an equitable and acceptably cost-effective listing ”, according to the PBAC .
Clinical trial data have suggested the injectable PrEP regimen is as effective or superior to daily oral PrEP . For new patients , two initiation doses ( 3mL / 600mg IM ) are administered a month apart .
Subsequent doses are scheduled once every two months , within seven days of the scheduled dosing date .
|
The injectable is an alternative to oral PrEP . |
|||||||
Weight loss drugs tied to GI disorders |
|||||||||||
Rachel Fieldhouse PATIENTS using GLP-1 receptor agonists for weight loss are nine times more likely to develop pancreatitis than those taking bupropion – naltrexone , researchers say . Use of liraglutide and semaglutide were also associated with a near fourfold increased risk of bowel obstruction and gastroparesis compared with the older fixed-dose combination treatment .
The University of British Columbia – led team analysed US patient prescription and diagnosis data from 2006 to 2020 to assess the risk of gastrointestinal disorders with the weight loss drugs .
The cohort included 4144 liraglutide users , 613 semaglutide users and 654 taking bupropion – naltrexone .
Overall , reports of pancreatitis , bowel obstruction and gastroparesis were significantly higher in patients taking either GLP-1 receptor agonist versus bupropion – naltrexone regardless of history of obesity or hyperlipidaemia .
For instance , the incidence of pancreatitis per 1000 person-years was 7.9 for liraglutide , 4.7 for semaglutide and 1.0 for bupropion – naltrexone .
The Canadian authors also detected a link between GLP-1 receptor agonists and biliary disease , but this was not statistically significant .
“ Given the wide use of these drugs , these adverse events — although rare — must be considered by patients who are contemplating using the drugs for weight loss because the risk – benefit calculus for this group might differ from that of those who use them for diabetes ,” they concluded .
The analysis excluded patients with diabetes and those without obesity to account for the marketing of semaglutide for weight loss after the study period had ended . JAMA 2023 ; 5 Oct .
|
CKD & Me
Book 1 So you have CKD ? Patient information
So you have CKD ?
This booklet is for people like you who have recently been diagnosed with chronic kidney disease ( CKD ). It supports what your doctor has already told you about CKD and the importance of your kidney health . If you have any further questions , please ask your healthcare professional .
This booklet contains tips to help manage chronic kidney disease ( CKD ). With help from your healthcare professional , there are many steps you can take to help slow the progression of CKD . 1
CKD & Me
FORXIGA& Me
Book 3 Your FORXIGA
Your FORXIGA ® medication
This booklet is for people who have been prescribed FORXIGA the progression of chronic kidney disease . new medicine and answers some common questions about FORXIGA ®. Please note , this booklet doesn ’ t take the place of talks between you and your healthcare professional .
Living with CKD
® to slow
1 It introduces you to your
Developed by
®
® medication Patient information
|