New Drugs III

Excerpt

Therapeutics Letter 20 explores the benefits and harms of the newer drugs alendronate, dorzolamide, acarbose, and olanzapine. Conclusions: In women with extremely low BMD, 100 need treatment with alendronate for 3 years to prevent 1 fracture detected on x-ray. In women with a previous pathologic fracture, 22 need treatment for 3 years to prevent one symptomatic fracture. Dorzolamide provides a clear therapeutic advantage over oral carbonic anhydrase. It should be reserved for patients in whom topical beta blockers or pilocarpine are not tolerated or ineffective. More safety and effectiveness evidence is needed. Acarbose can be used as an adjunct to diet and other oral agents to achieve glucose control in patients with NIDDM. Its main disadvantages are cost and the high incidence of gastrointestinal side effects. Olanzapine is effective in the symptomatic management of schizophrenia and has fewer extrapyramidal side effects in short-term trials. Long-term effectiveness and safety remain to be established. In the meantime it should be reserved for patients who are refractory to or demonstrate significant intolerance to standard antipsychotic therapy.