each year. may be at higher risk. In animal studies, liraglutide caused tumors of the thyroid gland; some of these tumors were cancers, although the dose Lawsone was eight times higher than what humans would receive. Because it isnt known whether liraglutide can cause thyroid tumors or medullary thyroid cancer, the drug should not be used as a first-line treatment until more studies are Lawsone completed. This agent is not recommended for patients at risk for medullary thyroid cancer or those with multiple endocrine neoplasia syndrome type 2. Sources: 2009;374:39C47; 2009;29:43SC54S; http://forecast.diabetes.org/print/node/1920; FDA, January 25, 2010 Xiaflex Improves Debilitating Hand Condition The FDA has approved Auxiliums Xiaflex (collagenase 2009;361:968; FDA, February 3, 2010; Associated Press NEW INDICATIONS Crestor CD59 Reduces Risk Of Cardiovascular Events Rosuvastatin calcium (Crestor, Astra-Zeneca), a cholesterol-lowering drug, is now approved for some patients with an increased risk of heart disease but who have not yet experienced it. The new indication for this statin is intended to reduce the likelihood of a heart attack or stroke or to decrease the need for a procedure to treat blocked arteries in these patients. The targeted group includes men who are 50 years of age and older and women who are 60 years of age and older with elevated high-sensitivity C-reactive protein (hsCRP) levels and at least one additional cardiovascular risk factor, such as smoking, hypertension, a family history of premature heart disease, or low levels of high-density lipoprotein-cholesterol (HDL-C). A nonspecific marker of inflammation, hsCRP is associated with the buildup of cholesterol and fatty material in the coronary arteries. The new indication does not support the drugs use in individuals with elevated hsCRP levels but who have no traditional cardiovascular risk factors. Rosuvastatin blocks an enzyme (HMGCCoA reductase) from making cholesterol. High levels of low-density lipoprotein-cholesterol (LDL-C) is a known risk factor for heart attacks, strokes, and heart disease. In the JUPITER trial, rosuvastatin patients experienced fewer cardiac events and needed fewer procedures such as angioplasties and coronar y artery bypass surgeries. Rosuvastatin is already approved for use in combination with diet and exercise to lower LDL-C levels and triglycerides and to slow the progression of atherosclerosis. Source: FDA, February 11, 2010 Rituxan for Leukemia The FDA has approved rituximab (Rituxan, Genentech/Roche Group/Biogen Idec) to treat certain patients with chronic lymphocytic leukemia (CLL). CLL primarily affects people older than 50 and arises from a group of white blood cells known as B cells. This drug is already approved for patients with non-Hodgkins lymphoma. The new indication is for patients with CLL who are beginning chemotherapy for the first time and for those who have not responded to other cancer drugs for CLL. Rituximab is given with fludarabine and cyclophosphamide. Rituximab is a monoclonal antibody that binds to the surface of cancer cells, making it easier for the patients immune system to attack the cancer cell as if it were a foreign pathogen. A boxed warning mentions infusion reactions; rashes and sores in the skin and mouth; progressive multifocal leukoencephalopathy (PML), a brain infection; and tumor lysis syndrome. When tumor cells are killed by the drug, they release toxins into the bloodstream that can cause kidney injury and may increase serum levels of potassium and phosphate. The role of rituximab in non-Hodgkins lymphoma is reviewed on page 148. Source: FDA, February 18, 2010 Afluria for Young Children Mercks Afluria inactive seasonal flu vaccine is now approved for use in children six months Lawsone of age or older. It was originally approved in September 2007 for persons 18 years of age and older against influenza caused by influenza virus subtype A and type B present Lawsone in the vaccine. This vaccine is not indicated for people with a hypersensitivity to eggs, neomycin, or polymyxin or for anyone who has had a life-threatening reaction to a previous influenza vaccination. The safety and effectiveness of the product have not been established in children younger.