GLG News by Physicians who Treat Peripheral Vascular Disease

   Shire PLC received an approvable letter from the FDA for its nonstimulant treatment for ADHD - Intuniv (guanfacine)   Most of the treatments for ADHD are stimulants (amphetamine derivatives) that can have potentially serious cardiovascular side effects. Unfortunately, to date,...

   The FDA advisory committee unanimously rejected rimonabant because of concerns of an increase in suicidal ideation seen in patients taking the highest dose of the medication (20 mg). This drug has been proven in several large studies to not only induce greater weight loss than other strategies,...

   Valsartan (an ARB) and amlodipine (a calcium channel blocker) are both useful drugs in treating hypertension and heart failure.  Most patients require more than 1 medication to reach goal in controlling their blood pressure.  Exforge (a combination of valsartan/amlodipine) will...

Peripheral lung nodules have been difficult for the bronchoscopist in the past to biopsy in order to identify the etiology. Using these two techniques, which requires some increased training by the interventionalist, the bronchoscopist may be able to now diagnose malignancy vs infection to help with...

   Peripheral arterial disease is a major problem in this country which is only recently being recognized for the epidemic that it has become.  This problem (PAD) coexists with coronary disease (heart attacks) and cerebrovascular disease (strokes) and has been neglected and underdiagnosed...

   Retail clinics will see a rapid expansion because of the convenience factor.  Patients want to be seen immediately when they have a health issue.  ER's used to fill this need, but the waits there have become worse than the waits in physician's offices and patients have sought...

   Ximalagatran is comparable to coumadin in stroke prevention.  In this analysis of 7000 patients with atrial fibrillation, the stroke rate was less with ximelagatran than with coumadin with a similar bleeding profile.  The combination of aspirin and coumadin did not improve the...

The Medtronic Endeavor III trial has been completed and the results show similar clinical outcomes compared to the Cypher stent in a controlled trial.  While the angiographic endpoints were somewhat worse for Endeavor than Cypher, the MACE rates and revascularization rates were similar.  Endeavor...

1) The article discusses the importance of IVUS and optimal deployment. 2) A major shortcoming is the failure to mention more complex lesions are being intervened (i.e. longer stent length, bifurcation) may/probably is a key factor in complications (i.e. thrombosis).

Exforge (valsartan/amlodipine) is likely to be well received by physicians who have been fond of Lotrel and prefer branded hypertensive therapies to generic agents.