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FEATURED STORIES FROM P&T NOVEMBER 2014

Diana Khaybullina PharmD
Ami Patel PharmD
Tina Zerilli PharmD

Over the last decade, great strides have been made in the understanding and management of pulmonary arterial hypertension (PAH; WHO Group 1). PAH is a chronic, progressive disorder of the pulmonary arterial circulation that leads to pathological increases in peripheral vascular resistance (PVR) and ultimately to right heart failure. Hemodynamically, PAH is characterized by a mean pulmonary artery pressure greater than or equal to 25 mm Hg at rest with a pulmonary artery wedge pressure less than or equal to 15 mm Hg and elevated PVR (greater than 3 mm Hg/l*min). Though PAH may be idiopathic in nature, it may also be heritable, acquired via drug exposure, or the result of disorders ranging from connective tissue disease and human immunodeficiency virus (HIV) infection to portal hypertension, among others. Based on data from the Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL), the incidence of PAH in U.S. adults is 2.0 per million, with approximately equal numbers of patients with idiopathic or heritable PAH versus PAH due to associated disorders. Survival rates progressively decline from the time of diagnosis (85% at one year versus 49% at seven years). However, data from various registries indicate that overall survival rates have improved in recent years, likely as a result of improved treatment options.

Miriam Reisman

The generic drug provokes a paradox of similarity: We believe, and yet we do not believe, that similar things are the same. We believe, and yet we do not believe, that similar things are different. And we are not sure which forms of proof should convince us of their exchangeability.

C. Lee Ventola MS

Epilepsy is a serious brain disorder with symptoms that can be treated successfully in most patients with one or more antiseizure drugs (ASDs). Approximately two-thirds of adults with new-onset epilepsy will achieve lasting seizure remission while taking ASDs, with about half experiencing mild-to-moderately severe adverse events (AEs) while using these agents. Despite the fact that drug therapy is effective for the majority of patients, significant unmet medical needs and treatment challenges remain. These include: drug-resistant epilepsy, adverse reactions, drug interactions, the need for better identification of epileptic syndromes, and a lack of anti-epileptogenic (AEG) agents that can prevent the development of epilepsy and its comorbidities.

P&T TV

From Sovaldi to Ebola: A Wide-ranging Interview with Dr. David Nash

A leading authority on population health, Dr. David Nash is optimistic about the future of disruptive innovation to improve healthcare in the U.S. The interview was conducted by P&T Editor Sonja Sherritze.

Interview