Claudia Ortiz Lopez, PharmD Candidate Cone Health Family Medicine News You Can Use… Claudia Ortiz Lopez, PharmD Candidate Rob Vincent, PharmD Pete Koval, PharmD Cone Health Family Medicine March, 2017

FDA Approval Parsabiv® (etelcalcetide) Class: calcium-sensing receptor agonist For the treatment of secondary hyperparathyroidism in adults with CKD on hemodialysis Dose: 2.5mg/0.5 ml, 5 mg/mL and 10mg/2mL for IV injection ADE: hypocalcemia, muscle spasm, nausea, diarrhea, vomiting Calcinomimetic or cacium-sensing receptor agonist? The recommended starting dose is 5 mg administered by intravenous bolus injection three times per week at the end of hemodialysis treatment. (2.1)  The maintenance dose is individualized and determined by titration based on parathyroid hormone (PTH) and corrected serum calcium response. The dose range is 2.5 to 15 mg three times per week. (2.1) http://pi.amgen.com/~/media/amgen/repositorysites/pi-amgen-com/parsabiv/parsabiv_pi.ashx

FDA Approval Siliq® (brodalumab) Class: human interleukin-17 receptor A antagonist For the treatment of moderate to severe plaque psoriasis Dose: 210 mg SQ at weeks 0, 1, 2, then 210 mg every 2 weeks ADE: injection site reaction, neutropenia, fatigue, diarrhea, myalgia Contraindicated if have chrons disease http://www.accessdata.fda.gov/drugsatfda_docs/label/2017/761032lbl.pdf

FDA Approval Tirosint-SOL® (levothyroxine sodium oral solution) Treatment of hypothyroidism Place in therapy: alternative dosage form for those that cannot swallow, tube fed OR possibly children with hypothyroidism Oral solution: 13, 25, 50, 75, 88, 100, 112, 125, 137, 150, 175, 200 mcg/mL Should i also include AE? Hyperthyroidism http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm533371.htm

Seasonal Influenza Vaccine Effectiveness CDC Flu Shot Effectiveness estimates: 2016-2017 = 48% Past Years 2015-16 = 47% 2014-15 = 19% 2013-14 = 52% 2012-13 = 49% https://www.cdc.gov/flu/professionals/vaccination/effectiveness-studies.htm

New IDSA guidelines for Meningitis/Ventriculitis For detecting and treating ventriculitis and meningitis occurring after invasive procedures Described symptoms associated with infection following each procedure Recommendations for preventing infection during surgery I do not know what to write here http://www.healio.com/infectious-disease/nosocomial-infections/news/online/%7Bcae7f730-0869-44d3-9399-80fdc53fb320%7D/idsa-guidelines-address-health-careassociated-ventriculitis-meningitis http://www.idsociety.org/Organ_System/

January P&T Approvals Brovana (arformoterol) will now be replacing all Long Acting Beta Agonists Dulera (mometasone furoate/formoterol) will now be substituting Symbicort and Advair Brovana (arformoterol) and Incruse (umeclidinium) will now be substituting all Long Acting Beta Agonists and Inhaled Corticosteroids combination products Automatically substitute arformoterol (Brovana®) nebulizer solution (15 mcg, one inhalation BID), for any dose of salmeterol (Serevent®), formoterol (Foradil®, Perforomist®), olodaterol (Striverdi®), or indacaterol (Arcapta®). Page  Remove budesonide/formoterol (Symbicort®) from the formulary.  For budesonide/formoterol (Symbicort®) or fluticasone propionate/salmeterol (Advair®), automatically substitute mometasone furoate/formoterol (Dulera®). Other formulary agents are also available as alternatives.  Add umeclidinium (Incruse®) to the formulary.  Allow automatic substitution of arformoterol (Brovana®) nebulizer (15 mcg BID) plus umeclidinium (Incruse®) inhaler (1 puff daily) for any order for vilanterol/umeclidinium (Anoro Ellipta®), olodaterol/tiotropium (Stiolto Respimat®), or formoterol/glycopyrrolate (Bevespi Aerosphere®) combination product. Cone Health Pharmacy and Therapeutics Committee Meeting Minutes, January 18th, 2017

January P&T Approvals Added Basaglar® insulin glargine U-100 to formulary Considered for formulary due to availability in pen device and cost Basaglar Kwikpen ® (#5) $295.02 vs Lantus Solostar (#5) $343.60 Basaglar® has been shown to be noninferior to Lantus® Cone Health Pharmacy and Therapeutics Committee Meeting Minutes, January 18th, 2017

February P&T Approvals Maintain linagliptin (Tradjenta ®) as sole DPP4 inhibitor Allow automatic substitution of linagliptin for: Alogliptin (Nesina ®) Saxaglipgin (Onglyza ®) Sitagliptin (Januvia ®) DPP4 Cone Health Pharmacy and Therapeutics Committee Meeting Minutes, February 15th, 2017

February P&T Action Inflectra (infliximab-dyyb), a biosimilar to Remicade (infliximab) Monoclonal antibodies that regulate inflammation and immune responses Not added to Cone Health formulary due to lack of significant cost advantage Crohn’s disease, pediatric Crohn’s disease in patients 6 years or older, ulcerative colitis, rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, and ankylosing spondylitis Should I include not added in the title = as that is the main topic Cone Health Pharmacy and Therapeutics Committee Meeting Minutes, February 15th, 2017