Australian Prescriber

Monoclonal antibodies that remove amyloid protein from the brain in people with early Alzheimer disease (e.g. lecanemab and donanemab) offer hope that disease modification may be possible. However, clinically meaningful benefits have not yet been demonstrated.

Although a common infectious syndrome, key questions in the management of community-acquired pneumonia in adults remain, including in severity stratification, choice of empirical antibiotic, route of administration and duration of antimicrobial therapy.

Deprescribing antihypertensive drugs is sometimes appropriate in frail older adults; however, the potential harms and benefits need to be carefully weighed and a deprescribing protocol implemented with close monitoring.

Development of a lymphoproliferative disorder is a well-recognised, but rare, complication of thiopurine therapy (e.g. azathioprine, mercaptopurine). Thiopurines continue to have an important role in the treatment of inflammatory bowel disease, but deprescribing should be considered in appropriate clinical circumstances.

The Medicines Repurposing Program aims to improve patient access to medicines by financially supporting sponsors to apply for TGA approval and PBS subsidy for new (off-label) therapeutic uses of medicines.

Inclisiran is a small interfering ribonucleic acid injection, approved to reduce low-density lipoprotein cholesterol in adults with hypercholesterolaemia or atherosclerosis, or at high risk of cardiovascular disease, who are on a maximum tolerated dose of a statin or are statin-intolerant.

The approval of two recombinant RSV vaccines provides an opportunity to prevent RSV-associated lower respiratory tract disease in older adults and infants. One vaccine is approved for older adults only; the other for older adults and pregnant women (to prevent RSV disease in their infant).

Nirsevimab is a long-acting monoclonal antibody that provides passive immunisation against RSV lower respiratory tract disease for at least 5 months after a single dose (usually enough for an entire RSV season). It is approved for newborns and infants (up to 24 months of age).