Sapropterin: a new therapeutic agent for phenylketonuria.

Objective: To summarize the role of pharmacotherapy in the management of phenylketonuria (PKU) and to review the pharmacology, pharmacokinetics, pharmacodynamics, efficacy data, and safety profile of sapropterin for this indication.

Data Sources: A literature search was conducted using MEDLINE (1966-May 2009), International Pharmaceutical Abstracts (1970-May 2009), and Cochrane database (2008) for the following key words: sapropterin, tetrahydrobiopterin, phenylketonurias, and phenylalanine.

Study Selection And Data Extraction: English-language studies involving humans examining the role of tetrahydrobiopterin (BH4) in the management of PKU were reviewed to evaluate the pharmacology, pharmacokinetics, pharmacodynamics, efficacy data, and safety profile for sapropterin.

Adherence to treatment guidelines in two primary care populations with gout.

Published guidelines for the treatment of gout aim to improve the evidenced-based management of this disorder. Unfortunately, several studies suggest that these guidelines are not routinely followed in clinical practice. Limited data exist comparing different groups of primary care providers regarding compliance with published gout guidelines.

Antiplatelet agents for prevention of recurrent ischemic stroke.

Prevention of secondary stroke is an important objective in the management of patients with ischemic stroke or TIA. Commonly used antiplatelet regimens for this indication include aspirin, clopidogrel and ASA-ERDP. Based on current evidence, ASA-ERDP appears to be more effective than aspirin monotherapy, and one study has shown that clopidogrel may be more effective than aspirin.

Intensive insulin therapy in critical care settings.

Hyperglycemia in hospitalized patients has been shown to increase both morbidity and mortality, regardless of the presence of preexisting diabetes. In order to achieve recommended glycemic goals, many patients require the use of intravenous insulin therapy in the critical care setting. Following the publication of a landmark trial evaluating the benefits of intensive insulin therapy in critically ill patients, a worldwide increased effort to achieve strict glycemic control has ensued.