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STEPS

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STEPS: Naltrexone/Bupropion (Contrave) for Weight Loss - American Family Physician

Apr 15, 2015 - Naltrexone/bupropion produces clinically significant weight loss when combined with a diet and exercise program. It decreases body weight in patients with diabetes, but its effect on diabetic outcomes is not known. A significant proportion of patients will experience adverse effects.

American Family Physician : STEPS

http://www.aafp.org/afp/2015/0415/p554.html

STEPS: Sofosbuvir/Velpatasvir (Epclusa) for Hepatitis C - American Family Physician

May 15, 2017 - Sofosbuvir/velpatasvir is an effective treatment for patients with HCV and has minimal adverse effects. It is the preferred treatment for patients with genotype 2 or 3. As with other curative treatments, it is very expensive.

American Family Physician : STEPS

http://www.aafp.org/afp/2017/0515/p664.html

STEPS: Albiglutide (Tanzeum) for Diabetes Mellitus - American Family Physician

Apr 15, 2017 - Reductions in A1C are less with albiglutide than with the first-line therapy metformin, and albiglutide costs significantly more than metformin and sulfonylureas. Albiglutide's ability to reduce diabetes-related morbidity and major cardiovascular events is unknown.

American Family Physician : STEPS

http://www.aafp.org/afp/2017/0415/p521.html

STEPS: Guanfacine (Intuniv) for Attention-Deficit/Hyperactivity Disorder - American ...

Feb 15, 2011 - Guanfacine is an effective short-term treatment option for ADHD in children six to 12 years of age. Sedation is a marked problem in many children. Patients should take the medication daily to avoid adverse effects that occur with abrupt discontinuation or when the guanfacine is restarted.

American Family Physician : STEPS

http://www.aafp.org/afp/2011/0215/p468.html

STEPS: Elbasvir/Grazoprevir (Zepatier) for Hepatitis C Virus Infection - American ...

Mar 15, 2017 - Elbasvir/grazoprevir is a safe and effective treatment for HCV genotypes 1 and 4, with or without compensated cirrhosis or HIV-1 coinfection. Patients with renal impairment, including those on hemodialysis, can use the medication.

American Family Physician : STEPS

http://www.aafp.org/afp/2017/0315/p393.html

STEPS: Apixaban (Eliquis) for Stroke Prevention in Atrial Fibrillation - American ...

Apr 15, 2014 - Apixaban is at least as effective as aspirin or warfarin for preventing strokes in high-risk patients with nonvalvular atrial fibrillation, especially those who cannot or will not take warfarin. It is slightly less likely to cause major bleeding and may have better compliance because it...

American Family Physician : STEPS

http://www.aafp.org/afp/2014/0415/p672.html

STEPS: Rifaximin (Xifaxan) for Irritable Bowel Syndrome - American Family Physician

Feb 15, 2017 - Rifaximin has good overall tolerability. A relatively short course of treatment results in sustained clinical benefit for at least 10 weeks, eliminating the need for continued therapy, with an NNT of 10. However, it is expensive and should be reserved for patients who cannot tolerate or...

American Family Physician : STEPS

http://www.aafp.org/afp/2017/0215/p258.html

STEPS: Empagliflozin (Jardiance) for Type 2 Diabetes Mellitus - American Family Physician

Dec 15, 2016 - Empagliflozin can be added to existing type 2 diabetes treatment to lower A1C levels, although there are less expensive options. In older patients with preexisting cardiovascular disease, empagliflozin can decrease all-cause mortality, cardiovascular mortality, and hospitalization for ...

American Family Physician : STEPS

http://www.aafp.org/afp/2016/1215/p1014.html

STEPS: Umeclidinium (Incruse Ellipta) for COPD - American Family Physician

Jan 15, 2017 - Umeclidinium is an easy-to-use, once-daily, well-tolerated, and relatively low-cost anti-cholinergic agent for maintenance therapy in patients with moderate to severe COPD.

American Family Physician : STEPS

http://www.aafp.org/afp/2017/0115/p120.html

STEPS: Sacubitril/Valsartan (Entresto) for Heart Failure - American Family Physician

Oct 15, 2016 - Sacubitril/valsartan provides a small mortality benefit and decreases heart failure–related hospitalizations over and above an ACE inhibitor. It may be used in place of an ACE inhibitor in patients receiving optimal doses of guideline-directed medical therapy that includes ACE ...

American Family Physician : STEPS

http://www.aafp.org/afp/2016/1015/p611.html

STEPS: Evolocumab (Repatha) for the Treatment of Hyperlipidemia - American Family ...

Nov 15, 2016 - Evolocumab is generally safe and effective at lowering serum LDL cholesterol levels for select patients who need marked cholesterol reduction and can tolerate injections. However, it remains unknown whether evolocumab prevents premature death from cardiovascular events.

American Family Physician : STEPS

http://www.aafp.org/afp/2016/1115/p843.html

STEPS: Liraglutide (Saxenda) for Weight Loss - American Family Physician

Jul 15, 2016 - Liraglutide, combined with lifestyle counseling, produces a clinically significant and sustained weight loss that continues as long as it is used. Nausea and vomiting, however, are common adverse effects, and about one in 10 patients will discontinue treatment.

American Family Physician : STEPS

http://www.aafp.org/afp/2016/0715/p161.html

STEPS: Suvorexant (Belsomra) for Insomnia - American Family Physician

Jun 15, 2016 - Suvorexant effectively increases total sleep time and decreases time to sleep onset. Because of its risk of abuse, significant incidence of next-day impairment, and high cost, it should be reserved for use in patients for whom other insomnia therapies, such as cognitive behavior therapy...

American Family Physician : STEPS

http://www.aafp.org/afp/2016/0615/p1016.html

STEPS: Ivermectin 1% Cream (Soolantra) for Inflammatory Lesions of Rosacea - American ...

Sep 15, 2016 - Ivermectin cream is an effective treatment for moderate to severe pustular rosacea, but it is more expensive than some other available treatments and has not been studied in patients with milder forms of rosacea. Generic metronidazole cream is a less expensive alternative, and long-term...

American Family Physician : STEPS

http://www.aafp.org/afp/2016/0915/p512.html

STEPS: Alirocumab (Praluent) for Treatment of Hyperlipidemia - American Family Physician

Aug 15, 2016 - Alirocumab is a novel lipid-lowering therapy that is highly effective at lowering LDL cholesterol when used in addition to statin therapy and diet. Its use should be limited to patients with either heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular ...

American Family Physician : STEPS

http://www.aafp.org/afp/2016/0815/p310.html

STEPS: Ivabradine (Corlanor) for Heart Failure - American Family Physician

Apr 15, 2016 - In patients with stable systolic heart failure already on maximal medication therapy, adding ivabradine may reduce the number of hospitalizations related to heart failure (NNT for two years = 20), but it does not reduce cardiovascular mortality. In addition, many patients will not ...

American Family Physician : STEPS

http://www.aafp.org/afp/2016/0415/p682.html

STEPS: Flibanserin (Addyi) for Hypoactive Sexual Desire Disorder in Premenopausal Women...

May 15, 2016 - Although flibanserin results in a modest improvement in the number of satisfying sexual events (approximately one more per month vs. placebo), it does not improve other measures, is considerably expensive, and has significant adverse effects.

American Family Physician : STEPS

http://www.aafp.org/afp/2016/0515/p826.html

STEPS: Conjugated Estrogens/Bazedoxifene (Duavee) for Menopausal Symptoms - American ...

Feb 15, 2016 - Conjugated estrogens/bazedoxifene is effective for the treatment of menopausal symptoms and may be better tolerated than conjugated estrogens/medroxyprogesterone. It will maintain bone mineral density in the lumbar spine and hip, but its effect on fractures is not known. Cardiovascular ...

American Family Physician : STEPS

http://www.aafp.org/afp/2016/0215/p307.html

STEPS: Timothy Grass Pollen Allergen Extract (Grastek) for Allergic Rhinitis - American...

Dec 15, 2015 - Timothy grass pollen allergen extract produces small improvements in allergic rhinitis symptoms and the use of allergy relief medications, with a high rate of adverse effects. It may, however, be an option for patients who desire an alternative to standard allergy symptom relief but who...

American Family Physician : STEPS

http://www.aafp.org/afp/2015/1215/p1096.html

STEPS: Vortioxetine (Brintellix) for the Treatment of Depression - American Family ...

Mar 1, 2015 - Current evidence does not support the routine use of vortioxetine in the treatment of depression. Family physicians most often encounter patients with mild to moderate depression, and vortioxetine has not been studied in this population. There is no clear benefit of using vortioxetine ...

American Family Physician : STEPS

http://www.aafp.org/afp/2015/0301/p325.html

STEPS: Levomilnacipran (Fetzima) for Major Depressive Disorder - American Family Physician

Oct 15, 2015 - Levomilnacipran should not be used in patients with mild to moderate depression until studies have proven its effectiveness. It is somewhat effective in patients with moderate to severe depression. The short-term adverse effect profile of levomilnacipran is similar to that of other SNRIs.

American Family Physician : STEPS

http://www.aafp.org/afp/2015/1015/p727.html

STEPS: Spinosad (Natroba) for Head Lice - American Family Physician

Jun 15, 2013 - Spinosad is safe and effective for the treatment of head lice; most patients will be lice-free after a single treatment. Nit combing following treatment is not necessary. These benefits must be weighed against its prescription-only status and higher cost compared with nonprescription ...

American Family Physician : STEPS

http://www.aafp.org/afp/2013/0615/p874.html

STEPS: Vorapaxar (Zontivity) for the Prevention of Thrombotic Cardiovascular Events - ...

Aug 15, 2015 - Vorapaxar should be limited to select patients with a history of MI or peripheral arterial disease who desire additional treatment for the prevention of MI.

American Family Physician : STEPS

http://www.aafp.org/afp/2015/0815/p304.html

STEPS: Dapagliflozin (Farxiga) for Type 2 Diabetes Mellitus - American Family Physician

Jun 15, 2015 - Dapagliflozin will lower A1C levels by an average of 0.7 percentage points when used alone or by an average of 0.5 percentage points when added to metformin therapy. Its effect on diabetes-associated morbidity and mortality has not been studied, and although it is well tolerated, there ...

American Family Physician : STEPS

http://www.aafp.org/afp/2015/0615/p828.html

STEPS: Phentermine/Topiramate (Qsymia) for Chronic Weight Management - American Family ...

Oct 15, 2014 - Phentermine/topiramate has been shown to be a good option for sustained weight loss in patients who are unable to lose weight with diet and exercise alone. It should not be given to patients with a history of significant heart disease, and women of childbearing age should use ...

American Family Physician : STEPS

http://www.aafp.org/afp/2014/1015/p576.html

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