Home' Australian Pharmacist : Australian Pharmacist November 2015 Contents Australian Pharmacist November 2015 I ©Pharmaceutical Society of Australia Ltd.
Xeljanz (tofacitinib citrate), a new oral
treatment alternative for patients
with moderate to severe rheumatoid
arthritis, was PBS listed on 1 October.
Xeljanz has been approved to treat
adults with moderate to severe
active rheumatoid arthritis, who
have had an inadequate response
to conventional disease-modifying
antirheumatic drugs (DMARDs), such
as methotrexate. Xeljanz belongs to a
new class of medicines known as Janus
kinase (JAK) inhibitors. JAK inhibitors
work inside cells by blocking the
signalling of proteins called cytokines,
which modulate aspects of the immune
response leading to inflammation.
At a recommended dosage of 5 mg
twice daily it can be used alone or
in combination with non-biological
DMARDs, including methotrexate.
Associate Professor Peter Nash,
Rheumatologist, said rheumatoid
arthritis was a serious and disabling
disease1 that affected approximately
, and many
patients did not adequately respond or
were intolerant to currently available
therapies. ‘Although multiple treatment
options for rheumatoid arthritis have
been available for some time, there
is a continued need for new options.
Research suggests up to one-third of
patients do not adequately respond
or are intolerant to currently available
treatments and about half stop
responding to any particular DMARD
within five years,’ Professor Nash said.
‘As a result, we are finding ourselves
cycling through multiple therapies,
so we need new treatment options
to help us preserve our patient’s
1. At: www.rheumatology.org/I-Am-A/Patient-Caregiver/
2. A picture of rheumatoid arthritis in Australia, Australian
Institute of Health and Welfare. At; www.aihw.gov.au/
Now PBS listed
XIGDUO® XR is the first once-daily
fixed-dose combination tablet of
SGLT2 inhibitor (dapagliflozin) and
metformin XR, for the treatment of
type 2 diabetes that will be listed on
the Pharmaceutical Benefits Scheme
(PBS) from 1 October 2015, for use in
It combines an SGLT2 inhibitor
(dapagliflozin) with extended release
metformin and is indicated as a once-a -
day adjunct to diet and exercise to
improve glycaemic control in adults
with type 2 diabetes mellitus when
treatment on both dapagliflozin and
metformin is appropriate.
Under the new streamlined PBS listing,
XIGDUO® XR will be reimbursed for
patients with HbA1c >7% currently
treated with metformin.
1. Schedule of Pharmaceutical Benefits. At: www.pbs.gov.au.
Last access 1 Oct 2015
2. XIGDUO® XR Approved Product Information.
Spiriva Soft Mist inhaler
The Spiriva Soft Mist inhaler is now available
in Australia and set to become the delivery
platform for a range of inhaled therapies
according to Boehringer Ingelheim (BI).
Spiriva (tiotropium bromide 5 mg) is the
first therapy available in the new Respimat
Soft Mist Inhaler1 and was added to the PBS
on 1 October for the treatment of COPD.
Spiriva HandiHaler (tiotropium bromide
18 mcg), which is currently the most widely
prescribed COPD maintenance therapy2
will continue to be available in Australia.3
The company has confirmed plans to make
a number of medications available via
the Respimat Soft Mist inhaler, which uses
mechanical energy rather than a propellant
to deliver medication to the airways as
a slow moving, fine mist. This design
feature helps maximise lung deposition
and reduce the amount of medication
deposited in the throat and mouth.
In studies across a number of patient
groups, including those with COPD
and asthma, the Respimat device has
recorded higher rates of lung deposition
with a range of medications compared
to traditional metered dose and dry
Unlike MDIs which require hand-breath
coordination or DPIs which are
breath-dependent, Respimat generates
an aerosol cloud independent of the
patient’s inspiratory effort and greatly
reduces the need to coordinate actuation
1. Spiriva Respimat approved Product Information (22 May 2015).
2. Boehringer Ingelheim, Data on file, 2015
3. Spiriva HandiHaler approved Product Information (22 May 2015).
4. Dalby R, et al. Int J Pharm 2004;283:1–9 .
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