The FDA has licensed the adjuvanted, recombinant varicella zoster virus (VZV) vaccine Shingrix (GSK) for prevention of herpes zoster (shingles) in adults of any age who are or will be at elevated risk because of disease- or therapy-induced immunodeficiency or immunosuppression. Shingrix has been licensed for herpes zoster prevention in adults ≥50 years old since 2017.1 It is the only VZV vaccine currently available in the US; Zostavax, a live-attenuated VZV vaccine, was withdrawn from the market in 2020.

Six vaccines are recommended for routine use in adults living in the USA (Guide for Adult Immunization, 2nd ed, Philadelphia:American College of Physicians, 1990). Immunization recommendations for travel outside the USA were published in The Medical Letter, volume 32, page 33, April 6, 1990.

Two new topical testosterone products, a 1% gel (Testim) and a buccal tablet (Striant), have been approved by the FDA for treatment of hypogonadism in men. This review briefly describes hypogonadism and its causes and lists other available formulations of testosterone. For the new products, information on pharmocokinetics, adverse effects, and dosage and administration is provided, as well as a summary of clinical trial results. A dosage and cost table for topical testosterone products is also included. The conclusion summarizes the safety and effectiveness of the new drugs and discusses the...

Most colorectal cancers arise from localized adenomatous polyps in a process that may take 10 years or more. Early detection and removal of a precancerous colonic lesion (polyp) can prevent cancer from developing.

The recombinant respiratory syncytial virus (RSV) vaccine Arexvy (GSK) has now received FDA approval for use in adults 50-59 years old who are at increased risk for lower respiratory tract disease (LRTD) caused by RSV. It was previously approved only for adults ≥60 years old. Two other RSV vaccines have received FDA approval: Abrysvo, a recombinant vaccine that is licensed for use in adults ≥60 years old and in pregnant women at 32-36 weeks' gestation to prevent RSV-associated LRTD in their infants, and mResvia, an mRNA vaccine recently licensed for use in adults ≥60 years old...

Recombinate (Baxter) and Kogenate (Miles), two recombinant-DNA-derived Factor VIII (rFVIII) preparations, were recently approved for marketing by the US Food and Drug Administration. Clotting factor concentrates are generally prepared from large plasma pools obtained from thousands of donors. Without adequate inactivation of viruses, these concentrates can transmit hepatitis B, hepatitis C, and the human immunodeficiency virus (HIV), among others. The new recombinant products, which include human albumin added as a stabilizer, are claimed to be free of blood-borne viruses.

Poractant alfa intratracheal suspension (Curosurf), a formulation of surfactant available in Europe since 1989, has been approved by the FDA for treatment of neonatal respiratory distress syndrome (RDS).

Laparoscopic surgery has become increasingly popular for the treatment of gastroesophageal reflux disease (GERD). The usual surgical procedure, a Nissen fundoplication, prevents reflux into the esophagus. The review compares medical treatment with a proton pump inhibitor vs. surgical therapy as well as open vs. the new laparoscopic technique. Morbidity and mortality with the procedures are discussed.

On February 27, 2021, the FDA issued an Emergency Use Authorization (EUA) for the Johnson & Johnson adenovirus-based vaccine for prevention of COVID-19 in persons ≥18 years old. It is the third COVID-19 vaccine to become available in the US and the first to require only a single dose. Two-dose mRNA-based vaccines manufactured by Pfizer-BioNTech and Moderna received EUAs in December 2020.

In February 2021, the FDA issued an Emergency Use Authorization (EUA) for the investigational monoclonal antibodies bamlanivimab and etesevimab (Lilly) for use together to treat mild to moderate COVID-19 in persons ≥12 years old who weigh ≥40 kg and are at high risk of progression to severe disease or hospitalization. The FDA has now expanded this EUA to allow use of the antibodies together for post-exposure prophylaxis of COVID-19 in such persons if they are not fully vaccinated against COVID-19 or are unlikely to have an adequate immune response to full vaccination and have...