The FDA has been busy this year reviewing new medications. As a practicing pharmacist, it is hard to remember everything so I wanted to outline the top 5 drug approvals in 2024 that may impact ambulatory care and geriatrics. Without further ado, here’s my top 5 drug approvals in 2024.
Vonoprazan (Voquezna)
MOA: Blocks the final step of gastric acid production by inhibiting the H+, K+ ATPase enzyme system.
It is approved for erosive esophagitis, GERD, and H. pylori infections when used with other agents such as amoxicillin and clarithromycin. Vonoprazan can be used similarly to other PPIs, such as omeprazole, taken once daily for 4 weeks. However, vonoprazan may be useful for those who do not experience relief from PPIs. Since it was just recently approved, the cost will be considerably higher than the common medications that are available over the counter. Our NAPLEX Nuggets study guide has been updated to include this medication in 2025!
Intranasal epinephrine (Neffy)
MOA: Epinephrine is a sympathomimetic catecholamine that acts on beta and alpha-adrenergic receptors to cause vasoconstriction and relaxes bronchial smooth muscles.
Neffy is an intranasal epinephrine product that can be used for anaphylaxis. It does not require any injection or needles such as other epinephrine products for anaphylaxis treatment. A study showed that Neffy had comparable safety and efficacy data to other available products on the market. It may be a great option for patients or caregivers who have fears of needles.
Aprocitentan (Tryvio)
MOA: Aprocitentan is an endothelin receptor antagonist. It inhibits the binding of ET-1 to ETA and ETB receptors and interferes with its effects of vasoconstriction, fibrosis, cell proliferation, and inflammation. ET-1 can cause endothelial dysfunction, vascular hypertrophy and remodeling and also increase aldosterone synthesis in hypertension.
Aprocitentan vs. placebo was studied in patients with hypertension who were already on 3 medications. The decrease in systolic blood pressure in patients receiving Aprocitentan was shown to be statistically significant. With the approval of aprocitentan, there is another option for those who experience resistant hypertension.
Ensifentrine (Ohtuvayre)
MOA: Ensifentrine is a small molecule that is an inhibitor of PDE3 and PDE4 enzymes that play a role in the signaling pathway for COPD.
Ensifentrine is a maintenance nebulizer treatment that is used twice daily for COPD. Since it is a nebulizer treatment, it may be an alternative for those who have trouble using an inhaler. It was well tolerated in studies and may provide a simplified therapy regimen for COPD patients.
Donanemab-azbt (Kisunla)
MOA: Donanemab-azbt is a humanized immunoglobulin gamma 1 (IgG1) monoclonal antibody directed against insoluble N-truncated pyroglutamate amyloid beta, thus reducing amyloid beta plaques in the brain. These plaques are a sign of Alzheimer’s Disease.
It is a monthly infusion, however discontinuation may be considered if the reduction of amyloid plaques to a minimal amount is seen on imaging. The other current medication similar to Kisunla is Leqembi, which is administered every 2 weeks. Both of these medications are costly, but Kisunla may provide a more convenient alternative for treatment.
There you have it, my top 5 drug approvals in 2024! What other recent approvals will have an impact on clinical practice?
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