Kathy Hitchens, PharmD, MSBA

As part of the 1987 international Montreal Protocol treaty to reduce/eliminate substances depleting the ozone layer, CFC (chlorofluorocarbon) propellants in albuterol metered-dose inhalers (MDIs) are gradually being replaced by HFAs (hydrofluoro-alkanes). The transition need not be complete until Dec. 31, 2008, when albuterol CFC-MDIs must be discontinued as mandated by the Food & Drug Administration. But the change is well under way. As Patty Johnson, spokeswoman for GlaxoSmithKline, noted, "We [GSK] already transitioned to Ventolin HFA MDI in early 2006."

Although jaw osteonecrosis is a rare complication of bisphosphonate therapy, the sheer numbers of bisphonphonate Rxs filled annually suggest this rare side effect may affect thousands of patients. Bisphosphonates are indicated for treating hypercalcemia of malignancy, multiple myeloma, bone metastases of solid tumors and Paget's disease, and for the treatment and prevention of osteoporosis.

The race is on. For both Type 1 and Type 2 diabetes, manufacturers are vying for pole positions with new therapeutic strategies that promise better disease management, improved quality of life, and ultimately prevention of diabetes complications.