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Quite the contrary, with a total of 50 new drugs, 2021 belongs to the most successful FDA years. We assign these new drugs to one of three levels of innovation: (1) first drug against a condition (\u201cfirst-in-indication\u201d), (2) first drug using a novel molecular mechanism (\u201cfirst-in-class\u201d), and (3) \u201cnext-in-class\u201d, i.e., a drug using an already exploited molecular mechanism. We identify 21 first-in-class, 28 next-in-class, and only one first-in-indication drugs. By treatment area, the largest group is once again cancer drugs, many of which target specific genetic alterations. Every second drug approved in 2021 targets an orphan disease, half of them being cancers. Small molecules continue to dominate new drug approvals, followed by antibodies and non-antibody biopharmaceuticals. In 2021, the FDA continued to approve drugs without strong evidence of clinical effects, best exemplified by the aducanumab controversy.<\/jats:p>","DOI":"10.1007\/s00210-022-02250-2","type":"journal-article","created":{"date-parts":[[2022,5,11]],"date-time":"2022-05-11T04:02:36Z","timestamp":1652241756000},"page":"867-885","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["A year in pharmacology: new drugs approved by the US Food and Drug Administration in 2021"],"prefix":"10.1007","volume":"395","author":[{"given":"Gizem","family":"Kayki-Mutlu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zinnet Sevval","family":"Aksoyalp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leszek","family":"Wojnowski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin C.","family":"Michel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,5,11]]},"reference":[{"key":"2250_CR1","doi-asserted-by":"publisher","first-page":"1964","DOI":"10.14336\/AD.2021.0719","volume":"12","author":"M Abyadeh","year":"2021","unstructured":"Abyadeh M, Gupta V, Gupta V, Chitranshi N, Wu Y, Amirkhani A, Meyfour A, Sheriff S, Shen T, Dhiman K, Ghasem HS, Paul AH, Stuart LG, Mirzaei M (2021) Comparative analysis of aducanumab, zagotenemab and pioglitazone as targeted treatment strategies for Alzheimer\u2019s disease. 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