english.prescrire.org > Prescrire International > N°69 - February 2004

n°69

February 2004

Issue Contents
Editorial

Free  Bad cooking

p.2
When the quest for profitability jeopardises the level of evidence through multiple statistical analyses and a lack of comparative trials.

New Products


Carglumic acid (new preparation)

p.3-4
An advance in rare urea cycle disorders

Adefovir dipivoxil (new preparation)

p.4-7
A third-line option in chronic hepatitis B

Verteporfin (new indication)

p.7-9
In certain age-related macular degeneration: too little evidence

Glatiramer (new preparation)

p.10-12
No place in multiple sclerosis

Voriconazole (new preparation)

p.13-16
A real advance in severe Scedosporium infection. Invasive aspergillosis: benefits to be confirmed

Aciclovir and valaciclovir

p.17
Corneal herpes: valaciclovir is now the reference oral treatment

Daclizumab

p.17
Kidney transplantation in children: basiliximab is still the reference drug

Ertapenem

p.17
No better than other betalactam agents

Adverse Effects


Hidden amphetamines: from smoking cessation to diabetes

p.18-20
Bupropion, benfluorex, ephedrine derivatives, methylphenidate
Several drugs that are not marketed as appetite suppressants nonetheless have amphetamine-like properties; these include amfebutamone (bupropion) for smoking withdrawal; benfluorex for adjuvant treatment of hypertriglyceridemia and diabetes with overweight; ephedrine derivatives for "ENT decongestion"; and methylphenidate for narcolepsy and attention deficit-hyperactivity disorder in children.

Somatropin and the Prader-Willi syndrome

p.21

Suicidal ideas with paroxetine or venlafaxine

p.21

Side effects in patients with cognitive disorders

p.21

Nephritis and proton pump inhibitors

p.21

Telithromycin and myasthenia

p.21

Reviews


Weak opiate analgesics

p.22-25
Modest practical merits
Paracetamol, nonsteroidal antiinflammatory drugs (NSAIDs) and aspirin are first-line drugs for mild to moderate pain. The paracetamol + codeine combination barely augments the analgesic effect of paracetamol but carries a higher risk of adverse effects. Combinations of paracetamol with dextropropoxyphene or tramadol are even less interesting.

The amphetamine appetite suppressant saga

p.26-29
All amphetamine derivatives marketed as appetite suppressants in the late 1990s were withdrawn from the French market, owing to life-threatening cardiovascular adverse effects such as pulmonary hypertension and valve disease. Sibutramine, marketed in France since 2001, is a closely related drug.

Herpetic keratitis

p.30
Antiviral agents moderately effective

Postoperative anaemia

p.30
Prevention and oral iron

Pregnancy and influenza vaccination

p.30
Few data, no known specific hazard

Bacterial meningitis: adjunctive steroid therapy

p.30
Fewer deaths and complications

Outlook


Free  Perinatal mortality in West Africa due to inappropiate medicalisation

p.31

Free  Research and development costs: the great illusion

p.32-36
The generally quoted costs of pharmaceutical research and development were calculated by an institute that is largely funded by the industry itself, based on confidential data provided by drug companies. Closer scrutiny shows that the costs are vastly overestimated. By accepting these data at face value, the health authorities are ignoring the ground rules of good management.

Free  Appetite suppressants: European Commission overturns appeal

p.37
On the basis of purely legal arguments, five appetite suppressants whose licences had been withdrawn may find their way back on to the market.

Free  Cut out the bluff

p.37
If we are to pay for real therapeutic progress, and not for simple commercial novelties, negotiations must be conducted on a transparent basis.

Forum


"medicamentation" of society: an example of social pharmacology

p.38-39

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