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In Prescrire's Spotlight

Drug residues in water: the pharmaceutical industry haggling over their removal  Editorial  Among various European directives on water pollution, the revised Urban Wastewater Treatment Directive came into force in early 2025. The pharmaceutical industry is seeking to dodge its obligations. Full article available for download (FREE) 1 November 2025

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Gefapixant (Lyfnua°) in refractory or unexplained chronic cough  Marketing Authorisations  Gefapixant, an antagonist of the purinergic receptors P2X3 and P2X2/3, has been authorised in the European Union for use in adults with refractory or unexplained chronic cough. Does gefapixant alleviate the symptoms or complications of chronic cough? Does it stop patients from coughing or reduce cough frequency? And what are its adverse effects? Full article available for download by subscribers 1 November 2025

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Alectinib (Alecensa°) as first-line treatment in advanced or metastatic ALK-positive non-small cell lung cancer  Marketing Authorisations  The initial marketing authorisation for the use of alectinib in patients with advanced or metastatic non-small cell lung cancer harbouring an ALK mutation was based on the preliminary results of two comparative randomised trials, called "Alex" and "Alur". More results from these trials, with longer follow-up, have become available since the evaluation published in our French edition in 2018. Full article available for download by subscribers 1 November 2025

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Semaglutide (Wegovy°) in excess body weight: sometimes useful for patients who also have a history of cardiovascular disease  Marketing Authorisations  The glucagon-like peptide 1 (GLP-1) agonist semaglutide was authorised in the European Union in 2021 for use in certain patients with overweight or obesity. At that time, in the absence of the results of the ongoing "Select" trial evaluating the effect of semaglutide versus placebo on the cardiovascular complications of excess body weight, it was preferable that these patients not count on this drug and that the focus be placed instead on a comprehensive (non-pharmacological) approach. Results from the Select trial were published in a scientific journal in 2023, and then presented in Prescrire International. In 2024, the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA), which have access to far more data than those presented in medical journals, published their public reports on the Select trial online. Full article available for download by subscribers 1 November 2025

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Drug-induced impulse control disorders: an insight into the devastating effects on patients' lives  Adverse Effects  An analysis of reports of adverse drug reactions involving pramipexole or aripiprazole, recorded in the US pharmacovigilance database, showed that 7.5% and 4.5% of reports, respectively, included an impulse control disorder such as pathological gambling, hypersexuality, impulsivity, compulsive shopping or hyperphagia. Full article available for download by subscribers 1 November 2025

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Clinical evaluation of medical devices: as of 2025, progress is difficult to ascertain and weaknesses persist  Outlook  The reforms culminating in the 2017 Medical Devices Regulation did not take into account the calls from Prescrire, among others, for the creation of a European Medical Devices Agency. Full article available for download (FREE) 1 November 2025

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Enjoy these features, and more, in our upcoming issues COMING SOON• Attenuated chikungunya vaccine • New complement inhibitors for paroxysmal nocturnal haemoglobinuria • Multiple sclerosis drugs and pregnancy • Methotrexate: evaluation of risk minimisation measures commissioned by the EMA > Subscribe now 1 November 2025

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ New! "2025 Free Special Edition", from the editors of Prescrire International  FREE SPECIAL EDITION  Check out this selection of articles to introduce you to Prescrire International, a wholly independent monthly drug bulletin, written by and for healthcare professionals. Includes an array of articles from the past year on drugs and health policy in Europe. > Click here for your free copy 1 January 2025

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Subscribe today for full access to top-quality content from Prescrire International  SUBSCRIBE NOW!  Enjoy access to subscriber-only content available on our website, including every article published in Prescrire International since 1992. Prices for a one-year subscription start at 165 euros (less for students and residents of lower-income countries). 1 January 2022

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Follow Prescrire International on LinkedIn and Facebook Keep up with the latest from Prescrire's editors, and support our values of independence and quality information, first and foremost in the interest of patients. Click here to > Follow us on LinkedIn or > Follow us on Facebook 1 January 2025

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Receive the free, monthly "Independent Drug & Healthcare Newsletter" Click here to sign up for the free Newsletter from the editors of the non-profit journal Prescrire International, with highlights of the contents of the latest issue. 1 July 2022

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Drugs to avoid, in the name of better patient care   DRUGS TO AVOID - 2025 UPDATE  Independent French medical journal Prescrire has published its annual update of drugs to avoid. The goal is to make it easier to choose high-quality care, and to prevent disproportionate harm to patients. > Read more

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Read more All the subjects in Prescrire's Spotlight >

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