english.prescrire.org > Spotlight > Archives : 2008

Spotlight: Archives

Every month, the subjects in Prescrire’s Spotlight.

2008 : 1 | 30 | 60

2008

Listen to patients for a better understanding of drugs' adverse effects

Reporting of adverse effects by patients helps build an improved understanding of drugs.

1 July 2008

Clinical trials should be registered to prevent data manipulation

Defining the protocols for clinical trials in publicly accessible registers prior to commencement of the trials would help identify drugs’ real risk-benefit balance.

1 July 2008

Cramps: no to Okimus°

This quinine-based drug used to treat nocturnal leg cramps has a distinctly unfavourable risk-benefit balance. Its packaging and presentation are unsafe, making it look like a sweet, which poses a real danger to children.

1 July 2008

In the June issue of Prescrire International:
Papillomavirus vaccine types 16 and 18

FREE DOWNLOAD The papillomavirus 16, 18 vaccine, like the papillomavirus 6, 11, 16, 18 vaccine, reduces the risk of high-grade cervical dysplasia due to all viral genotypes by about 40% in young women who are not yet infected at the time of vaccination. The vaccine does not seem to provoke any serious adverse effects, but there is no proof that it reduces the risk of cancer.
Full text available for free download.

1 June 2008

Arterial hypertension: second-line treatment

FEATURED REVIEW Reliable evidence supports the use of thiazide diuretics as first-line treatment for uncomplicated arterial hypertension. When patients fail to reach blood pressure targets, or this treatment is poorly tolerated, what are the best second-line options? We reviewed the available evidence, based on our standard in-house methodology.
Full review (4p) in English available for download by subscribers.

1 June 2008

Slight memory loss: cholinesterase inhibitors offer no proven benefit

In people over 50 presenting moderate memory loss, cholinesterase inhibitors, marketed as a treatment for Alzheimer’s disease, offer no proven benefit in preventing dementia, and cause numerous adverse effects.

1 June 2008

Antioxydants: no proven preventive effect, and some even increase mortality

In the absence of an obvious deficiency, antioxydants (vitamin E, carotene, etc.) have no proven health benefits, and some are probably harmful.

1 June 2008

SSRI antidepressants cause aggression

Treatment of depressive patients should start with non-drug measures. Antidepressants should be reserved for incapacitating disorders that are resistant to these measures, and patients should be closely monitored.

1 June 2008

Depression in children:
drugs should not be a first-line treatment

Treatment of children and adolescents considered to be depressive should rely first and foremost on non-drug treatments. Currently there is no antidepressant that has a favourable risk-benefit balance in children.

1 June 2008

Knowing a disease’s natural history helps make decisions

1 June 2008

Aliskiren : no evidence of clinical efficacy

FEATURED REVIEW Aliskiren is the first renin inhibitor to reach the market for management of arterial hypertension. The adverse effect profile does not seem to be any better than that of other antihypertensive drugs, and better-assessed drugs with longer followup are available.
Full review (4p) in English available for download by subscribers.

1 May 2008

No to pharmaceutical firms'
"compliance support" programmes

1 May 2008

Trimetazidine:
witholding information from patients

Trimetazidine has an unfavourable risk-benefit balance. Contrary to the information provided to health professionals, the patient information leaflet does not inform patients of the need to review the prescription after three months' treatment.

1 May 2008

"Freely available" drugs: not compulsory

Some drugs are described as "freely available" to patients in pharmacies. But where will patients find reliable information enable them to make informed choices?

1 May 2008

Self-medication: brand name mix-ups

Brand name extensions known as "umbrella" brands, created to bring several drugs under one name, reduce drugs to a mass-market product and patients to consumers who are unaware of what they are taking.

1 May 2008

Osteoporosis and the prevention of fractures: bisphosphonates offer little benefit after 5 years

Bisphosphonate treatment for postmenopausal women with severe osteoporosis provides limited efficacy for the first 5 years, but can cause sometimes severe adverse effects. Beyond this period, the benefit is minimal given the adverse effects.

1 May 2008

In the April issue of Prescrire International:
Budesonide + formoterol, a step backwards

FREE DOWNLOAD The budesonide + formoterol combination should not be recommended for "on demand" use to control asthma attacks. It exposes patients to an added risk of adverse effects, and undermines the clear distinction between maintenance treatment and control of attacks that has been found to help patients manage their asthma.
Full text available for free download.

1 April 2008

Osteodensitometry in healthy
postmenopausal women

1 April 2008

Medical guidelines: pros and cons

Medical guidelines are a good thing if doctors are failing to provide optimum patient care. But they should not be allowed to hinder doctors seeking to identify the best care for each individual patient.

1 April 2008

Helping smokers quit: avoid varenicline

More and more cases of gastrointestinal, neuropsychiatric and cardiovascular adverse effects linked to varenicline are being reported.

1 April 2008

Cox-2 inhibitors: half measures

Although Cox-2 inhibitors present no demonstrable therapeutic advantages, they have been shown to cause serious adverse effects. Drug regulatory agencies have settled for half-measures that favour the interests of the pharmaceuticals industry.

1 April 2008

Paediatrics: beware of unsuitable drugs and cosmetics

Some cosmetics and drugs used to treat benign disorders in children can expose them to potentially severe adverse effects.

1 April 2008

Colchicine: interactions and severe, sometimes fatal adverse effects

The use of colchicine is controversial due to its severe, sometimes fatal adverse effects. It is best only to prescribe it for gout attacks if analgesics and antiinflammatory treatments prove ineffective.

1 April 2008

Acne: danger of lesions of the mucous membranes with isotretinoin

In addition to the risk of teratogenic effects, oral isotretinoin can cause adverse effects to the mucous membranes, especially in the stomach.

1 April 2008

Obesity: sibutramine linked to cardiac disorder

New evidence confirms that sibutramine has an unfavourable risk-benefit balance, with sometimes severe, even fatal, adverse effects.

1 April 2008

Oral mucositis due to cancer treatments:
oral hygiene and ice cubes

FEATURED REVIEW Oral mucositis is a frequent adverse effect of cancer chemotherapy and radiotherapy, and can keep patients from drinking and eating normally. Prevention is based on orodental care and ice. Other treatments are no more effective and carry a risk of known or poorly documented adverse effects.
Full review (3p) in English available for download by subscribers.

1 March 2008

Giving up smoking: varenicline linked to depression and suicidal thoughts

For smokers wishing to quit, if medical treatment is necessary, nicotine is the best option as it has a more favourable risk-benefit balance.

1 March 2008

Taste disorders may be drug related

Numerous drugs can cause taste disorders, which can lead to anorexia and a deterioration in a patient’s general condition.

1 March 2008

Compulsive behaviour can be drug related

Some drugs, particularly those used to treat Parkinson’s disease, cause pathological behaviour such as gambling or hypersexuality, which can affect a person’s family and social life and even have legal consequences.

1 March 2008

Passive smoking: avoidable harm

It is now a fact that passive smoking is damaging.

1 March 2008