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Every month, the subjects in Prescrire’s Spotlight.
2009 : 1 | 30 | 60 | 90
NEWS UPDATEBenfluorex's negative risk-benefit balance has been known for years. It took until late November 2009 for the French Health Products Safety Agency (AFSSAPS) to finally suspend its marketing authorisation.
1 December 2009
FEATURED REVIEW Agomelatine, a melatonin receptor agonist, is approved in the European Union for the treatment of depression. Agomelatine has unproven efficacy and poorly documented adverse effects. It is better to continue to use older antidepressants such as tricyclics or selective serotonin reuptake inhibitors. Full review (4p) in English available for download by subscribers.
FREE DOWNLOAD Pantoprazole, available without a prescription for the symptoms of gastroesophageal reflux, has a better risk-benefit balance than H2 receptor antagonists, but should not be used by pregnant women. Full text available for free download.
The European Commission is proposing to entrust pharmaceutical companies with the post-marketing monitoring of their own drugs – entailing the risk that firms will cover up evidence of adverse effects that might harm sales.
Vaccinate people with a high risk of severe complications, and choose the vaccine best suited to each individual. Not all H1N1v vaccines are created equal, and their usefulness differs according to several factors.
When a nonsteroidal anti-inflammatory is necessary, it is best to avoid nimesulide in favour of another drug with a better risk-benefit balance.
When infection must be avoided: frequent hand-washing, and surgical masks for patients.
Prescrire reports that antivirals should not be relied upon in combating the H1N1 virus, and summarises strategies for limiting the risks for pregnant women and infants.
Topical treatment of the symptoms is usually sufficient. Treatments with severe adverse effects should be avoided as far as possible.
The "Rencontres Prescrire 2010" will be held in Brussels Friday 28 and Saturday 29 May. The event will be conducted in French, but a broad range of European and international participants and viewpoints are expected, and encouraged.
FEATURED REVIEWThe best-assessed treatment for preventing relapses is a combination of aspirin and clopidogrel. Whereas prasugrel, in one trial, was no more beneficial than clopidogrel in reducing mortality and increased the risk of bleeding and other serious adverse effects. Full review (3p) in English available for download by subscribers.
1 November 2009
As of October 2009, the H1N1v flu virus has barely spread in France, but things are still feverish as regards vaccines. Many of the questions still have no clear answers. Contradictory information is swirling around every which way. And probably disinformation as well.
Transparency is the latest buzzword. But health agencies, the health industry and their intermediaries do not practise it.
In 2009, the value of routine screening for prostate cancer has not been clearly proven, but its adverse effects have.
Pharmaceutical companies are using every trick in the book to delay competition from generics or new drugs.
On 1 October, the French journal Prescrire announced the winners of its annual book award, the "Prix Prescrire". Four books in French were singled out by Prescrire’s Editorial Staff for the quality, impartiality and usefulness of their information.
The European Medicines Agency (EMEA) is allowing pharmaceutical companies to develop sales strategies based on drugs' brand names, at the risk of creating confusion for patients.
In type 2 diabetes patients, losing weight and adopting a "Mediterranean" diet, without being totally inflexible, reduces cardiovascular events and increases life expectancy.
Cough and cold remedies have little effect and are little – if at all – better than a placebo. Some expose patients, children in particular, to severe and disproportionate adverse effects.
Reliable, independently produced and regularly updated, Prescrire's new patient-information feature will help subscribers to get patients actively involved in decisions concerning their care.
FEATURED REVIEW After having considered other diagnoses and checked for signs of complication, the first step in treating renal colic is to control the pain. Which non-invasive treatments have a positive risk-benefit balance? We review the available evidence, based on standard Prescrire methodology. Full review (5p) in English available for download by subscribers.
1 October 2009
FREE DOWNLOADA French pharmacovigilance report reveals more frequent adverse effects and a higher proportion of severe adverse effects with minocycline than with doxycycline. Full text available for free download.
Using a drug’s international nonproprietary name (INN) is particularly helpful in avoiding confusion between similar brand names.
Experience acquired around the world indicates that the H1N1 flu is of similar clinical severity to that of bad seasonal flu outbreaks.
The political and media frenzy around the H1N1 pandemic is disproportionate, given the flu's only moderate severity.
Over the past decade, the number of patients admitted to hospital in France for adverse effects associated with drug treatments has not decreased. There are lessons to be learned and improvements to be made.
Despite its unfavourable risk-benefit balance, etoricoxib, a nonsteroidal anti-inflammatory drug, is set to be marketed in France.
Only one orally administered cannabis derivative, THC, is effective in providing a little relief from some pains associated with multiple sclerosis, at the cost of sometimes serious neuropsychological effects.
Some food colourings seem to increase activity in children diagnosed as hyperactive, but the same appears to apply to children not diagnosed as hyperactive. It is better to avoid exposing any children to food colourings.
The European Medicines Agency (EMEA) is reluctant to publish vital documents relating to drugs, in order to protect pharmaceutical companies' interests.
24 September 2009