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Treatment options: drugs to be avoided

Every January, Prescrire publishes an independent review of therapeutic advances made over the previous year.

Prescrire's annual review of treatment options allows health professionals to ensure that they haven't overlooked any important therapeutic advances. The Prescrire Awards, announced on 20 January, highlight the most outstanding breakthroughs.

Prescrire's review also identifies drugs that doctors should cross off their prescription list. In 2004, this included thalidomide, used to prevent reactions in transplants (oncology); this drug offers no proven benefits but causes serious harm. The same applies to melagatran and ximelagatran for the prevention of thrombosis (cardiology): no advantage and too much risk . Pimecrolimus, used in the treatment of atopic eczema (dermatology), entails a risk and offers very little benefit. Nasal sumatriptan is not very effective and too dangerous for treating migraines in adolescents (neuro-psychiatry). Sustained-release risperidone injections, a long-term treatment for schizophrenia, offer no benefits (neuro-psychiatry).

In 2004, the rofecoxib (Vioxx°) affair served as a reminder that current regulations on marketing authorisations have failed to prevent a decline in drug safety. Health professionals cannot protect their patients' health if they do not challenge the information provided by the authorities and by pharmaceutical companies. Prescrire's review will help them to be more discerning in their choice of drugs.

©Prescrire January 2005

Source: "Enrichir sa panoplie thérapeutique : bilan de l'année 2004" Rev Prescrire 2005 ; 25 (257) : 27-62.

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