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Spotlight

Every month, the subjects in Prescrire’s Spotlight.

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Order of magnitude

 Editorial  In many fields, such as aeronautical or mechanical engineering, accurate measurements and precise execution are essential. This is also true in some fields of medicine, such as pathology, where treatment decisions can hinge on the accuracy of a histological description or test result. However, in medicine in general and health care in particular, accurate measurements are not always available.
1 April 2023

Prescrire's ratings of new drugs in 2022

  Marketing Authorisations  Only 11 of the 124 new marketing authorisations analysed and rated in our French edition in 2022 represented a notable therapeutic advance for patients.
1 April 2023

Belimumab (Benlysta°) in lupus nephritis

  Marketing Authorisations  Belimumab, a monoclonal antibody directed against a protein called BLyS (B lymphocyte stimulator), was initially authorised in the European Union for subcutaneous or intravenous use in systemic lupus erythematosus. It has now also been authorised for use in active lupus nephritis.
1 April 2023

Omicron variant BQ.1.1: nirmatrelvir + ritonavir retains activity, monoclonal antibodies do not

 COVID-19  The Sars-CoV-2 circulating in France as of December 2022 is the BQ.1.1 sublineage of Omicron variant BA.5. To what degree does this affect the possible benefits of treatment with Sars-CoV-2-specific monoclonal antibodies or the combination of nirmatrelvir + ritonavir (Paxlovid°)? A few studies have provided some answers to this question.
1 April 2023

Ibrutinib: increased risk of sudden death

 Adverse Effects  Data from clinical trials show a 5-fold greater risk of sudden or cardiac death with ibrutinib than with comparators.
1 April 2023

The Drug Prescrire Awards for 2022: no "Pilule d'Or", one drug on the "Honours List". Details in the March issue of Prescrire International

Prescrire Awards None of the drugs examined by Prescrire in 2022 represented a major therapeutic advance worthy of a Pilule d'Or ("Golden Pill" Award). One drug made the Honours List, while one other was cited as Noteworthy.
1 March 2023

Negligence

 Editorial  According to a World Health Organization (WHO) news release from 27 October 2022, almost 11 million people worldwide fell ill with tuberculosis in 2021, including about a million children. More than 1.5 million people died from tuberculosis.
1 March 2023

Oral vitamin D supplementation: dangerous overdoses caused by errors

 Adverse Effects  Vitamin D overdose exposes patients to the risk of hypercalcaemia and hyperphosphataemia, and their sometimes serious or even fatal adverse effects, including: thirst, polyuria, anorexia, constipation, muscle weakness, fatigue, nausea and vomiting, confusion and renal disorders.
Full article (3 pages) available for download by subscribers
1 March 2023

Empagliflozin (Jardiance°) in chronic heart failure

  Marketing Authorisations  Given the absence of any comparison with other heart-failure drugs, empagliflozin has not been shown to represent a therapeutic advance. In particular, when the left ventricular ejection fraction is reduced, there is no evidence to suggest that empagliflozin offers any advantages over dapagliflozin.
Full article (2 pages) available for download by subscribers
1 March 2023

Winners and losers

  Marketing Authorisations  In the European Union, it has been possible since the mid-2000s for a drug's marketing authorisation to be conditional, i.e. granted on condition that the company subsequently provides data to justify full, standard marketing authorisation. The stated aim is commendable: hasten access to a drug in situations where no satisfactory options are available to patients and healthcare professionals.
Full article (1 page) available for download by subscribers
1 March 2023

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