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Spotlight

Every month, the subjects in Prescrire’s Spotlight.

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Cytotoxic drugs: risks for healthcare professionals

Exposure to cytotoxic drugs, which are often genotoxic, carcinogenic or reprotoxic, poses a risk to the health of healthcare and other professionals.
1 May 2020

New data on the cardiac adverse effects of the combination of hydroxychloroquine (Plaquenil°) with azithromycin (Zithromax° or other brands)

 NEWS UPDATE  As of mid-April 2020, more and more clinical data are confirming that the combination of hydroxychloroquine (Plaquenil°) with azithromycin (Zithromax° or other brands) carries a risk of serious cardiac adverse effects: prolongation of the QT interval with a high risk of cardiac arrhythmia and torsade de pointes, and cardiovascular mortality, which is increased by the addition of azithromycin. Several cases of cardiac arrest have been reported.
16 April 2020

Covid-19 and hydroxychloroquine (Plaquenil°): new data show no evidence of efficacy

 NEWS UPDATE  The results of a new randomised comparative but non-blinded trial of high-dose hydroxychloroquine (Plaquenil°) versus standard care in 150 patients hospitalised for covid-19 have been published. The only notable difference between the groups was the high incidence of adverse effects in the group treated with hydroxychloroquine. The results of other studies (non-randomised and providing only low-quality evidence) show no evidence that hydroxychloroquine has efficacy against covid-19.
16 April 2020

Covid-19 and hydroxychloroquine (Plaquenil°): still no conclusive results

 NEWS UPDATE  On 9 April 2020, the Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, Marseille, released a summary of a non-comparative study in 1061 people who had a positive PCR test result for Sars-CoV-2, the virus responsible for covid-19. Most had mild or no symptoms. All were treated with hydroxychloroquine and azithromycin. Most recovered within 10 days, as is the case, even without treatment, when symptoms are relatively mild. Without a control group, these results can neither confirm nor rule out the value of the treatment administered.
15 April 2020

Covid-19 and hydroxychloroquine: uncertainties and unanswered questions

 NEWS UPDATE  Results of a comparative trial of hydroxychloroquine (Plaquenil°) in 62 patients were published at the end of March 2020. The remaining uncertainty in the wake of these results means that the comparative trials currently underway must be continued, and great care should still be taken in the use of hydroxychloroquine, given its cardiac and other harms.
02 April 2020

Covid-19 and hydroxychloroquine: caution

 NEWS UPDATE  Hydroxychloroquine was not shown to be effective in a randomised trial in 30 patients with covid-19, the results of which were published in China in early March 2020. The hypothesis that this drug sometimes worsens covid-19 has not been ruled out. Short-course treatment with hydroxychloroquine carries a risk of various adverse effects, some of which can be fatal, especially in the event of an overdose.
30 March 2020

Pillflix3D°: an Innovative new manufacturing process that could revolutionise the way we solve medicines shortages

1 April 2020

• Watch out for acute shortages... of critical thinking!

Poisson d'avrilTo err is human, but when computers are involved, things can really get out of hand. Our ever-encroaching digital magic too often causes humans to put their critical faculties on hold. In these days of chronic drug shortages, contagious panic and an acute dependence on virtual everything, it's more vital than ever to hang on to one's good old-fashioned thinking cap.
1 April 2020

Lithium during pregnancy: malformations, fetotoxicity and uncertain long-term effects

FEATURED REVIEW Outside the context of pregnancy, lithium is the standard "mood stabiliser" for the treatment of bipolar disorder. What are the main known short-term and long-term consequences of in utero exposure to lithium?
Full review (3 pages) available for download by subscribers.
1 April 2020

In the April issue of Prescrire International: Denosumab (Prolia°) and steroid-induced osteoporosis

FREE DOWNLOAD Denosumab (Prolia°) has an unfavourable harm-benefit balance in the prevention of osteoporotic fractures. It has also been authorised in the prevention of osteoporosis induced by prolonged corticosteroid therapy. How do Prescrire's editors rate denosumab in this situation?
Full text available for free download.
1 April 2020

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