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Spotlight

Every month, the subjects in Prescrire’s Spotlight.

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Covid-19 and severe breathing problems: dexamethasone reduced mortality in one trial

 NEWS UPDATE  Some detailed preliminary results were released on 23 June 2020 from a randomised trial in patients hospitalised for covid-19 (the “Recovery” trial). Adding the corticosteroid dexamethasone (for up to 10 days) to usual care reduced 28-day mortality in patients receiving oxygen or mechanical ventilation, but appeared unnecessarily dangerous in other patients.
24 June 2020

Andexanet alfa (Ondexxya°) as an antidote to xabans: inadequate clinical evaluation

FEATURED REVIEW The evaluation of andexanet alfa for the management of severe bleeding in patients receiving apixaban or rivaroxaban is inadequate. When bleeding occurs in a patient receiving a xaban, the key action is to put in place proven emergency supportive measures.
Full review (4 pages) available for download by subscribers.
1 July 2020

In the July-August issue of Prescrire International: aflibercept (Eylea°) in diabetic macular oedema without visual impairment

FREE DOWNLOAD What is the efficacy of aflibercept in patients with diabetic macular oedema without visual impairment at the time of diagnosis?
Full text available for free download.
1 July 2020

Proper evaluation, for patients' sake

EDITORIALProper drug evaluation, based on trials designed to provide sufficiently high-level evidence and conclusive results, using patient-relevant clinical outcomes, is the best way of ensuring that drugs are used judiciously, without causing unnecessary harm.
1 July 2020

Pulmonary arterial hypertension: sometimes drug-induced

Many drugs can cause pulmonary arterial hypertension, which sometimes improves when treatment is halted.
1 July 2020

Prescrire's annual drug packaging review: slow progress and dangers

The drug packaging market is improving, but there are also still many examples as of 2020 that pose a danger to patients, in particular children and pregnant women. These flaws affect prescribers, pharmacists and nurses through the complications they cause.
1 July 2020

Illustrated examples of dangerous drug packaging, from Prescrire's annual packaging review

A drug’s packaging (box, bottle, leaflet, etc.) is crucial in preventing administration errors. Three examples from Prescrire's annual drug packaging review illustrate the types of packaging flaws we identified as dangerous in 2019, flaws which have long been known to health authorities.
1 July 2020

Intra-articular hyaluronic acid injection for knee osteoarthritis: efficacy and adverse effects underestimated?

Queries and Comments Prescrire concluded in 2016 that the harm-benefit balance of hyaluronic acid by intra-articular injection seemed unfavourable. Several readers have since expressed their profound disagreement, citing the effects noted in their daily practice. How can such a difference be explained? Could the clinical data available in 2020 potentially call Prescrire's conclusions into question?
1 July 2020

Increased risk of skin cancer with hydrochlorothiazide: what are the practical consequences?

Queries and Comments In 2018, Prescrire reported the findings of two case-control studies that showed an increased risk of non-melanoma skin cancers in patients treated with hydrochlorothiazide, a first-choice antihypertensive drug. Does the evidence available in 2020 affect this drug's harm-benefit balance in hypertension?
1 July 2020

Lack of access to drug evaluation data: a recurrent problem, not confined to covid-19

 NEWS UPDATE  An article reporting the results of pharmacoepidemiological studies on the use of hydroxychloroquine in covid-19 has been retracted. The reasons given centre on the fact that access to the raw data was only granted to certain authors. This is a recurrent problem, not confined to evaluations of drugs for covid-19.
08 June 2020

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