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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

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Covid-19 and drug trials: what to make of the initial results?  NEWS UPDATE  As of 23 March 2020, there are no relevant clinical trial results demonstrating the efficacy of hydroxychloroquine, either alone or in combination with azithromycin. And no efficicacy has been proven for the lopinavir + ritonavir combination in severe covid-19, according to the results of a randomised controlled trial. Until more is known, the hypothetical efficacy of the proposed treatment must be weighed against its known or predictable adverse effects, to avoid making things even worse. 23 March 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

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Drugs in 2019: a brief review Eleven of the 108 new drugs, combinations, dose strengths, pharmaceutical forms or indications analysed and rated in our French edition in 2019 constituted a notable therapeutic advance, improving patient care in a variety of fields: haemophilia, various cancers, HIV infection, hepatitis C and rare diseases. 1 April 2020

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Drugs in 2019: therapeutic advances, compared with the previous 9 years GRAPHICS From Prescrire's recap "Drugs in 2019: a brief review", graphics comparing the therapeutic advances during 2019 with the advances made in prior years, along with a table summarising Prescrire's ratings of new products and indications over the past 10 years.  1 April 2020

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ France's Mediator° disaster: creating awareness around conflicts of interest Media coverage of the Mediator° disaster in 2010-2011 opened the public’s eyes to the conflicts of interest of many experts working for the French drug regulatory agency. Have health care professionals realised that these conflicts damage credibility, patient confidence and quality of care? 1 April 2020

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Zolgensma°: the drug of extremes For some years now, the escalating cost of new drugs has increasingly threatened access to health care. In 2019, Zolgensma° (onasemnogene abeparvovec-xioi) reached the absurd price of about 2 million euros for the single injection that is required to treat each patient. 1 April 2020

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Drugs to avoid in the name of better patient care: 2020 update The independent French medical journal Prescrire's annual review of drugs to avoid includes documented cases of 105 drugs authorised in the European Union that are more dangerous than beneficial. The aim is to make it easier to choose safe, effective treatments, primarily to avoid exposing patients to unacceptable harms. 1 February 2020

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Independent information does exist, but deserves more attention and visibility In a published response to the article "Pathways to independence: towards producing and using trustworthy evidence"  published online at bmj.com (BMJ 2019;367:l6576), Prescrire points out that independent sources of information do exist, and many, like Prescrire, are members of the International Society of Drug Bulletins. 06 February 2020

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Enjoy these features, and more, in our upcoming issues COMING SOON Methadone and cancer pain • Injectable zanamivir in influenza : judgement reserved • Pregabalin or gabapentin during pregnancy • MMR vaccine: no link with autism • Dulaglutide and type 2 diabetes •  Exposure of healthcare professionals to cytotoxic drugs... > Subscribe now 1 April 2020

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Subscribe today for full access to top-quality content from Prescrire International Subscribe now Enjoy access to subscriber-only content available on our website, including every article published in Prescrire International since 1992. Prices for a one-year subscription start at 150 euros (less for students and residents of lower-income countries). 1 December 2018

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ "Top Texts of 2019", from the editors of Prescrire International  FREE SPECIAL EDITION  Check out this brand new sampling of texts selected by our editors to introduce you to Prescrire International, a wholly independent monthly journal, written by and for healthcare professionals 28 August 2019

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Receive the free, monthly "Independent Drug & Healthcare Newsletter" Click here to sign up for the free Newsletter from the editors of the non-profit journal Prescrire International, with highlights of the contents of the latest issue. 1 September 2018

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