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Dabrafenib (Tafinlar°) and trametinib (Mekinist°) combined, as adjuvant therapy for stage III melanoma with a BRAF V600 mutation FEATURED REVIEW This combination has now been authorised in the European Union for the adjuvant treatment of patients with melanoma and lymph node involvement but no other metastases, when the tumour cells express a BRAF V600 mutation. Does this combination extend survival in this situation? Does it reduce the incidence of recurrence? What more is known about its adverse effects? Full review (3 pages) available for download by subscribers. 1 June 2020

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ In the June issue of Prescrire International: Antispasmodics during pregnancy, in brief FREE DOWNLOAD Various drugs termed antispasmodics are offered to treat pain of gastrointestinal, urinary or gynaecological origin, often despite unconvincing evaluation. What are the risks to the mother and the unborn child when taken during pregnancy? Full article available for free download. 1 June 2020

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Curiosity is an admirable quality Editorial How is it that the link between benfluorex (formerly marketed under the brand name Mediator°) and heart valve disease was unrecognised for decades by most French cardiologists? Despite the drug’s widespread use, the frequency of these valve disorders, and constant advances in echocardiography? 1 June 2020

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Drug-induced heart valve disease: a blind spot for cardiologists Exposure to benfluorex (Mediator°) caused hundreds of deaths in France, in particular from heart valve disease. Before the withdrawal of Mediator°, many cardiologists attributed these drug-induced valve disorders to other causes, often rheumatic heart disease, even though rheumatic fever had long since become very rare. 1 June 2020

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Prescrire: independence and transparency, in the name of better patient care The independent French medical journal Prescrire is produced by healthcare professionals who strive to protect medical information and continuing education from the contradictory influences at play in the medico-pharmaceutical arena. 1 June 2020

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Tramadol: an opioid analgesic to be used with caution Classified as a weak opioid, tramadol poses risks that require the same vigilance as with morphine. 1 June 2020

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Thyroid hormone treatment: no proof of benefit in asymptomatic subclinical hypothyroidism. According to a systematic review of comparative trials in approximately 2 000 patients, symptomless hypothyroidism discovered incidentally does not require thyroid hormone treatment (levothyroxine). 1 June 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

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Follow Prescrire International on Facebook and Twitter Keep up with the latest from Prescrire's editors, and support our values of independence and quality information, first and foremost in the interest of patients. Click here to > Follow us on Facebook or > Follow us on Twitter 1 June 2020

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Enjoy these features, and more, in our upcoming issues COMING SOON Andexanet alfa as an antidote to xabans • Abemaciclib and inoperable breast cancer • Drug-induced pulmonary arterial hypertension • Hydrochlorothiazide and risk of skin cancer • Intra-articular hyaluronic acid injection for knee osteoarthritis... > Subscribe now 1 June 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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