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In Prescrire's Spotlight

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

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Covid-19 : Follow Prescrire's independent, evidence-based analysis of the pandemic  COVID-19  Prescrire's editors are publishing an ongoing series of news updates featuring independent analysis of developments related to the covid-19 pandemic. Useful and practical information, to help healthcare professionals gain a clear and balanced view. 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

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ 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

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ 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

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Enjoy these features, and more, in our upcoming issues COMING SOON Apalutamide and enzalutamide in non-metastatic prostate cancer • Cannabidiol in certain severe forms of childhood epilepsy • Melatonin for sleep disorders in children with autism • Drug-induced priapism • VEGF inhibitors: arterial aneurysm • Proton pump inhibitors in infants... > Subscribe now 1 July 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 July 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

¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯¯ Read more All the subjects in Prescrire's Spotlight >

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