n°74

December 2004

Issue Contents
Editorial

Free  Vioxx°: no surprise

p.202
Once again this fiasco was predictable if the available data on the coxib class had been carefully appraised. Prescribers could therefore have avoided giving their patients drugs that offer no therapeutic advantages but carry an added risk of adverse effects.

Marketing Authorisations

Sustained-release methylphenidate

p.203-206
New pharmaceutical forms: a slight advantage for a small number of children

Influenza vaccine with squalene adjuvant

p.206-208
No better than available products

Pimecrolimus

p.209-212
Me-too: too many risks, not beneficial enough in atopic dermatitis

Palivizumab

p.213-216
Moderate reduction in hospitalisation rate

Meningococcal C vaccine conjugated with tetanus toxoid

p.217
No decisive advantage

Laronidase

p.217
IIn type I mucopolysaccharidosis: moderately effective; further studies required

Valproic acid

p.217
Sustained-release granules: not yet assessed on clinical endpoints

Adverse Effects

Systemic adverse effects of hepatitis B vaccines are rare

p.218-226
Cohort studies and case-control studies are consistent: if the risk of demyelinating disease ever exists, the patients concerned are rare. Anaphylactic reactions are exceptional. The risk-benefit balance is favourable in people at risk of hepatitis B.

Coxibs: no better than other NSAIDS

p.226
Late confirmation by medicines agencies.

Stroke and death associated with olanzapine

p.226
Do not use in elderly patients with dementia

Reviews

Acute sore throat - Antibiotics for acute group A streptococcal pharyngitis

p.227-232
Immediate antibiotic therapy when symptoms are severe or progress to locoregional suppuration, and when local incidence of rheumatic fever is high. In other situations and whether or not group A streptococci is involved, antibiotic therapy should be started only if symptoms do not improve after 48 hours. Penicillin is still the first-line antibiotic. Preventing rheumatic fever with benzathine benzylpenicillin is no longer a treatment aim in rich countries with low endemicity.

Drug-related risks during heat waves

p.233
Reconsider treatments in patients at risks

Penicillin in acute streptococcal A pharyngitis

p.233
Still the reference antibiotic

Outlook

Free  Adverse effects: direct reporting by patients is beneficial

p.234-235
A British study shows that reporting by patients and professionals is complementary. Health authorities have to set up a system for managing patient reporting.

Free  Coxibs: we want our money back!

p.236
Coxibs offer no clear benefit over classical NSAIDs
Cutting coxib prices is urgently needed. The companies concerned ought to refund the massive over-cost paid by taxpayers and patients.

Forum

Atorvastatin (Tahor

p.237
Between evaluation data and prescribing, more or less rational beliefs come into it.

What progress with methylphenidate sustained-release osmotic tablets?

p.238-239
A manager at Janssen-Cilag failed to challenge a review by la revue Prescrire.

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