n°84

August 2006

Issue Contents
Editorial

Free  A con trick

p.122
Dazzling headlines on rimonabant but hard evidence is lacking

Marketing Authorisations

Rimonabant (obesity) (new drug)

p.123-126
Do not prescribe this drug: it has limited effects and adverse effects are poorly documented, especially in the long term

Pegaptanib (macular degeneration) (new drug)

p.127-129
Limited effects on a surrogate outcome do not justify the risks and inconvenience of treatment

Imiquimod: basal cell carcinoma: inferior to other treatments

p.130-131

Topiramate (migraine prevention) (new indication)

p.132-133
Topiramate has more frequent and serious adverse effects than propranolol, and its efficacy is no better

Oxaliplatin (adjuvant treatment of colon cancer)

p.134
Very limited benefits offset by severe adverse effects

Triclabendazole (fascioliasis)

p.134
A real advance in treatment of fascioliasis

Tiotropium (COPD)

p.134
No clear advantage over existing inhaled antimuscarinic agent

Nasal fluticasone, nasal mometasone (nasal polyps)

p.135
No better than beclometasone

7-valent pneumococcal conjugate vaccine: primary vaccination between 2 and 5 years of age: only for certain children

p.135

Adverse Effects

Reversible parkinsonism linked to trimetazidine (continued)

p.136
There is no justification in using trimetazidine in any of the indications

Hormone replacement therapy aggravates postmenopausal urinary incontinence

p.137-138
Hormone replacement therapy does not protect against urinary incontinence

Methylphenidate: cardiac risks

p.138
Cardiotoxicity is a further reason to restrict use of this amphetamine psychostimulant

Free  Free access to pharmacovigilance data

p.138
The UK regulatory agency and the Dutch Lareb centre

Ibritumomab: serious cutaneous reactions

p.139

Glitazones and macular oedema

p.139
The role of glitazones should be considered in patients with ocular symptoms

Glucosamine allergy

p.139
Reports of angioedema, urticaria, pruritus

Telithromycin: severe hepatitis

p.139
Confirmed hepatotoxicity: do not use this antibiotic

Reviews

The metabolic syndrome

p.140-143
An artificial and irrelevant notion

Hairy-cell leukaemia

p.143-144
First-line treatment with cladribine or pentostatin

Cranberry and urinary tract infections

p.145-146
Slightly fewer episodes in young women, but watch out for interactions

Omega-3 polyunsaturated fatty acids for secondary cardiovascular prevention

p.147
It is best to recommend the Mediterranean diet

Basal cell carcinoma

p.147
Metastases are rare - Surgery is the first-line treatment

Outlook

Free  Conflicts of interest in the spotlight

p.148-149
Center for Science in the Public Interest (CSPI)

Free  La revue Prescrire Contribution to Consultation of Pharmacovigilance in the EU

p.149-153
The new legislation must be fully applied, and provisions for patient safety and public transparency must be improved

Free  Survey 15 years of monitoring and one simple conclusion: don't expect sales representatives to help improve healthcare quality

p.154-159
Sales reps focus on efficacy, sometimes encourage off-label use, and rarely mention adverse effects

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