The medical journal Prescrire looks back on its main advice issued in 2019 to better manage patients and limit the risk of side effects.
With the start of the year comes time to take stock. The independent medical journal Prescribe published on January 1, 2020 a summary of the recommendations published over the past year in terms of care, therapeutic solutions and drugs for better care.
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Effective drugs to remember
First point: the drugs to remember for their effectiveness. This is for example the case of dupilumab (Dupixent) which improves the symptoms in 30% of patients bothered by a eczema atopic in addition to placebo, after failure of local treatments and ciclosporin.
Likewise, in alcohol dependent patients, the baclofen moderate doses (30 mg daily) should Prescribe be considered an option for “help control the alcohol consumption“.
Regarding cancer treatment, the review Prescribe also recognizes the usefulness of pembrolizumab (Keytruda) for lengthening survival in metastatic bronchial cancer and that of axilabetagen ciloleucel (Yescarta) for increasing the chances of survival for patients with lymphoma.
Diclofenac and ibuprofen
The review also highlights the new knowledge acquired to better understand the risks of drugs. Prescribe returns to two alerts issued this year. The first concerns the higher cardiovascular risks in the month following the taking of diclofenac (Voltarene or other) than with ibuprofen or naproxen.
The second deals with the cases ofhypoglycaemia in patients treated for diabetes caused by antiviral drugs for hepatitis C.
Pulmonology, psychiatry and ENT
Finally, the review highlights the progress made in improving patient care. First, it recalls that thescan lung test is as good as chest x-ray in children with pneumonia and which, unlike radio, has the advantage of not exposing to ionizing radiation.
In the area of adult psychiatry, Prescribe notes that when a drug neuroleptic by oral route seems justified in the event of a psychotic episode, the choice between the various possible neuroleptics must above all be guided by their profile of undesirable effects “given the lack of a tangible difference in efficiency“between these different drugs.
Last point addressed in this report: the paracetamol is the first choice treatment for sore throat of infectious origin when non-steroidal anti-inflammatory drugs (NSAIDs) are to be avoided since they increase the risk of serious infectious complications such as phlegmons.
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