Prescrire international
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Anomalies in the international non-proprietary name (INN) nomenclature show that the international harmonisation of nonproprietary drug names has not been achieved. When pharmaceutical companies request a new INN, they try to obtain an INN that serves their interests, and then use it for promotional or anticompetitive purposes. Drug regulatory agencies are not fulfilling their duty to protect existing INNs, particularly with regard to biosimilars (copies of biotechnology-derived drugs), giving rise in particular to anomalous names. The independence of the World Health Organization INN programme must be safeguarded to ensure that the universal terminology it is responsible for developing is applied worldwide.
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Prescrire international · Oct 2014
Bedaquiline. More data needed on this dangerous antitubercular drug.
Active tuberculosis is a serious, sometimes fatal, bacterial infection. Multidrug-resistant strains are associated with higher mortality. Bedaquiline, a diarylquinoline antibiotic, has been authorised in the EU, in combination with other antibiotics, for patients with multidrug-resistant pulmonary tuberculosis. ⋯ The most frequently reported adverse effects were headache, nausea, arthralgia and pulmonary infections. In practice, bedaquiline reduced the number of contagious patients with multidrug-resistant pulmonary tuberculosis, but mortality was higher than in the placebo group. Its harm-benefit balance is unclear, especially in patients with extensively drug-resistant tuberculosis, for whom there are very few active antibiotics available.
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Prescrire international · Sep 2014
ReviewTreating essential hypertension. The first choice is usually a thiazide diuretic.
We concluded in 2004 that the first-choice treatment for hypertension in adults was single-agent therapy with the thiazide diuretic chlortalidone or, when this drug is not available, the thiazide diuretic hydrochlorothiazide. As of early 2014, does evidence challenge this choice in adults without diabetes or cardiovascular or renal disease? To answer this question, we reviewed the available evidence, using the standard Prescrire methodology. The current treatment threshold for hypertensive adults without diabetes or cardiovascular or renal disease is blood pressure above 160/100 mmHg or 160/90 mmHg, with some uncertainty over which diastolic threshold should be used. ⋯ As of early 2014, the first-choice treatment for hypertension in nondiabetic adults without cardiovascular or renal disease should be chlortalidone. If chlortalidone is not available, it appears reasonable to choose another thiazide diuretic, hydrochlorothiazide, possibly combined with amiloride or triamterene. When a diuretic cannot be used, it is better to choose an ACE inhibitor: captopril, lisinopril or ramipril.