Prescrire international
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Prescrire international · Oct 2013
Controlled Clinical TrialFentanyl buccal film. New oral transmucosal form has no advantages in breakthrough pain.
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Cystic fibrosis is a serious genetic disease due to mutations in the gene encoding CFTR (Cystic FibrosisTransmembrane conductance Regulator), a protein involved in cellular transmembrane transport, particularly of chloride ions. Ivacaftor is described as a selective potentiator of CFTR protein. It is now licensed for the treatment of cystic fibrosis patients 6 years of age and older who carry the CFTR G551D mutation, which is the case for about 4% to 5% of cystic fibrosis patients. ⋯ Ivacaftorcarries a risk of numerous pharmacokinetic interactions that can require dose adjustment, particularly for patients with hepatic impairment and those receiving cytochrome P450 isozyme 3A inhibitors or inducers. Given the absence of data, ivacaftor should be avoided during pregnancy. In practice, in 2013, it is not possible to determine the harm-benefit balance of ivacaftor due to the high risk of drug interactions, as well as a possible increased risk of infections and liver toxicity.
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Prescrire international · Sep 2013
Secondary cardiovascular prevention: omega-3 fatty acids ineffective.
A meta-analysis of comparative clinical trials including about 20,000 patients with a history of cardiovascular disease showed that omega-3 fatty acid supplementation did not reduce the risk of a subsequent cardiovascular event.
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Prescrire international · Sep 2013
Intranasal live attenuated seasonal influenza vaccine: does not challenge current practice.
Influenza vaccination of children is only justified when there is a risk of serious influenza complications. In 2012, a live attenuated vaccine for intranasal administration was authorised in the European Union for influenza prevention in individuals aged from 2 to less than 18 years. This type of vaccine has been available in the United States since 2003. ⋯ In practice, there is no firm evidence that this live attenuated influenza vaccine has any clinical advantages over injected vaccines, including in children at risk of influenza complications. In addition, this vaccine is unsuitable for the very children who are most in need of protection against influenza. It is better to stick with injected influenza vaccines.