Drug and therapeutics bulletin
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About 10% of people aged over 55 years in the UK report having some restriction of daily activity because of knee osteoarthritis, around 25% of whom are severely disabled. Every year, symptomatic knee osteoarthritis accounts for about 0.5% of all primary care consultations in those over 55 years, rising to 1% in those over 70 years. Acupuncture is increasingly being used within the NHS, particularly for painful conditions such as osteoarthritis, but its place within mainstream healthcare remains controversial. Here we examine what, if anything, acupuncture offers in the management of patients with osteoarthritis of the knee.
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Duloxetine, a combined serotonin and norepinephrine reuptake inhibitor, is licensed in the UK under two brand names for a total of three different indications. It is available as Cymbalta (jointly promoted by Boehringer Ingelheim and Lilly) for the treatment of patients with major depression, or with diabetic peripheral neuropathic pain; and as Yentreve (Lilly) for the treatment of women with "moderate to severe" stress urinary incontinence. Here we consider whether duloxetine has a role in the treatment of patients with any of these conditions.
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About 14% of adults in the UK have migraines. Drugs used in migraine prophylaxis include beta-blockers (e.g. propranolol), 5HT antagonists (e.g. pizotifen), antidepressants (e.g. amitriptyline), antiepileptics (e.g. sodium valproate) and NSAIDs. The antiepileptic topiramate (Topamax-Janssen-Cilag) is licensed for the prophylaxis of migraine headache in patients aged over 16 years. Here we discuss the place of topiramate in migraine prophylaxis.
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Every year in the UK, around 16,000 people die from colorectal cancer, the second commonest cause of death from cancer in the UK after lung cancer. Over half of all people with colorectal cancer eventually die of metastatic disease. ⋯ Bevacizumab (pronounced be-va-see-zoo-mab) (Avastin - Roche) and cetuximab (se-tuks-ee-mab) (Erbitux - Merck) are two new monoclonal antibodies licensed for treating patients with metastatic colorectal cancer. Here we assess their efficacy and safety.
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There are many potential outcomes or endpoints to choose from to assess the effects of asthma treatments, and a wide range of such measures are used in different trials. This can make it difficult to compare treatment outcomes from different trials and to understand whether new treatments offer a genuine clinical benefit for patients. Here we review the common endpoints used in trials to assess the efficacy of asthma treatments.