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Friday 22 December 2017

Big Pharma announces new drugs. We await to hear about their side effects, and how patients will be harmed by them

MIMS, first published in 1959, claims that it is an "essential prescribing and clinical reference for general practice", and so it is, probably. It is published quarterly, and print copies are sent free of charge to all UK-based GPs. What they claim to be their top 10 stories for 2017 make interesting reading. Here are some of them.

Quinine for muscle cramps linked to increased mortality.
This announces that long-term use of quinine for nocturnal leg cramps, something that doctors have prescribed for many years, has now been found to increase the risk of mortality. The British study was published in the medical journal, JAMA. It is yet another pharmaceutical drug that has been found to be deadly to patients, but as usual, only after many patients have died in order to prove it!

The authors of the study concluded that "the benefits of quinine in reducing cramps should be balanced against the risks" and owing to the poor benefit-to-risk ratio, both NICE and the drug regulator MHRA now (belatedly) advise that quinine should not be considered as a routine treatment for nocturnal leg cramps. However, this does NOT constitute a ban! It can still be considered when self-care measures fail, and cramps cause regular disruption of sleep.

Adjust gabapentin dose to avoid respiratory depression, MHRA advises
Gabapentin, perhaps better known as Neurontin, is a drug used for epilepsy, neuropathic pain, hot flashes, and restless legs syndrome. For many years it has been associated with a rare risk of severe respiratory depression when prescribed with or without concomitant opioids. (Many drug side effects are described as 'rare' to reassure patients and to encourage them to take the drug. But remember, only 1% to 10% of adverse drug reactions are ever notified).

Now the MHRA has issued a drug safety update - which means they were not aware of all the adverse drug effects before, but the damage done to patients is now sufficiently clear to have to come clean!

                "Prescribers should consider whether the dose of gabapentin needs to be adjusted in patients at higher risk of respiratory depression, including patients with compromised respiratory function, those with respiratory or neurological disease or renal impairment, patients taking other CNS depressants and elderly people."

The game of Russian Roulette, played with our health at stake, clearly continues within the conventional medical establishment!

First triple combination inhaler launched for COPD
The other top 10 stories are apparently considered to be good news! Trimbow has been approved as 'maintenance treatment' in adults with moderate to severe COPD "who are not adequately treated by the combination of an inhaled corticosteroid and a long-acting beta2-agonist". It says that as COPD patients deteriorate in time treatment needs to be progressively increased, and patients may have to take several drugs through two or three different inhalers. Trimbow simplifies treatment by providing just one inhaler, and a 'measured' dose.

Nothing about safety, of course. But inhalers are steroid drugs, with serious known side effects. Trimbow apparently enables patients to risk the side effects more efficiently. As as COPD patients 'deteriorate in time' it would appear that they are not entirely effective either!

Liraglutide provides new weight loss option for overweight and obese adults
MIMS tells us that Liraglutide, an anti diabetic drug, is now available as Saxenda - for weight management in obese patients and overweight patients with one or more associated comorbidities. What it does not tell us is that this 'top 10' story concerns a drug that already has a length list of side effects, some of them extremely serious, as detailed in this webpage. MIMS mentions a few of these, but it would appear that any 'new' branding of an old drug constitutes good news for the conventional medical establishment!

Baricitinib: oral rheumatoid arthritis treatment in new drug class
Baricitinib, or Alumiant, is now available to doctors for the treatment of moderate-to-severe active rheumatoid arthritis. More good news! The drug is apparently a 'Janus kinase inhibitor'. No, I don't know either - so let MIMS explain.

               "There are four known Janus kinase (JAK) enzymes. Baricitinib is a reversible inhibitor of JAK1 and JAK2, which are widely expressed and mediate signalling of multiple cytokines implicated in the pathogenesis of RA, including interleukin-6, granulocyte-macrophage colony-stimulating factor and interferons."

Perhaps it is sufficient to say that Baricitinib is another drug that seems to prevent our bodies working normally! So it is a drug that will cause side effects. MIMS does its best to explain what these are.

               "The most frequent adverse events seen with baricitinib during trials were increases in LDL-cholesterol, upper respiratory tract infections and nausea. The risks and benefits of treatment should be carefully considered before initiating therapy in patients with active, chronic or recurrent infections. Lipids should be assessed 12 weeks after starting treatment."

However, as this is a new drug, and if history repeats itself, the full side effects will not be known until patients are prescribed the drug, suffer them, report them, and conventional medicine takes action. This might take several years, during which time lots of patients will suffer!

Tofacitinib: new type of rheumatoid arthritis treatment launches
So, yet more 'good news' for sufferers of rheumatoid arthritis! MIMS says that Tofacitinib, or Xeljanz is a new oral treatment option for patients with moderate to severe active rheumatoid arthritis. It says that it belongs to a new class of therapies called Janus kinase (JAK) inhibitors. I feel that we have heard this before, quite recently! So its a new drug, and the good news is that doctors can now use it. So what about side effects? At least, the side effects currently known after just 3 months of clinical trials?
               "The most common serious adverse reactions to tofacitinib are serious infections, including pneumonia, cellulitis and herpes zoster."

The drug is also known to cause headache, respiratory tract infections, nasopharyngitis, diarrhoea, nausea and hypertension. Nothing too serious there, then. No wonder the drug regulator approved them! And I am sure that doctors will, right now, be treating their arthritis patients in the hope that they won't contract any of these conditions, or indeed any of the other adverse drug effects not yet known to conventional medicine.

So it must have been an exciting 'good news' year for MIMS, with these warnings about the new side effects of old drugs, and the new drugs with unknown side effects!. Perhaps what this really demonstrates is more 'good news' - that there is absolutely no 'good news' coming out of conventional medicine at the moment.

Sick people need to understand that conventional medicine has little to offer patients. There are no good new drugs coming through the pipeline, and plenty of bad new about old, failing drugs. Time for everyone to check out alternative medicine before conventional medicine fails completely.