Every year for the past 11 years, Prescrire has updated its medication review that she advises to rule out care “first so as not to harm the patients and to avoid damage”. Following this analysis, certain drugs are added, others are withdrawn, either because their marketing has been stopped by decision of the laboratory which produces them or of a health authority, or for the time of a re-examination by Prescrire of their risk-benefit balance.
In what is commonly called the “black list”, we find:
- Medicines which, taking into account the clinical situation, expose to disproportionate risks compared to the benefits they bring;
- Old drugs whose use is outdated, because other newer drugs have a more favorable risk-benefit balance;
- Recent drugs, whose benefit-risk balance is less favorable than that of older drugs;
- Drugs whose effectiveness is not proven beyond that of a placebo, and which expose to particularly serious adverse effects.
What changes between 2022 and 2023?
This year, three additional drugs have been ruled out:
- A peanut seed powder containing peanut protein (Palforzia°), used orally in the desensitization of peanut allergy. “Because it increases the frequency of allergic reactions in the daily life of patients, including those motivating the administration of adrenaline” emphasizes the review.
- THE roxadustat (Evrenzo°), authorized in anemia linked to chronic renal failure. “Because it is globally no more effective than epoetins in correcting anemia, whereas it seems to increase mortality in some patients and its adverse effect profile is more burdened”.
- There tincture of opium (Dropizal°), composed of various poppy constituents, authorized in severe diarrhoea. “Because it does not provide any clinical advantage compared to loperamide (Imodium° or other), an opioid marketed alone in this situation”.
In addition, two drugs have been removed from the list of drugs to be ruled out, the time to re-evaluate their benefit-risk balance.
- I’idebenone (Raxone°) : Prescrire re-evaluates its benefit-risk balance in Leber optic neuropathy.
- THE teriflunomide (Aubagio°): an immunosuppressant authorized in multiple sclerosis, withdrawn from the balance sheet because Prescrire is evaluating its benefit-risk balance in an extension of indication in children from the age of 10.
This year, these are 107 drugs are more dangerous than helpful in all the indications appearing in their MA, including 88 are marketed in France who have been put on the spot for any of the above reasons. “Most often, when drug treatment seems desirable, other options have a better risk-benefit balance than these drugs to be ruled out. And in certain situations, the most prudent option is not to use a drug” explain those responsible for Prescribing.
>> Namely: The 2023 review of drugs to be ruled out is available in the Prescrire Application.
What was on the 2022 list?
>> A drug to avoid: Fintepla (fenfluramine), an old amphetamine, licensed for Dravet’s disease, a rare and severe form of childhood epilepsy.
>> Medications removed from the list: gliflozins, ciclosporin eye drops and cimetidine. Some data showing efficacy on clinical endpoints led to their removal from the list despite their very heavy side effect profile.
Among the drugs singled out by the magazine Prescrire, we find of course several medicines used to relieve cough : ambroxol (Muxol or other) and bromhexine (Bisolvon), oxomemazine (Toplexil or other), which lead to disproportionate adverse effects or serious skin reactions. Pentoxyverine (Vicks pectoral syrup) which exposes to heart rhythm disorders.
We also find all oral or nasal decongestants used in case of colds and stuffy nose which expose to serious or even fatal cardiovascular disorders.
But also several drugs for depression : agomelatine (Valdoxan), citalopram (Seropram° or other) and escitalopram (Seroplex° or other), duloxetine (Cymbalta° or other), milnacipran (Milnacipran Arrow° or other) and venlafaxine (Effexor LP° or other). Prescrire also points out that esketamine in solution for nasal spraying (Spravato°), has a very uncertain effectiveness in so-called resistant depressions. Its neuropsychic adverse effects are frequent, including dissociation syndromes.
>> And also discover here the list of drugs that had already been ruled out in previous years.