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Pfizer’s record-breaking fine for overcharging the NHS
In an extraordinary ruling issued as we go to press, the UK Competition and Markets Authority (CMA) has handed out the largest fine in its history to pharma giant Pfizer for price-gouging a well-established epilepsy drug.
Rob Munro

Have the benefits of taking statins been overstated, while under-estimating the side-effects?
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The benefits and risks of statins have recently been the subject of much controversy and debate. Dr Malhotra and colleagues argue that selective reporting and publication bias may be overestimating the efficacy and underestimating the side-effects of statins.
Aseem Malhotra, John Abramson, Michel De Lorgeril and Sherif Sultan

Recent developments in the prevention and treatment of dementia
There are currently no disease-modifying therapies for dementia; existing licensed drugs offer symptomatic treatment only. This article explores recent developments in the search for more effective interventions for the prevention and treatment of Alzheimer’s and other forms of dementia.
Ann Robinson

The use of SGLT2 inhibitors to manage type 2 diabetes is associated with a higher risk of genitourinary infections
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The SGLT2 inhibitors dapagliflozin, canagliflozin and empagliflozin are now becoming established in the management of type 2 diabetes, but they are associated with an increased risk of genital and urinary tract infections, compounding the problem that people with diabetes are already at higher risk than the general population.
Steve Chaplin

Effective management of thyroid disorders, including autoimmune and iatrogenic hypothyroidism and Graves’ disease
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Most cases of primary hypothyroidism can be managed in general practice but thyrotoxicosis requires referral for an accurate diagnosis before treatment can be commenced. This review discusses the recommended management of thyroid disorders with a focus on autoimmune and iatrogenic hypothyroidism and Graves’ disease.
Anthony Weetman

NICE multimorbidity guideline: coping with complexity in care
The NICE guideline Multimorbidity: Clinical Assessment and Management was published in September, offering an opportunity to optimise the care of patients with multiple long-term health conditions.
Nina Barnett, Rupert Payne and Alaster Rutherford

Religious constraints on prescribing medication
It is important for prescribers to take any religious dietary restrictions into consideration when prescribing in order to optimise treatment. This article summarises the main dietary restrictions of the largest religious groups in the UK and the problems that may be encountered with medication ingredients.
Joy Ogden

Duavive HRT: conjugated oestrogens with bazedoxifene
Duavive is a new oral HRT formulation containing conjugated oestrogens and the selective oestrogen-receptor modulator bazedoxifene and is indicated for the treatment of oestrogen deficiency symptoms in postmenopausal women with a uterus who cannot take progestogen containing therapy. This article discusses its properties, efficacy and adverse effects.
Steve Chaplin 

New from NICE
NG58: Co-existing severe mental illness and substance misuse: community health and social care services.


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