Prescrire international
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Prescrire international · Feb 2013
ReviewNeoadjuvant trastuzumab for breast cancer. Better to stick with proven treatments.
No documented increase in overall survival with neoadjuvant trastuzumab, given the lack of trials versus chemotherapy in combination with adjuvant trastuzumab.
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Prescrire international · Jan 2013
Comparative StudyOxycodone + naloxone: choose morphine and optimal laxative therapy instead.
At high doses of oxycodone, the fixed-dose combination of oxycodone plus naloxone complicates therapeutic management and will likely have lower analgesic efficacy.
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Avoidance of irritants such as tobacco smoke slows the progression of severe chronic obstructive pulmonary disease (COPD). Drugs have only a modest, purely symptomatic effect; a bronchodilator is combined with an inhaled corticosteroid when exacerbations are frequent. Oxygen therapy prolongs survival in very severe disease. ⋯ Roflumilast is metabolised by cytochrome P450 isoenzymes CYP 3A4 and CYP 1A2, creating a high potential for pharmacokinetic interactions. In practice, it is better not to use roflumilast. For patients with severe COPD and repeated exacerbations, the standard treatment remains an inhaled bronchodilator combined with an inhaled corticosteroid, or oxygen therapy in some cases.