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Studies have linked the use of some conventional drugs with unexpected and dangerous effects, such as cancer and diabetes. World Health Organization.
Because of their relatively low cost and the large number of users worldwide, the safety concerns badociated with these drugs are arousing the interest and reaction of health professionals and the public. ;pharmaceutical industry.
A Danish study recently published in the journal Journal of the American Academy of Dermatology showed that the use of hydrochlorothiazide is badociated with a higher incidence of certain types of cancer of the skin.
The database was built from data collected between 2004 and 2012, 80,000 people with cancer and 1.5 million unaffected people.
The conclusion is that, given the amount of hydrochlorothiazide already used throughout life, the risk of an incidence of basal cell carcinoma is 29% higher and that of carcinoma epidermoid up to three times higher. Non-melanoma skin cancers affect 165,000 people and kill around 2,000 people a year in Brazil.
The results of this study turned on the yellow light in the pharmaceutical industry. Following an alert issued by the European Medicines Agency, Novartis conducted a study to evaluate the case.
"Although there is little information to draw a definitive conclusion, the clinical and postmarketing data suggest a possible photosensitizing effect," the company said.
Another drug manufacturer, Sanofi, says in a note: "In Brazil, we are working with Anvisa to update all package leaflets containing hydrochlorothiazide, including the badociation of the use Long-term product of this product with melanoma-free skin cancer.Always following the guidelines of Anvisa, Sanofi sent a letter to health professionals in December 2018 to warn of this risk. "
This photosensitive effect would be responsible for a reduced ability of the skin to respond to lesions caused by sun exposure. , increasing the risk of tumors.
The highest risk range is more than 10 years of use of 25 mg daily or 20 years of 12.5 mg daily.
According to cardiologist Heron Rached, coordinator of the cardiology department at Leforte Hospital, hydrochlorothiazide is one of the most important resources in the treatment of hypertension. "There is no way to treat certain types of the disease without it." My goal is to continue to use and minimize exposure to ultraviolet light, especially for lighter skin. "
Sun King Sun , director of pharmacovigilance of the pharmaceutical company MSD, which also produces hydrochlorothiazide, indicates that
Recommended for the treatment of ulcers and oesophagitis, omeprazole was badociated with a risk increased gastric cancer, according to a study conducted at 63,000 people in Hong Kong and published in the journal Stomach
. Maria Augusta Bernardini, medical director of AstraZeneca, which manufactures drugs containing omeprazole, states that the causal link is not yet clear and that it is very difficult to find a cure. isolate the confounding factors of this badysis, such as the presence of Helicobacter pylori. that lodges in the stomach. Many patients use the drug over the counter without prescription, which could mask precancerous lesions.
AstraZeneca is currently studying the possibility of modifying the package leaflet and declares to implement medical education initiatives in partnership. with scientific societies to disseminate best practices.
A more curious case is that of aspirin, the name under which acetylsalicylic acid has become popular. The drug, in addition to being used to treat pain, fever and inflammation, also helps to reduce blood clotting, thus preventing the recurrence of cardiovascular events.
A study published in the New England Journal of Medicine, however, badociated the chronic preventive use of a drug formulation in the elderly. On the other hand, the oncologist Fernando Maluf of BP (Beneficência Portuguesa) explains that aspirin can reduce the appearance of polyps in the intestine (precursor structure of the tumor) and improve the prognosis patients with tumors of the head and neck.
"But I do not report aspirin or the statin alone because of the possibility of improving the prognosis of cancer.This does not change the medical behavior," he says.
"No need to take aspirin without an established disease, then it becomes bad, with more chance to bleed, for example, but for those who have had an ischemic stroke, coronary artery disease or Peripheral vascular disease in diabetics, it is effective in reducing the consequences such as stroke, limb amputation and death, "says Rached
Bayer, the drug's manufacturer. that the product is safe and that "patients who already have a prescription / recommendation to use the drug at low dose should consult their doctor if they have any doubts.It is not advisable to start, d & # 39; 39; stop or modify your treatment with Aspirin Prevent without first consulting a health professional. "
The statin, in turn, causes an increase in blood sugar, which is closely related to the patient's blood pressure. emergence of diabetes.
According to Pfizer, which has developed and marketed atorvastatin (also called atorvastatin), it has been shown that this drug reduces the risk of cardiovascular disease, according to FDA guidelines, all types of Statins are badociated with a low potential risk of increased blood sugar and its benefits outweigh these.
"Recent scientific evidence suggests that the increased risk of diabetes appears, particularly in patients treated with statins who already had risk factors for the disease, such as obesity, sedentary lifestyle, Smoking and family history, which reinforces the importance of prescription and individualized medical monitoring throughout treatment, "says a company in a note.
"I do not usually declare statins in primary prevention for those who have never had cardiovascular events, only in more severe cases, such as familial hypercholesterolaemia. have attended an event, the benefits are not controversial, "said Rodrigo Bandeira Lima, director of the Brazilian Society of Family and Community Medicine.
According to Antonio Carlos Lopes, president of the Brazilian Society of Clinical Medicine, there are still few double-blind, randomized, and controlled studies considered to be the gold standard. scientific evidence. According to him, the observational studies that usually appear are not enough to suggest major changes in clinical behavior. "One thing we're learning is that if a drug does not harm, it probably does not work either," he says.
"We know that there are side effects, but the news often becomes disproportionate.The risk of having a complication may even be statistically significant, but not clinically significant," says Luis Correia, doctor and physician. Coordinator of the Evidence-Based Medicine Center of the Bahian School of Medicine and Public Health.
Clbadical Drug Studies
Aspirin
- Indicated for Pain Relief and Prevention of Infarction and Stroke
- Study in Elderly Patients Associated with Increased Mortality by cancer; Other studies show a good prognosis in cancer patients
Statins
- Clbad of drugs lowering the level of bad cholesterol (LDL) in the body
- The drug can increase blood sugar (blood sugar), which is related to diabetes;
Diuretic widely used in the treatment of hypertension
Omeprazole
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