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Friday, 31 May 2013

Painkillers: powerful drugs with important adverse effects

A new report in the Lancet from the Oxford Clinical Trials Unit provides an update on potential risks from newer and traditional painkillers of the non-steroidal anti-inflammatory drug type. The report analysed results of a large number of clinical trials comparing these painkillers against placebo or against a comparator different painkiller. Studies were largely of high doses of the drugs, prescribed for relatively short duration - on average for under a year.

Below is a summary of my comments on the Lancet article provided to the Science Media Centre.

"In this pooled assessment (meta-analysis) of a large number of clinical trials against placebo or other pain-killer options, the Oxford Clinical Trials Service Unit confirm previous reports that the newer pain-killer drugs – coxibs - are associated with a clinically important increase in risk of coronary disease.

"Their major new finding is that among traditional non-steroidal anti-inflammatory painkiller drugs [tNSAIDs] – diclofenac, and possibly ibuprofen, but not naproxen appear associated with a similar increase fatal and non-fatal coronary heart events to the coxibs. However all naproxen, like all coxibs and tNSAIDs they studied, was associated with increased risk of heart failure and gastro-intestinal complications such as bleeding.

"The type of vascular risk with these painkillers appeared selective as none of these treatments were associated with an increase in stroke risk.

“Cautions include that we are not told about details of adjustments across treatment groups for degree of different cardiovascular risk factors e.g. from smoking as a source of bias. And the authors themselves acknowledge that their findings are largely for high dose tNSAIDs and for treatment on average for under a year. They note that they therefore cannot be sure whether the reported coronary and other risks would persist in patients on longer term treatment or on lower doses of these medicines.

“The paper underscores a key point for patients and prescribers: powerful drugs may have serious harmful effects. It is therefore important to be cautious when considering use of these medicines and to take into account cardiovascular risk, and risk of stomach or intestinal adverse effects, when tNSAIDs are prescribed or obtained over the counter, and when coxibs are considered.”

Many patients taking these tablets rely on them for relief of symptoms from arthritis and other long-term painful conditions. Patients who are concerned should consult their medical or pharmacist adviser.

See also articles by reporters on BBC Health, Reuters, Agence France Presse, CBS News ...

Sunday, 19 May 2013

Winners of the Open, NHS and Young Poets 2013 Hippocrates Prize for Poetry and Medicine

The winners were announced by the judges at an International Symposium on Poetry and Medicine at the Wellcome Rooms in London on Saturday 18th May.

More on the 2013 Hippocrates Awards:

Harvard poet and physician Rafael Campo wins Hippocrates Open International Prize for Poetry and Medicine

Psychotherapist Mary V Williams wins Hippocrates NHS Prize for Poetry and Medicine

English poet Rosalind Jana awarded international Hippocrates Young Poets Prize for Poetry and Medicine 

Rafael Campo discusses poetry, medicine and his Hippocrates Open Award winning poem

Rosalind Jana talking about her Hippocrates Young Poets Award.

The judges also agreed 18 commendations in the NHS category - one each from Scotland and Wales, and 16 from England; and 20 in the Open International category – one each from Ireland, Scotland and Israel, seven from the USA and 10 from England, from the Isle of Wight to Yorkshire.

Open Awards

The £5000 open international Hippocrates first prize has been awarded to Harvard poet and physician
Rafael Campo
Rafael Campo. The second prize was shared by UK poet Matthew Barton, US Afghan war veteran Liam Corley from California and New Zealand poet Sue Wootton.

Rafael Campo said “I am delighted to receive this prestigious international prize. Through my poem – about a dying patient – I was able to address the power of empathy to combat the distance we almost reflexively adopt toward our patients and confront our own shortcomings”.

NHS Awards

The £5000 Hippocrates NHS first prize went to poet and novelist Mary V Williams from Shropshire,
Mary V Williams
who trained in psychotherapy.

The second prize went to former nurse Ann Elisabeth Gray who runs a care home Cornwall and the third prize was shared by family doctor Ann Lilian Jay from LLandysul in Wales, hospital chaplain Ian McDowell from London, and senior lecturer in midwifery Bella Madden from Milton Keynes.

Mary Williams said “My poem ‘Downs’ was inspired by my working in a pre-school nursery for special needs children, by their need for love and acceptance, and their ability to give back so much in return”.

The Hippocrates Prize is one of the most valuable poetry prizes in the world, with a yearly purse of £15000.

Young Poets Award

English poet Rosalind Jana has been awarded the inaugural international Hippocrates Young Poets
Rosalind Jana

£500 Prize. 17 year old Rosalind Jana is from Hereford Sixth Form College in England. The award was presented at the Hippocrates Awards ceremony at the Wellcome Trust in London on Saturday 18th May.

The international Hippocrates Prize for Young Poets is for an unpublished poem in English on a medical theme. Entries were invited from young poets anywhere in the world aged 14 to 18 years. The 2013 Prize attracted entries from young poets from the UK, USA and Australia.

The winning entry was decided by judge and award-winning poet Clare Pollard who also commended US poet Talin Tahajian from Belmont in Massachusetts.

Notes to editors

For more information about Hippocrates Prize winners and extracts of their winning poems, contact

Hippocrates Prize website

Saturday, 4 May 2013

EACPT Awards to be presented at August Geneva Congress

The EACPT has announced its awards for 2013, to be presented at the 11th EACPT Congress in Geneva 28th - 31st August 2013. 
The Special Award for services to the EACPT goes to Professor Michael Orme, who co-founded the EACPT 20 years ago in 1993. Professor was EACPT founding secretary then Chairman and played a major role in growing EACPT into a major international organisation representing all clinical pharmacology societies in Europe and their over 4000 clinical pharmacologist members.
The  2013 EACPT Scientific Award goes to Dr David Devos from the Department of Medical Pharmacology at the Universit√© Lille Nord de France. The EACPT Scientific Award is for the report by Dr Devos, using methylphenidate as a new approach to treating Parkinson's disease. 
The paper, for which Dr Devos was corresponding author, was published in the July 2012 issue of 
the high impact international journal -  Lancet NeurologyThe prize includes a 2000 € award.
The 2013 Lifetime Achievement Award of the European Association of Clinical Pharmacology and Therapeutics goes jointly to Professor Sir Michael Rawlins and to Professor Carlo Patrono, for their outstanding contributions to the national and international benefits of clinical pharmacology for medicine, health care and patient safety.

 EACPT website. 

Official EACPT journal - Clinical Therapeutics