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American Medicine

New drugs offer promising benefits but potentially greater risk side effects

Every day we read about new drugs that have been approved by the FDA for different diseases.  This is especially common in anti-cancer drugs, where many new treatments are currently reaching the market.

Are new drugs better than older drugs?  Each of these new drugs has met the FDA criteria for improving outcomes compared to standard treatments.  But many times these standard treatments are not the best therapies that we currently use for disease management.  But once a new drug is found to better than some standard therapy, the new drug is eligible to be approved by the FDA to be marketed to patients in the United States.

Furthermore, in these trials of new drugs compared to standard drugs, patients are also monitored for toxicity or side effects of the new drug.  How do the new drugs compare to standard drugs in side effects?

A recent article gives us a shocking answer to this question.  S. Niraula and co-authors (Journal of Clinical Oncology 2012; 30: 312) looked at 38 different clinical trials comparing new drugs to standard drugs.  Surprisingly, there was a 40% greater chance of dying of a toxic reaction with the new drugs. According to the study, 33% of patients receiving new drugs stopped treatment due to side effects. Severe toxic reactions were over 50% more common with the new drugs compared to standard drugs.

When you are considering a new drug therapy with your physician, remember that the new drugs are promoted in the doctor’s office by sales representatives of the drug companies.  Older standard drugs which have become generic are no longer are promoted in the doctor’s office by sales representatives.  Doctors might be more inclined to use a new drug because the doctor was listening to the “better” results of these new drugs described by drug reps, without having the chance to do in depth research. Many of these new drugs are truly superior, but the article mentioned above shows that many of these new drugs may also have more side effects.

Here are some tips for considering new drugs in your doctor’s office:

– Always discuss both the benefits and the risks of a new drug treatment with your physician

– Ask the physician if the toxic reactions are common, and if it would be better to use a standard or generic drug first before using a more expensive and more recently developed therapy

-Ask physicians how often they have had to discontinue these new drugs with patients that they have been treating in their office

– Ask how recently the new drug had begun being used by the doctor in the office. Does the doctor have much personal experience with the drug?

– Check out the list of side effects of the medication on the internet

For a more complete description of where to find side effects of drugs, and how to discuss new drug therapies with your physician, see my new book Surviving American Medicine.