Figures from the Editor's selected issue highlights will be displayed each month in the journal image carousel on the BJCP homepage http://bpspubs.onlinelibrary.wiley.com/hub/journal/10.1111/(ISSN)1365‐2125/
This issue will be published shortly before October 31st and perhaps therefore the moment Britain will leave the EU. These pictures are of the dunes near my home in the vicinity of Leiden and I am running on top of a tank wall that was installed here by the occupying German forces to prevent an assault from England. The wall is still there together with many other defense installations. It is a poignant reminder that building barriers between countries is a bad idea and that the separation will eventually end even though the concrete may remain for centuries. I am using these pictures to remind all our readers and authors that BJCP will never join in any effort to build walls and we are convinced that scientific collaboration will survive all attempts to separate the scientific community.
Rare disease specialists and clinical pharmacologists unite: Increase collection of longitudinal data!
Gijs W.E. Santen and Adam F. Cohen
DOI: http://doi.org/10.1111/bcp.14079
Why would rare disease specialists join forces with clinical pharmacologists? The reasons are given by Gijs Santen from the Leiden University Medical Centre in collaboration with your Editor in Chief. Gijs is a clinical geneticist. As molecular biology increasingly demonstrates the causes of hitherto untreatable degenerative diseases there may be treatments developed, but this will take time. Because a certain defeatism reigns around these rare and often fatally degenerative conditions, there has been very little study of the natural course or potential precise biomarkers. When treatments do finally appear, it will be very difficult to study them. In this editorial a plea is made to spend the time waiting for potential treatments documenting the natural course of the diseases and by validating useful biomarkers.
The association between medication non‐adherence and adverse health outcomes in ageing populations: A systematic review and meta‐analysis
Caroline A. Walsh, Caitriona Cahir, Sarah Tecklenborg, Catherine Byrne, Michael A. Culbertson and Kathleen E. Bennett
DOI: http://doi.org/10.1111/bcp.14075
Caroline Walsh and colleagues from both the Royal College of Surgeons in Dublin and the University of Dublin were interested to see if elderly patients not taking their medicine would result in complications or alternatively if doing what the doctor says would make them better. They performed a meta‐analysis of many observational studies, randomization being impossible for obvious reasons. Non‐adherence (putting aside how difficult it is to measure this) slightly increased all‐cause hospitalization. Good adherence reduced long term mortality. As with all meta‐analyses we hope it reflects the truth, and it sounds plausible. So, take your pills and you will live longer and be hospitalized less often. This suggests that all therapies prescribed are exactly right for all patients, otherwise they would get better if they ceased treatment. We are not sure that that is the case, however.
Biosimilars of low molecular weight heparins: Relevant background information for your drug formulary
Jacobus R.B.J. Brouwers, Jeanine E. Roeters van Lennep and Maarten J. Beinema
DOI: http://doi.org/10.1111/bcp.14081
There are now biosimilars appearing for Low Molecular Weight Heparins. Koos Brouwers and colleagues dived into the regulatory and clinical literature to shed some light on the way these can be tested. As these medicines are fairly heterogenous it is a challenge to show that they are similar over time, let alone determine that a new preparation is bioequivalent, so overall this was a hard job to take on. This review launches the System of Objectified Judgment Analysis/Infomatrix method, and we urge our readers to find out what it is and why it will solve this problem.
Social media monitoring on the perceived safety of medication use during pregnancy: A case study from the Netherlands
Marleen M.H.J. van Gelder, Annemarije Rog, Sebastian J.H. Bredie, Wietske Kievit, Hedvig Nordeng and Tom H. van de Belt
DOI: http://doi.org/10.1111/bcp.14083
BJCP is a provider of medical data, that are slowly collected, laboriously written up, edited, edited again and sometimes again, often rejected, but in about half of cases finally published. That is the best we can do and even then, in the end it may not always be 100% accurate. This is of course considered old‐fashioned compared to the internet, where information flows freely, influences many and is used and abused by many. American presidents use it to change the course of hurricanes and British politicians to change the course of history, but enough said about that. Pregnant women also use the internet to discuss their use of medicines. Marleen van Gelder from Nijmegen and colleagues listened to the chatter using a search tool and found that most of it was providing bad information. It goes to show that there may be something beneficial in a slow and accurate information supply after all.
Evaluation of online clinical pharmacology curriculum resources for medical students
Xi Yue Zhang, Anne M. Holbrook, Laura Nguyen, Justin Lee, Saeed Al Qahtani, Michael Cristian Garcia, Dan Perri, Mitchell Levine, Rakesh V. Patel and Simon Maxwell
DOI: http://doi.org/10.1111/bcp.14085
Luckily there is also useful stuff on the internet, and Xi Yue Zhang and a team from Canada, Saudi Arabia and the UK investigated the educational resources for clinical pharmacology available online. Students all over the world can benefit from the efforts of educators they may never even have met, but of course it is the quality of the material that is crucially important. After sending a questionnaire to 236 medical schools around the globe, but apparently limiting the study to English speaking schools (and perhaps ignoring that English is spoken in other places), they selected 8 sites of which 2 were in countries where English is not the first language (and actually one of the sites selected was not, strictly speaking, exclusively offering clinical pharmacology educational material). This is how the internet can make a positive difference for doctors and, more importantly, patients, who may as a result receive more informed prescriptions.
Efficacy of THN102 (a combination of modafinil and flecainide) on vigilance and cognition during 40‐hour total sleep deprivation in healthy subjects: Glial connexins as a therapeutic target
Fabien Sauvet, Mégane Erblang, Danielle Gomez‐Merino, Arnaud Rabat, Mathias Guillard, Dominique Dubourdieu, Hervé Lefloch, Catherine Drogou, Pascal Van Beers, Clément Bougard, Cyprien Bourrrilhon, Pierrick Arnal, Werner Rein, Franck Mouthon, Francoise Brunner‐Ferber, Damien Leger, Yves Dauvilliers, Mounir Chennaoui and Mathieu Charvériat
DOI: http://doi.org/10.1111/bcp.14098
When you fall asleep during a repetitive departmental meeting or when the power point slides and the dimmed light at a presentation get the better of you, caffeine generally helps. There are more extreme situations in which staying awake is crucial and no organization is more interested in this than the military. Fabien Sauvet from the French army medical research institute, together with a battalion of authors from the military hospital and two companies in France and Switzerland, hypothesized that sleepiness could be ameliorated by modafinil (which we already knew worked, but not how it worked) in combination with low dose flecainide with a potential effect on glial connexins. The combination was better than modafinil alone in a group of sleep deprived (presumably) soldiers. Very interesting pharmacology and neurophysiology, and it is sad that the no deal Brexit the new UK government administration so keenly desires will deprive British political soldiers of something to prevent extreme somnolence during their exhausting days. At this point we would have shown you a picture of an MP asleep in Parliament, but the law prevents this so look it up yourself.
Issue highlights. Br J Clin Pharmacol. 2019;85:2455–2456. 10.1111/bcp.14143