Remdesivir (Veklury) for the Treatment of COVID-19 in the Inpatient Setting

Details

Several drug treatments for COVID-19 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are approved for use in Canada. This systematic review evaluated the efficacy and safety of remdesivir for the treatment of COVID-19 in hospitalized adult and adolescent patients from settings within the health care systems in Canada or from countries with economies similar to Canada. We also characterized which hospitalized patients are most likely to benefit from treatment with remdesivir.

Nirmatrelvir-Ritonavir (Paxlovid) for the Treatment of COVID-19

Details

Several drug treatments for COVID-19 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are approved for use in Canada. This systematic review evaluated the efficacy, effectiveness, and safety of nirmatrelvir-ritonavir in adults with SARS-CoV-2 infection who are considered high risk but are not hospitalized. We also characterized which patients are most likely to benefit from treatment with nirmatrelvir-ritonavir.

Safety of Ozempic for Type II Diabetes

Details

The objective of this query is to determine whether there are potential safety signals among adults with type 2 diabetes mellitus newly treated with Ozempic relative to similar patients newly treated with sitagliptin. This query attempts to replicate the US FDA Sentinel’s tree-based scan statistic (TreeScan), based on potential safety signal identification analysis, using the Canadian Network for Observational Drug Effect Studies (CNODES) adaptation of the Sentinel Common Data Model to identify potential postmarket safety signals for Ozempic in Canada.

Buprenorphine Formulations for Opioid Use Disorder

Details

Opioid use disorder (OUD) poses a serious public health issue in Canada. Buprenorphine formulations are important OUD treatment options but their comparative clinical effectiveness, safety, and cost-effectiveness are unclear. Previous reviews noted limited differences in clinical outcomes between different buprenorphine formulations but emphasized methodological issues and insufficient Canadian evidence. This report aims to analyze recent comparative evidence on buprenorphine formulations and assess their use in public drug plans across Canada.

Use of Oral Fluoroquinolones in Canada: Drug Utilization Study Update

Details

Health Canada conducted various risk assessments of systemic fluoroquinolones, which enabled them to take regulatory measures in 2017, including issuing a Dear Health Care Professional Letter, updating their labels, and amending their indications to reflect their risk-benefit profile.

The main objective of the query is to assess the impact of the risk-minimization measures applied in 2017 by comparing the current trends of fluoroquinolone use to those from a previous drug utilization study conducted by the Canadian Network for Observational Drug Effect Studies (CNODES).

An Analysis of Demographic and Utilization Patterns of Patients Accessing Emergency Departments in Canada

Details

In response to the current crisis in emergency care in Canada, Canada's Drug Agency is working on a series of reports to help identify factors contributing to emergency department (ED) overcrowding, identify and describe interventions that can effectively alleviate ED overcrowding, understand the impact of ED overcrowding on quality of care, patient safety, staff and health professional learners’ well-being, and assess how ED overcrowding has changed over the years.

Overview of Systematic Reviews of Immune Checkpoint Inhibitors in Non–Small-Cell Lung Cancer with EGFR, ALK, ROS1, and RET Actionable Driver Mutations

Details

This review evaluated the efficacy and safety of immune checkpoint inhibitors as monotherapy in patients with previously treated advanced or metastatic non–small-cell lung cancer (NSCLC) harbouring EGFR, ALK, ROS1, or RET mutations. Thirteen systematic reviews of randomized controlled trials were assessed, revealing critical methodological flaws. All reviews focused on survival outcomes for patients with NSCLC  with EGFR mutations, relying on the same set of 4 clinical trials, and largely overlooked other outcomes or patient groups.

Case Carts in Surgical Settings

Details

Question(s)

  1. What is the comparative clinical effectiveness of closed case carts versus open case carts in surgical settings?
  2. What are the evidence-based guidelines regarding case carts in surgical settings?

Key Message

What Is the Issue?

Case carts are commonly used in perioperative practice to transport surgical instruments and supplies to and from surgical settings in a timely manner. Open case carts are easy to manoeuvre and clean, while closed case carts effectively contain both sterile and contaminated surgical supplies during transport. Appropriate selection of case carts for surgical settings may support effective workflow processes, infection prevention and control measures, and personnel safety.

What Did We Do?

To inform decisions about appropriate selection of case carts, Canada's Drug Agency sought to identify and summarize the literature comparing infection control and personnel safety between open and closed case carts. An information specialist conducted a search of peer-reviewed and grey literature sources. Canada's Drug Agency also attempted to identify guidelines about the appropriate use of case carts in surgical settings.

What Did We Find?

No studies directly evaluating the comparative clinical effectiveness of open versus closed case carts or guidelines concerning their use in surgical settings were identified that met the inclusion criteria for this review. Research focused on the management of infection control and prevention and personnel safety is needed to evaluate the clinical effectiveness of open and closed case carts and inform guidance concerning the selection of open versus closed case carts in surgical settings.

What Does It Mean?

Without any comparative effectiveness evidence, decision-makers may want to consider the organizational features (e.g., sterile processing workflow systems, transport distance to the operating room) to inform the choice of either open or closed case carts. Measures to promote personnel safety when using any case cart may include training for use as well as cart inspection and monitoring processes.

Routine Dental Polishing for Oral Health

Details

Question(s)

  1. What is the clinical effectiveness of routine dental polishing for the maintenance of oral health in adults and children?
  2. What is the cost-effectiveness of routine dental polishing for the maintenance of oral health in adults and children?
  3. What are the evidence-based guidelines regarding the use of routine dental polishing for the maintenance of oral health in adults and children?

Key Message

Professional dental care is important to help maintain oral health. Routine dental cleaning usually includes both scaling and polishing. Scaling is the removal of plaque and tartar from the crown and root surfaces of teeth. Polishing is the removal of residual plaque and external stains from the teeth. To support decisions about the optimal components for professional dental cleaning, it is important to understand the potential benefits and harms of routine dental polishing when compared to no routine dental polishing.

Trends in Opioid Prescribing in Canada, 2018-2022

Details

This study analyzed trends in prescription opioid use for pain and opioid agonist therapy (OAT) from January 2018 to December 2022 across 6 Canadian provinces. A decline in new and overall prescription opioid use for pain, with higher rates among females, older adults, lower-income, and rural residents was found. Hydromorphone use increased, while oxycodone use decreased. OAT use varied by province, with increases in Alberta, Saskatchewan, and Manitoba, and stable rates in British Columbia, Ontario, and Quebec. Buprenorphine use rose across all provinces.