107 Evaluation of the efficacy, safety and utilization of racemic mixtures versus single enantiomers in British Columbia primary care: a comprehensive review
Abstract
Objectives The primary objective of this focused literature review was to determine whether clinically significant differences exist in the efficacy and safety of commonly prescribed racemic mixtures compared to their corresponding single enantiomers in British Columbia (BC). We aimed to assess whether the theoretical pharmacological advantages of single enantiomers translate into meaningful clinical benefits in practice. As a secondary objective, we analyzed drug utilization patterns and associated expenditures within primary care settings in BC, with a focus on evaluating the cost differences between single enantiomers and their racemic counterparts. Furthermore, we critically evaluated the credibility of manufacturers’ claims regarding the clinical superiority of single enantiomers. By addressing these objectives, we aimed to provide a comprehensive evaluation of the clinical outcomes associated with racemic mixtures and single enantiomers, ensuring that any additional financial burden placed on patients is justified by meaningful clinical benefit. Method The top 200 most prescribed drugs in BC, from January 1 to May 31, 2024, based on patient count and prescription volume, were reviewed to identify currently marketed racemic mixture and single enantiomer drug pairs. To be eligible, at least one drug had to appear among the top 200 list. A systematic literature search was conducted using MEDLINE, Embase, PubMed, Epistemonikos, and Cochrane CENTRAL from their inception…
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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