The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.
Letter to the Editor
The editorial ‘Data informs debate’ (Aust Prescr 2015;38:38-9) describes the uncertainties around the efficacy and safety of new medicines entering the market. It outlines the role that increased access to clinical trial data may have in informing assessments about the appropriate place of new drugs in clinical practice.
Just as it is important to consider new drugs, it is also important to consider the use of currently available drugs in new markets, or new populations. Populations vary, for a variety of reasons, in their response to specific drug therapies.1,2
Australia has a unique population in its Aboriginal and Torres Strait Islander people. This population may not have been included in clinical trials, so further analysis of trial data will often not be informative. Substantial uncertainty exists regarding the safety and efficacy of medicines in Aboriginal and Torres Strait Islander people, despite their need for extensive use of medicines to manage the high burden of disease.
It is important that Australian prescribers are aware of the limitations of drug safety and efficacy data for Aboriginal and Torres Strait Islander people. Clinicians are encouraged to publish their own observations, including reporting adverse drug reactions, to the Therapeutic Goods Administration. These observations are essential to inform robust assessment of medicines for Australia’s indigenous populations.3
Repatriation General Hospital
Daw Park, SA
University of South Australia
- Miller DR, Oliveria SA, Berlowitz DR, Fincke BG, Stang P, Lillienfeld DE. Angioedema incidence in US veterans initiating angiotensin-converting enzyme inhibitors. Hypertension 2008;51:1624-30.
- Gabb GM, Vitry A, Limaye V, Alhami G. Serious statin associated myotoxicity and rhabdomyolysis in Aboriginal and Torres Strait Islanders: a case series. Intern Med J 2013;43:987-92.
- Mahajan H, Thynne T, Gabb GM, Poh EW. Drug safety in Aboriginal Australians: three cases of angiotensin converting enzyme inhibitor angioedema. Intern Med J 2015;45:231-3.
- Harding DJ, Subramaniam K, MacQuillan G, Davis J, Nolan D. Severe drug-induced hypersensitivity syndrome with a shared HLA-B allele. Med J Aust 2012;197:411-3.
- Haysom L, Samaras K, Stapylton C, Wines J. Statin associated myotoxicity in an incarcerated Indigenous youth – the perfect storm. Med J Aust 2015;202:381-2.