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Editor's Note
Nov 12, 2012

Risks and Benefits of Medications in Real-World PracticeComment on “Comparative Risk for Angioedema Associated With the Use of Drugs That Target the Renin-Angiotensin-Aldosterone System”

Arch Intern Med. 2012;172(20):1590. doi:10.1001/2013.jamainternmed.868

All drugs have adverse effects. The challenge for practicing physicians is to determine which medications have the fewest adverse effects for a given therapeutic benefit. Unfortunately, drugs with similar indications often have not been directly compared with one another because their approvals were based on comparison with placebo or with only one member of the same or a similar class. Moreover, the comparable risks for unusual adverse effects with a group of different medications having similar indications can be even more challenging because most phase 3 efficacy trials are not powered to accurately estimate or even detect the incidence of unusual occurrences.

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