The ranitidine cancer signal largely disappears with a fair comparator

The edition in brief

A Drug Safety analysis of US (FAERS) and Japanese (JADER) spontaneous reports found ranitidine cancer reports surged to 140,985 in 2020–21, mostly from consumers and clustered around regulatory action and litigation; strong signals in unrestricted analyses were largely lost when compared against famotidine or restricted to the pre-recall period, and a Japanese signal (PRR 3.54) vanished when all drug involvement was counted (PRR 0.92). Most large cohort studies found no increased cancer risk. The FDA lists a Class II recall of compounded tirzepatide/niacinamide vials from one US pharmacy for lack of sterility assurance. A meta-analysis of six paediatric cohorts (173 children with inflammatory bowel disease) switching from intravenous to subcutaneous infliximab found 93% maintained remission and new anti-drug antibodies were rare, though the route is not approved under 18. Among the 100 drugs most prescribed in US sickle cell disease, 43 carried interaction risk, mainly through CYP3A4, with oxycodone and fentanyl among the commonest affected substrates.