Objective: Menopausal hormone therapy (HT) is a proven risk factor for breast cancer. Recent reports presented declining trends in breast cancer incidence, which were attributed to parallel declining trends in HT. Therefore, we analyzed recent data on hormone therapy and breast cancer incidence in Germany. Methods: We performed a population-based survey using breast cancer incidence (from cancer registries) and hormone prescription data (from health insurances) for the time period from 1997 to 2006. Age-standardized rates were calculated and joinpoint regression analyses for trends were performed. Results: Prescription of HT started to decline in 1999; about 2 years later, a parallel decline in breast cancer incidence was observed. HT prescription decreased by 69% up to 2006, and breast cancer incidence by 6.8% for all age groups (2002–2005) and 12.8% in the age group from 50 to 69 years. The reductions in HT prescription and breast cancer incidence were markedly correlated across the federal states in Germany. Conclusion: The recent decline in breast cancer incidence following decreasing HT prescription suggests a causal relationship between the risk of breast cancer and HT in Germany. Even after the ‘big HT drop’ in Germany, significant differences in HT prescription as well as breast cancer incidence persist at the federal state level. These results should be discussed in a public health context.

With rivaroxaban, no significant differences were observed compared to phenprocoumon with regard to hospitalized bleedings or ischemic strokes. Dabigatran was associated with fewer bleedings and a similar risk of ischemic strokes compared to phenprocoumon. Apixaban was also associated with fewer bleedings but was unexpectedly associated with more ischemic strokes, possibly reflecting selective prescribing. The association of rivaroxaban with higher all-cause mortality unrelated to bleedings or strokes has been described previously but remains to be explained.

Objectives Data on quinolone consumption in the community were collected from 30 EU/European Economic Area (EEA) countries over two decades. This article reviews temporal trends, seasonal variation, presence of change-points and changes in the composition of main subgroups of quinolones. Methods For the period 1997–2017, data on consumption of quinolones, i.e. ATC group J01M, in the community and aggregated at the level of the active substance, were collected using the WHO ATC/DDD methodology (ATC/DDD index 2019). Consumption was expressed in DDD per 1000 inhabitants per day and in packages per 1000 inhabitants per day. Quinolone consumption was analysed by subgroups based on pharmacokinetic profile, and presented as trends, seasonal variation, presence of change-points and compositional changes. Results In 2017, quinolone consumption in the community expressed in DDD per 1000 inhabitants per day varied by a factor of 8.2 between countries with the highest (Bulgaria) and the lowest (Norway) consumption. The second-generation quinolones accounted for >50% of quinolone consumption in most countries. Quinolone consumption significantly increased up to 2001, and did not change significantly afterwards. Seasonal variation increased significantly over time. Proportional consumption of third-generation quinolones significantly increased over time relative to that of second-generation quinolones, while proportional consumption of both third- and second-generation quinolones significantly increased relative to that of first-generation quinolones. Levofloxacin and moxifloxacin represented >40% of quinolone consumption in the community in southern EU/EEA countries. Conclusions Quinolone consumption in the community is no longer increasing in the EU/EEA, but its seasonal variation continues to increase significantly as is the proportion of quinolones to treat respiratory infections.

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PRISCUS und PRISCUS 2.0: Potenziell inadäquate Medikation für den deutschen Arzneimittelmarkt -53 4.3 Datengrundlage und Methoden -54 4.4 PRISCUS-2.0-Arzneistoffe -55 4.5 Ergebnisse -56 4.5.1 Verordnungen von PRISCUS-Medikamenten -58 4.5.2 Verordnungen von PRISCUS-2.0-Medikamenten nach Alter und Geschlecht -58 4.5.3 Verordnungen von PRISCUS-2.0-Medikamenten nach Wirkstoffen -61 4.5.4Verordnungen von PRISCUS-2.0-Medikamenten nach Facharztgruppen -64 4.5.5Verordnungen von PRISCUS-2.0-Medikamenten ausgewählter Wirkstoffgruppen nach Facharztgruppen -66 4.5.6Verordnungen von PRISCUS-2.0-Medikamenten in den Regionen Deutschlands -71