Clinical pharmacy education varies widely between European countries, and several major changes have taken place in France. This review aims to describe the current state of pharmacy education in France, focusing on clinical pharmacy. Research into legislative texts on pharmacy education in France was conducted based on the national database "legifrance". A complementary search on clinical pharmacy teaching methods used in France was carried out on the Medline, Embase, Pascal and Francis database for articles published from 2008 to 30 April 2021. Pharmacy studies are taught in universities and last from six to ten years, depending on the student's chosen options. The scientific curriculum is defined at the national level. Students choose their professional path after the fourth year with specialized courses. Whatever the direction chosen, all students have several internships, including a half-time one-year hospital internship, with patient-centered hospital functions within medical and pharmaceutical teams. The status of clinical pharmacy has been enhanced under French law and regulations, improving clinical pharmacy education, which is now skill-based, in a progressive, active, and dynamic process, with community or hospital pharmacists as university teachers and closer to real-life clinical pharmacy. Teaching is increasingly innovative, and this needs to be shared and reported in the literature. Several important reforms have modernized French pharmacy studies in recent years, conferring a pivotal place for clinical pharmacy.
Biologic reference drugs and their copies, biosimilars, have a complex structure. Biosimilars need to demonstrate their biosimilarity during development but unpredictable variations can remain, such as micro-heterogeneity. The healthcare community may raise questions regarding the clinical outcomes induced by this micro-heterogeneity. Indeed, unwanted immune reactions may be induced for numerous reasons, including product variations. However, it is challenging to assess these unwanted immune reactions because of the multiplicity of causes and potential delays before any reaction. Moreover, safety assessments as part of preclinical studies and clinical trials may be of limited value with respect to immunogenicity assessments because they are performed on a standardised population during a limited period. Real-life data could therefore supplement the assessments of clinical trials by including data on the real-life use of biosimilars, such as switches. Furthermore, real-life data also include any economic incentives to prescribe or use biosimilars. This article raises the question of relevance of automating real life data processing regarding Biosimilars. The objective is to initiate a discussion about different approaches involving Machine Learning. So, the discussion is established regarding implementation of Neural Network model to ensure safety of biosimilars subject to economic incentives. Nevertheless, the application of Machine Learning in the healthcare field raises ethical, legal and technical issues that require further discussion.
Background: Many different bone substitutes, such as autografts, allografts or synthetic biomaterials have been proposed to restore alveolar bone loss and support efficient placement of dental implants. This experimental study evaluated the osteoconductive properties of an injectable bone substitute (IBS) composed of a polymeric carrier and a calcium phosphate mineral phase, used to fill mandibular and maxillary canine extraction sockets. Methods: The polymer was a cellulose derivative (methyl‐hydroxy‐propyl‐cellulose, MHPC), and the mineral phase consisted of granules of biphasic calcium phosphate (BCP) ceramics 200 to 500 μm in diameter. Mandibular and maxillary premolars extracted from 3 dogs (a total of extraction sites) were immediately treated with the IBS left unfilled as control sites. Animals were sacrificed months after implantation and all extraction sockets were prepared for histological evaluation. Results: Qualitative histological studies showed that the IBS was able to support the extensive apposition of wellmineralized newly formed lamellar bone over the entire socket surface and appeared to prevent alveolar ridge bone loss in treated extraction sites. Quantitative evaluation showed that the amount of newly formed bone was significantly higher in mandibular than maxillary extraction sockets for both treated and control sites. Conclusions: An injectable bone substitute composed of a polymeric carrier and calcium phosphate was effective in enhancing the bone fill of extraction sockets. This approach may prove promising for periodontal lesions. The material expressed osteoconductive capacities, and the biological properties of the mineral phase were conserved. J Periodontol 1999;70:375‐383.
