- More questions than answers from systemic evaluation of rituximab studies
- IVIG distribution up in 2006
- Platelet growth factors showing promise in ITP
- Slow down to avoid mindless eating—and lose weight
- Bulgur offers more than fiber
- Thinking can change the brain
- On the Web
- ITP Conference 2007 – Program now on the web site
MORE QUESTIONS THAN ANSWERS FROM SYSTEMIC EVALUATION OF RITUXIMAB STUDIES
Because rituximab has become a common treatment for patients with idiopathic thrombocytopenic purpura (ITP), researchers at McMasters University in Ontario, Canada, reviewed the medical literature to determine how much evidence exists to support the use of the drug in ITP. They found 19 reports on efficacy (313 patients) and 29 reports on safety (306 patients). More than 60 percent of adults experienced an increase in overall platelet counts and one study found that a shorter period between diagnosis and rituximab administration resulted in better relapse-free survival. However, sixty-six of 306 patients experienced mild or moderate adverse events and 9 patients across the studies died. Importantly, none of the studies were “controlled studies”, comparing patients taking the drug with similar patients not taking the drug. Overall, the authors determined that “the quality of the evidence in support of rituximab for the treatment of adult ITP is poor.” They go on to caution against indiscriminate use of this treatment, stating that randomized, controlled trials of rituximab in patients with ITP are “urgently needed.”
Arnold DM, Dentali F, Crowther MA, Meyer RM, Cook RJ, Sigouin C, Fraser GA, Lim W, Kelton JG. Systematic review: Efficacy and safety of rituximab for adults with idiopathic thrombocytopenic purpura. Annals of Internal Medicine. 2007;146:25-33.
IVIG DISTRIBUTION UP IN 2006
Data from the Plasma Protein Therapeutics Association (PPTA) indicate that, during the first 11 months of 2006, IVIG distribution in the U.S. market exceeded the total amount distributed in 2005. More than 29,500 kg of IVIG were distributed between January and November 2006. PPTA has developed a Stakeholder Toolkit with information on plasma protein therapy manufacturing process and available resources (http://pptaglobal.org/en/stakeholder.cfm). Comments and recommendations on the toolkit should be sent to Diana Krueger at firstname.lastname@example.org.
PLATELET GROWTH FACTORS SHOWING PROMISE IN ITP
ITP patients may soon be able to boost their platelet production with fewer side effects, thanks to two oral drugs that are nearing the end of clinical trials. Two other drugs in earlier trials are also showing promise. The new drug, a non-peptide oral platelet growth factor is called Promacta (eltrombopag), and in a trial of 231 ITP patients at Weill Cornell Medical Center in New York City, three-fourths of patients getting the drug experienced a rise in platelets sufficient to restore healthy clotting. The maker of eltrombopag, GlaxoSmithKline, also announced results from a phase 2 international trial in 117 adults with chronic ITP, randomized to placebo or 3 different doses of eltrombopag. At all 3 doses, platelet counts rose compared with placebo.
During a presentation at the American Society of Hematology Meeting, Dr. David Kuter presented results from a clinical trial of AMG531. In that trial the compound boosted platelet counts in 31 of 36 ITP patients.
The other drugs that show promise are AKR-501, and SB559448.
Science News, January 13, 2007, pg. 29. Hematology & Oncology News & Issues, January 2007, pg. 21.
SLOW DOWN TO AVOID MINDLESS EATING—AND LOSE WEIGHT
People who eat more slowly and deliberately consume fewer calories at a meal than those who speed through the meal, according to research at the University of Rhode Island. Tips in a new book, “Mindless Eating,” by researcher Brian Wansink, of Cornell University, include try to be the last person to start eating, decide how much to eat before sitting down, use smaller dishes so portions look larger, and don’t eat in front of the TV or in the car.
Parker-Pope, T. Latest Weight-Loss Advice: Slow Down and Pay Attention. Wall Street Journal, January 16, 2007, pg. D1.
BULGUR OFFERS MORE THAN FIBER
Bulgur is made from wheat kernels that are first boiled or steamed, then dried and cracked into pieces. It is a good source of complex carbohydrates, contains 6 grams of fiber per cup (twice the amount found in brown rice!), and it offers a healthy dose of minerals and antioxidants. Bulgur can substitute for rice in any dish.
One more tip: exercising for 45 minutes, five days a week, may help prevent you from catching a cold.
Environmental Nutrition, January 2007, pg. 8.
POSITIVE MOOD MAY WARD OFF COLDS
Another way to ward off a cold is to keep a positive mood, according to research from Carnegie Mellon University in Pittsburgh. The researchers suspect that positive emotions stimulate symptom-fighting substances. They exposed more than 300 volunteers to cold viruses via nasal drops. Those who displayed generally positive outlooks, including feelings of liveliness, cheerfulness, and being at ease, were least likely to develop cold symptoms.
Science News, December 16, 2006, pg. 387.
THINKING CAN CHANGE THE BRAIN
The Dalai Lama has been encouraging brain researchers to study whether thoughts could cause physical changes in the brain. Neuroscientists already knew that the adult brain can change—its structure and activity can morph in response to experience. Experiments had shown that intensely practiced movements can alter the motor cortex of stroke patients and allow them to move once paralyzed arms or legs. But the Dalai Lama was interested in whether thought could rewire the brain. Experiments by scientists at University of Toronto found that, in depressed adults, the antidepressant paroxetine yielded the same outward effect as cognitive-behavior therapy. All of the patients came out of their depression. However, the impacts on the brain were different. Cognitive therapy rewired the brain in different areas than the drug. Additional studies found that meditation can change the function of the brain as well, making it easier for the brain to turn on circuits that underlie compassion and empathy.
How Thinking Can Change the Brain. Wall Street Journal, January 19, 2007, Pg. B1. [Book excerpt from “Train Your Mind, Change Your Brain” by Sharon Begley]
ON THE WEB
Two Websites vie for consumer audience
Steve Case, founder of American Online, is launching a new Website that will “put health care back into the hands of the consumer.” RevolutionHealth.com will start off free, but eventually charge about $100/year for premium services. It will digitally store medical records and provide telephone services that coach patients about their health, match them with doctors, and help unsnarl insurance claims. The existing leader in the market, WebMD.com, is competing by offering more of its services for consumers free. WebMD.com already maintains health records and enables users to personalize its site.
Tesoriero HW. The Doctor’s Office Gets Crowded on the Web, Wall Street Journal, January 22, 2007, pg. B1.
- Finding free and low-cost services
Adults age 50-plus face a sizable list of health screening tests. Some people don’t get tested when they need to. Others get screened too frequently. The U.S. Preventive Services Task Force suggests that early detection tests should be targeted based on an individual’s age, gender, underlying health conditions and family history. Low-cost and free services can be found through several sources:
- The Free Clinic Foundation of America
- American Cancer Society
www.cancer.org or 1-800-227-2345.
- Centers for Disease Control and Prevention (CDC)
information on low-cost mammogram and Pap tests. Call 1-800-232-4636. The CDC’s WISEWOMAN program provides chronic disease risk-factor screening and referrals for low-income and uninsured women ages 40 to 64 in 15 states. Go to www.cdc.gov/wisewoman
- National Kidney Foundation
lists locations that offer free screenings.
- Lions Club International
provides free vision screenings and recycled glasses.
- American Optometric Association
lists doctors who give free exams to those with no vision coverage.
www.aoa.org (click on “AOA Public Programs).
- American Academy of Ophthalmology
provides exams and treatment to those ages 65 and up, through EyeCare America foundation at 1-800-222-3937.
Fleck C. How’s Your Health? AARP Bulletin, December 2006, g. 20.
Remodeling? Tips for a Healthier Home
“It’s gotten much easier to avoid troublesome products and to incorporate cleaner materials and techniques into your remodeling job,” according to the Website, www.alternativemedicine.com. Nontoxic materials have come down in price, and many more contractors are accustomed to using them.
For details, go to www.alternativemedicine.com. In the search box, type in “healthy home” to find the full article, “Blueprint for a Healthy Home”, by Sally Lehrman.