This e-newsletter is a monthly publication of the Platelet Disorder Support Association. The information in this newsletter is for educational purposes only. For advice on your unique medical condition, please consult a health care professional.
Contents:
ITP Research and Treatments
- Romiplostim (Nplate®) Superior to Standard of Care in New ITP Study
- Eltrombopag (Promacta®) Approved in Japan
- More Drugs Found to Cause Drug-induced Thrombocytopenia
- Platelet Death Regulated by Internal Timer
Hospitals, Insurance, and Medical Care
- Doctors More Likely to Mention Drug and Surgery Advantages
- Patient Participation Key in Oregon Healthcare
General Health and Medicine
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ITP Research and Treatments
ROMIPLOSTIM (NPLATE®) SUPERIOR TO STANDARD OF CARE IN NEW ITP STUDY
In a year-long randomized clinical trial, 234 patients with ITP were treated with either romiplostim (Nplate®), a treatment that stimulates the bone marrow to produce more platelets, or the usual treatments for ITP. At the end of the trial, the group taking romiplostim had a much greater platelet response, fewer serious side-effects, a better quality-of-life, and required fewer splenectomies and blood transfusions than the group receiving the standard treatments.
Kuter DJ, et al. “Romiplostim or Standard of Care in Patients with Immune Thrombocytopenia. N Engl J Med. 2010 Nov 11;363(20):1889-1899.
http://www.ncbi.nlm.nih.gov/pubmed/21067381
ELTROMBOPAG APPROVED IN JAPAN
The Japanese Ministry of Health, Labour and Welfare gave its approval of eltrombopag, (named Promacta ® in the US and Revolade ® elsewhere) for the treatment of chronic ITP. Eltrombopag, a pill that stimulates platelet growth, was approved in the European Union in March and has been available in the US since 2008.
Darcé K. “Ligand blood-disorder drug sold in Japan.” Signs on San Diego. Nov 8, 2010
http://www.signonsandiego.com/news/2010/nov/08/ligand-blood-disorder-drug-sold-japan/
“GSK Reports Japanese Clearance for ITP Drug as Partner Ligand Gets $2M in Govt Grants.” GEN news highlights: Nov 2, 2010
http://www.genengnews.com/gen-news-highlights/gsk-reports-japanese-clearance-for-itp-drug-as-partner-ligand-gets-2m-in-gov-t-grants/81244168/
For more information about romiplostim, eltrobopag, and the other platelet growth factors see:
http://www.pdsa.org/treatments/conventional/platelet-growth-factors.html
MORE DRUGS FOUND TO CAUSE DRUG-INDUCED THROMBOCYTOPENIA
Researchers tallied the number of drug-induced thrombocytopenia reports in three sources: journal articles, the government’s adverse event database, and laboratory samples processed by the Platelet and Neutrophil Immunology Laboratory of the Blood Center of Wisconsin, a lab that analyzes drug-associated antibodies. They found 588 thrombocytopenia-causing drugs that appeared on at least one of the lists and 23 drugs that appeared on all three. For a drug to be considered a cause of thrombocytopenia, there should be a relationship between the start of the drug and low platelets, the platelet count should be below 30,000, and there should be no other cause of low platelets.
For a list of drugs suspected to cause low platelets in some people see Dr. George’s web site:
http://www.ouhsc.edu/platelets/ditp.html
Warkentin TE et al. “DITP causation: 3 methods better than 1?” Blood. 2010 Sep 23;116(12):2002-3.
Reese JA et al, “Identifying drugs that cause acute thrombocytopenia: an analysis using 3 distinct methods.” Blood. 2010 Sep 23;116(12):2127-33.
http://www.ncbi.nlm.nih.gov/pubmed/20530792
PLATELET DEATH REGULATED BY INTERNAL TIMER
In people with ITP, platelets often die because they are coated with antibodies. However, some platelets are eliminated in the same way as platelets expire in people without the disease. At one time it was thought that platelet death was triggered by external damage, the ‘multiple-hit’ theory. Now Australian scientists conclude that platelets are ‘born’ with an internal ‘timer’ that controls their fate.
Dowling MR, “Platelet senescence is regulated by an internal timer, not damage inflicted by hits.” Blood. 2010 Sep 9;116(10):1776-8.
http://www.ncbi.nlm.nih.gov/pubmed/20530288
Hospitals, Insurance, and Medical Care
DOCTORS MORE LIKELY TO MENTION DRUG, TEST, AND SURGERY ADVANTAGES
In a recent study of 3000 patients, the participants reported that they received much more information about the benefits of drugs, tests, or surgeries than the disadvantages or negative side-effects. On average, patients were able to answer only half of the questions necessary to understand the therapy. According to Dr. Michael Barry of Harvard Medical School and president of the Foundation for Informed Medical Decision Making, the study sponsor, “The study clearly demonstrates that people routinely make poorly informed medical decisions."
Bowman, L, “Medical: Study finds docs offer too little info to patients, Scripps Howard News Service. Oct 20, 2010.
http://www.newsnet5.com/dpp/news/health/Medical-Study-finds-docs-offer-too-little-info-to-patients_6474380443
PATIENT PARTICIPATION KEY IN HEALTHCARE
Patients and Families as Health Care Leaders,” a program by Quality Corp. funded by the Robert Wood Johnson Foundation, aims to improve healthcare quality and safety by more fully engaging patients and families in all levels of healthcare organization administration. While this program currently focuses on six organizations in Oregon, the goal is to share the best practices throughout the US. “When patients and families serve in leadership roles in the governance of healthcare organizations… we believe that health systems can be revolutionized,” Mary Minniti, quality improvement director for PeaceHealth and director of the grant explained.
“Six Health Groups Start Patient Advisory Councils:The Oregon Health Care Quality Corporation will provide technical assistance and start-up funding” The Lund Report Press Release, September 28, 2010
http://www.thelundreport.org/resource/six_health_groups_start_patient_advisory_councils
General Health and Medicine
IMPROVE YOUR HEALTH WITH SUPERSTAR VEGETABLES
Vegetables provide vitamins, fiber and help protect against cardiovascular disease, diabetes, high blood pressure, cataracts, and cancer. But a recent study by the Centers for Disease Control shows that only 26 percent of Americans eat more than 3 servings of vegetables per day and that includes fries and the lettuce and tomato on hamburgers. The current recommendation is 4 to 5 servings of vegetables daily. Note: The Center for Science in the Public Interest lists kale as the vegetable with the most concentrated nutrients followed by spinach, collard greens, turnip greens, Swiss chard, canned pumpkin, mustard greens, sweet potato, broccoli and carrots.
Brody, JE. “Even Benefits Don’t Tempt Us to Vegetables” New York Times. Oct. 4, 2010.
http://www.nytimes.com/2010/10/05/health/05brody.html
VECTOR-BORNE DISEASES: A GROWING THREAT
Vector-borne diseases, infectious diseases transmitted by insects, are becoming more prevalent, according to the American Public Health Association. The recent outbreaks in Florida and southern Texas of dengue, a disease carried by mosquitoes, could be due to climate change, increased travel, or poverty. Whatever the cause, physicians and patients are encouraged to be alert for this growing disease threat.
For more information on vector-borne diseases see:
http://www.cdc.gov/ncidod/dvbid/index.html
Krisberg K, “Vector-borne diseases growing as threats to U.S. public health: Climate change, travel linked to illness,” The Nation's Health September 2010 vol. 40 no. 7 1-21
http://thenationshealth.aphapublications.org/content/40/7/1.2.full
Note: Some vector-borne diseases, including dengue, can cause low platelets.
See http://www.pdsa.org/treatments/conventional/antibiotics.html for a list and some references.
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