PDSA E-News: March 30, 2015

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ITP Conference 2015

Registration is now open. Rooms are going fast. Don’t miss out!

“To Treat or Not to Treat: Bleeding Risk vs. Treatment Side Effects”.
That is just one of the session topics at ITP Conference 2015. Check out this year’s program here:

CONFERENCE INFORMATION

ITP & PLATELET DISORDERS RESEARCH & TREATMENTS

Oxidative Stress Found to Play Role in Active ITP in Children and Adolescents

Mom hugging child The trigger of what causes ITP is still elusive. Researchers know oxidative stress, caused by free radicals, plays a role in many autoimmune disorders. This study of children and adolescents looked at a possible direct link between platelets in ITP and oxidative stress. Researchers assessed oxidant–antioxidant systems and evaluated effect of antioxidant therapy on platelet count (PC) and bleeding score (BS) in ITP patients. In the six-month prospective, randomized double blind study 39 patients were newly diagnosed with ITP (ND), Group 1 (G1), and 39 patients had chronic ITP, Group 2 (G2). Both groups were compared with 39 healthy controls. Half of each group, G1A and G2A, each received daily antioxidant therapy, while Groups G1B and G2B received placebo. Key primary endpoints were the difference in change from baseline to six months in ITP-specific bleeding assessment and total antioxidant capacity (TAC).

Results showed TAC was significantly lower in newly diagnosed ITP patients compared to chronic ITP patients. Both groups showed lower levels than the healthy controls. At the end of the study both BS and PC improved a great deal in patients who received antioxidant compared to placebo. Researchers concluded there were reduced antioxidant mechanisms in ITP patients. Antioxidant therapy reduced the oxidative stress in both the newly diagnosed and chronic ITP patients. Some well-known antioxidants include Vitamins A, C, and E. Eating an anti-inflammatory diet also helps reduce oxidative stress.

Elalfy MS, Elhenaway YI, Deifalla S, et al. “Oxidant/antioxidant status in children and adolescents with immune thrombocytopenia (ITP) and the role of an adjuvant antioxidant therapy.” Pediatr Blood Cancer 2015, Feb 7: doi: 10.1002/pbc.25434 [Epub ahead of print]
http://www.ncbi.nlm.nih.gov/pubmed/25663642
http://informahealthcare.com/doi/abs/10.3109/09537104.2011.610909

Eltrombopag Treatment after Stopping Romiplostim Appears Safe for ITP Patients

In a Spanish retrospective study, researchers analyzed data from 51 adults with ITP who had first been treated with romiplostim (Nplate®), followed by Eltrombopag (Promacta®). The majority of patients (32) were women; median age was 49. Patients, on average, received romiplostim treatment for 12 months (range was 5-21 months) before receiving eltrombopag. Reasons for switching to eltrombopag included: lack of efficacy (25 patients), patient preference (16), platelet count fluctuation (6), and adverse effects (4). Results showed that 80% (41) of the patients responded to eltrombopag. Of those, 67% (35) had complete responses. About a year later 31 patients still had complete response. Responses were seen in patients who switched due to patient preference, platelet count fluctuation, and adverse effects. A third of the patients experienced at least one adverse event. The researchers concluded use of eltrombopag after romiplostim treatment for ITP is safe and effective.

Gonazález-Porras JR, Mingot-Castellano ME, Andrade MM, et al. “Eltrombopag after romiplostim appears safe in treating ITP.” Br J Haematol. 2014, April, 169 (1): 111-116.
http://www.ncbi.nlm.nih.gov/pubmed/25521630

Is Your Current ITP Treatment Working for You?

Rigel Pharmaceuticals Inc. is conducting a Phase 3 clinical study with an investigational drug, fostamatinib, for the treatment of patients with persistent or chronic ITP. If you are 18 years of age or older, have had a diagnosis of ITP for at least 3 months and have previously received at least 1 typical regimen for the treatment of ITP you may be eligible. There are a number of clinical trial sites already open in the U.S., Canada and Europe.

For a complete site list, please visit - http://tinyurl.com/ITPtrialsites.

HOSPITALS, INSURANCE & MEDICAL CARE

New Sleep Guidelines Recommend More Sleep for Most Age Groups

The National Sleep Foundation (NSF) and an expert panel issued new guidelines for amount of sleep needed in all age groups. They recommended additional sleep time range for most ages. The Foundation worked with experts from sleep, anatomy and physiology, pediatrics, neurology, gerontology, and gynecology to reach their conclusions. This is the first time a professional organization produced age-specific sleep duration recommendations based on systematic review of world literature related to sleep duration, health, performance, and safety.

In previous guidelines teens (14 to 17) had the range of 8.5 - 9.5 hours per night, now widened to 8 - 10 hours per night. School age children (6 - 13) had their range increased from 9 - 11 hours to 10 - 11 hours. For adults (26 - 64) the sleep range remained at 7 - 9 hours. A new age category was added for older adults (age 65+) of 7 - 8 hours. The researchers said people far out of the range for their age group may be engaging in sleep restriction or may have serious health problems that affect their health and well-being. The Foundation encourages doctors to ask their patients about their sleep, which will contribute to improved health and well-being, better patient care, and lower healthcare costs.

Hirshkowitz M, et al. “National Sleep Foundation updates its sleep duration recommendations.” Sleep Health: The Journal of the National Sleep Foundation, 2015, January, doi: 10.1016/j.sleh.2014.12.010.
http://sleepfoundation.org/media-center/press-release/national-sleep-foundation-recommends-new-sleep-times
http://www.healio.com/internal-medicine/sleep-medicine/news/online/%7B69a78086-1a2e-49cd-83ad-9e8e3524dd00%7D/national-sleep-foundation-updates-its-sleep-duration-recommendations

GENERAL HEALTH & MEDICINE

More Evidence for the Benefits of the Mediterranean Diet

Mediterranean style food People with ITP have some increased risk for blood clots. However, there’s good news. New research findings from an observational study at Columbia University Medical Center, NY, indicate eating a Mediterranean Diet, rich with fruits, vegetables, nuts, fish, olive oil, and legumes and which is low in in red meat, animal fats, dairy and sweets, can reduce stroke risk by 18% compared with less healthy diets. This study reported on data from the California Teachers Study that included 104,268 female teachers who completed widely used, validated food-frequency questionnaires.

After adjusting for other stroke risks, such as physical activity levels and socioeconomic factors, researchers found ischemic stroke (a stroke caused by a clot) risk was lower in women who regularly ate a Mediterranean diet. The study was restricted to just one state—California. Although the researchers could not prove cause and effect, there was strong evidence that closely following a Mediterranean diet significantly reduced stroke risk.

“More Evidence Mediterranean Diet May Reduce Stroke Risk.” Medscape. March 12, 2015.
http://www.medscape.com/viewarticle/841359

PDSA LOCAL SUPPORT GROUP MEETINGS

April 1, 2015: ITP Parents Teleconference Group
April 8, 2015: Canada Teleconference Group
April 11, 2015: Chicago, IL
April 11, 2015: Nashville, TN
April 26, 2015: Seattle, WA

May 9, 2015: Phoenix, AZ
May 14, 2015: Cleveland, OH
May 16, 2015: Central/North, NJ
May 16, 2015: Milwaukee, WI

UPCOMING EVENTS

April 12, 2015: Ashburn, VA
May 30, 2015: Ames, IA
September 19, 2015: Chicago, IL
September 27, 2015: Everett, WA
November 21, 2015: Pedal for Platelets El Tour de Tucson, AZ
TBD: Cleveland, OH

MORE FROM PDSA

The ITP Poke-R Club is for children and adolescents with ITP in the US who are paid members of PDSA. Parents can request a Poke-R Club kit for their child.
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