http://213.180.84.248/ezpublish-4.0.1/index.phphttp://213.180.84.248/ezpublish-4.0.1/index.php/About-PPME/News/Calcium-supplements-and-the-risk-of-cardiovascular-events<p> Osteoporosis is a major cause of morbidity and mortality in older people and most guidelines recommend adequate calcium intake as an integral part of the prevention or treatment of osteoporosis. In the light of conflicting evidence about the effect on cardiovascular health, researchers did a meta-analysis of trials of cardiovascular events in randomised trials of calcium supplements without vitamin D [1]. </p> <p> The study, totalling 12,000 participants, found that calcium supplements increase the risk of myocardial infarction by about 30%. Given the modest benefits of calcium supplements on bone density and fracture prevention, a reassessment of the role of calcium supplements in the management of osteoporosis is warranted. </p> <p> 1. BMJ. 2010;341:c3691. </p> http://213.180.84.248/ezpublish-4.0.1/index.php/About-PPME/News/Lilly-fighting-generic-competition<p> Eli Lilly and Co. is seeking a temporary block on sales of generic versions of its drug atomoxetine (Strattera) while it appeals against a ruling that declared a key patent invalid. </p> <p> The attention-deficit hyperactivity disorder drug is mostly prescribed in the US; nevertheless world sales last year reached Euros 475 million and Lilly’s shares have dropped because of the anticipated reduction in earnings. The patent had been set to expire in 2017. At least seven generic drug-makers have tentative approvals from the FDA to sell the drug.<br />The case is typical of many, as originator companies seek to preserve and extend patents while generics companies try to overcome them. </p> http://213.180.84.248/ezpublish-4.0.1/index.php/About-PPME/News/Big-fuss-about-ARB-study<p> The EMA plans to review the possible risk of cancer in patients taking angiotensin-receptor blockers (ARBs), based on a meta-analysis in <i>Lancet Oncology </i>that suggested a “modest but significant” link between ARBs and cancer [1]. In particular telmisartan was associated with lung cancer. </p> <p> However several hypertension experts are calling the paper deeply flawed. They contend that there is no clear pathophysiology to explain any ARB-cancer link and are worried that the publicity will deter patients prescribed ARBs from taking them, exposing them to cardiovascular and renal illness. Several opinion leaders spoke to the press at the recent European Society of Hypertension meeting and criticised the paper for omitting several important ARB trials and saying it is extremely unlikely that cancers would develop in such a short time period. </p> <p> 1. Lancet. doi:10.1016/S1470-2045(10)70106-6. </p> http://213.180.84.248/ezpublish-4.0.1/index.php/About-PPME/News/Adjuvant-chemotherapy-following-radical-cystectomy<p> The use of adjuvant chemotherapy (AC) after radical cystectomy is of benefit to patients with high-risk bladder cancer. </p> <p> A lack of evidence for use of AC in patients who have had the bladder and surrounding tissues removed due to cancer led to a retrospective multicentre observational study to investigate the possible benefit [1]. A total of 3,947 patients were included in the study and grouped into quintiles based on their risk of disease progression. AC, received by 932 patients (23.6%) in the cohort, was defined as chemotherapy given within 90 days of radical cystectomy in patients without evidence of disease recurrence. </p> <p> When analysed according to risk of progression, those in the quintile at highest risk appeared to benefit from AC (Hazard Ratio 0.75, 95%CI 0.62–0.90, p = 0.002). The median survival was 5.8 weeks longer than in patients not receiving AC (p &lt; 0.001). </p> <p> 1. Clin Cancer Res. doi:10.1158/1078-0432.CCR-10-0457 </p> http://213.180.84.248/ezpublish-4.0.1/index.php/About-PPME/News/DMARDs-should-remain-first-choice-drugs-in-RA<p> A systematic review and meta-analysis of published research indicates that in patients with rheumatoid arthritis (RA), combinations of disease-modifying anti-rheumatic drugs (DMARDs) have similar efficacy to biological agents. A comprehensive literature search was carried out for randomised controlled trials investigating the effect of drug treatment in RA patients. </p> <p> The authors conclude that DMARDs, glucocorticoid, biological treatments and combinations all reduce RA radiographic progression by 50–80%. One study found no difference between a biological agent and combination DMARD plus step-down glucocorticoid therapy, and they note that all other comparisons between biological agents and DMARD have been unbalanced using only one DMARD: further studies versus combinations are needed and should be demanded by regulatory authorities. The expensive biological agents should be reserved for patients for whom DMARDs in combination are ineffective. </p> <p> 1. Arthritis Rheum, published early online 17 June 2010 </p> http://213.180.84.248/ezpublish-4.0.1/index.php/About-PPME/News/Infection-prophylaxis-for-PEG<p> The deposition of co-trimoxazole solution into a newly inserted percutaneous endoscopic gastrostomy (PEG) tube is at least as effective at preventing wound infections as IV cefuroxime given prior to the procedure. </p> <p> Infection is the most common acute complication associated with the insertion of a PEG catheter; insertion site infection occurring in around one third of patients. A single IV dose of cefuroxime one hour prior to the procedure is the current gold standard of antibiotic prophylaxis. The new technique is a cheaper and technically easier option for prophylaxis. </p> <p> The authors note some trial limitations but the new strategy of antibiotic prophylaxis “can be administered rapidly and is inexpensive, safe, less likely to be administered needlessly [as they are given prior to the procedure, IV antibiotics are sometimes when PEG insertion is not performed] and could be used wherever the PEG procedure is done”. </p> <p> 1. BMJ. 2010;341:c3115 </p> http://213.180.84.248/ezpublish-4.0.1/index.php/About-PPME/News/Nanoparticle-research<p> Clusters of heated, magnetic nanoparticles targeted at cell membranes can remotely control ion channels, neurons and even animal behaviour, according to a paper published by University at Buffalo physicists in Nature Nanotechnology. <br /> The research could have broad application, potentially resulting in innovative cancer treatments that remotely manipulate selected proteins or cells in specific tissues, or improved diabetes therapies that remotely stimulate pancreatic cells to release insulin. The work also could be applied to the development of new therapies for some neurological disorders that result from insufficient neuro-stimulation. <br />The method uses magnetic fields to stimulate cells both <i>in vitro</i> and <i>in vivo</i>. The University at Buffalo researchers have demonstrated that their method can open calcium ion channels, activate neurons in cell culture and even manipulate the movements of the tiny nematode, C. elegans. </p> http://213.180.84.248/ezpublish-4.0.1/index.php/About-PPME/News/Low-vitamin-D-levels-in-diabetics<p> A small but long-term observational study suggests that low vitamin D levels may be associated with increased risk of all-cause and cardiovascular mortality in patients with type 2 diabetes. </p> <p> Increasing evidence links low vitamin D levels with greater risk of a range of serious diseases, including cardiovascular disease. As patients with type 2 diabetes are already at increased mortality risk, especially cardiovascular mortality, the authors of this study aimed to determine whether there was any association between vitamin D levels and mortality in such patients. They used data from an existing cohort established in 1987, for which blood samples were available for measurement of vitamin D levels. </p> <p> The study concludes that in type 2 diabetic patients, severe vitamin D deficiency predicts increased risk of all-cause and cardiovascular mortality, independent of conventional cardiovascular risk factors. Whether vitamin D substitution improves prognosis remains to be investigated. </p> <p> doi:10.2337/dc10-0582 </p> http://213.180.84.248/ezpublish-4.0.1/index.php/About-PPME/News/Diabetes-UK-launches-new-online-diabetes-risk-test<p> On 6 July 2010, Diabetes UK launched a new online type 2 diabetes risk score test that is more accurate, personal and user-friendly. The test, which consists of seven questions, uses a points system to identify if a person is at low, increased, moderate or high risk of developing diabetes. It then offers appropriate advice to people, as well as providing advice from case studies that have the same level of risk, and those considered at moderate to high risk can print out a letter for their GP. </p> <p> The OECD estimates average OECD diabetes prevalence at &gt; 6% in the population aged 20–79 years for 2010. It ranges from &lt; 5% in Iceland, Norway and UK to &gt; 10% in Mexico and the US. </p> <p> www.diabetes.org.uk </p> http://213.180.84.248/ezpublish-4.0.1/index.php/About-PPME/News/Imatinib-faces-competition<p> Two head-to-head trials involving chronic myeloid leukaemia (CML) found patients responding better to dasatinib than imatinib after a year [1] and likewise better to nilotinib, also after a year [2]. </p> <p> At the end of the year, the rate of confirmed complete cytogenetic response was significantly higher among patients who received dasatinib rather than imatinib (77% vs 66%, p<i> </i>= 0.0067). The rates of complete cytogenetic response by 12 months were significantly higher for nilotinib (80% for a 300 mg dose and 78% for a 400 mg dose) than for imatinib (65%; p &lt; 0.001 for both comparisons). </p> <p> It is speculated that the competitors might be given first-line status in the near future, which might result in a choice being possible on grounds of cost or toxicity. </p> <p> 1. N Engl J Med. 2010;362:2260-70 </p> <p> 2. N Engl J Med. 2010;362:2251-9 </p>