Study Hormones may ward off dementia
Thu, 03 May 2007 03:05:16 GMT
By JEFF DONN, Associated Press Writer
BOSTON - New research suggests that hormone therapy taken soon after menopause may help protect against the mental decline of dementia, even though it raises that risk in elderly women.
The study adds yet another frustrating twist to the back-and-forth findings about whether hormone-replacement therapy protects against diseases of aging. Though the accepted answer has been "no" in recent years, the latest evidence suggests that timing of treatments may be key, at least for heart attacks and now for dementia.
"When you give it may be very important," said Dr. Sam Gandy, an
Alzheimer's disease expert at Thomas Jefferson University in Philadelphia.
The new findings were released Wednesday in Boston at a meeting of the American Academy of Neurology. Experts cautioned that they are preliminary.
Lead researcher Dr. Victor Henderson, of Stanford University, agreed that it's too soon to consider putting younger women back on hormones to forestall dementia.
For decades, women routinely took hormones to treat the hot flashes of menopause and to ward off ailments of aging. Then, in 2002, a milestone study showed higher risks of heart attack, stroke, and breast cancer with estrogen-progestin treatments. Estrogen-only pills were later also linked to stroke.
As a result, millions of women gave up the pills, and government experts advised women to use them only for severe menopause symptoms and to take the lowest dose for the shortest time possible.
But in recent weeks, mounting evidence has emerged that women who take such drugs closer to menopause may get more benefit or confront less risk than women who start taking them later. An analysis this month indicated the drugs do not raise the risk of heart attack for women ages 50-to-59, and they seem to survive longer with the drug.
The latest findings focused on 7,153 women in an offshoot study of the huge Women's Health Initiative that tracked breast cancer and heart disease. The cognitive study was funded by the
National Institutes of Health and by Wyeth, which sells hormone treatments.
Previous research showed that women who take hormones after age 65 experience a 75 percent increased risk of dementia over other women.
But this study found the opposite for women who took hormones before age 65: Dementia risk was reduced by nearly half.
Dementia developed in 22 of 2,228 women — or only 1 percent — who took hormones at the earlier time, but in 84 of 4,925 who did not — or 1.7 percent. The apparent protective effect was especially strong for Alzheimer's disease, a common form of dementia.
"It's an intriguing and biologically plausible finding ... but it needs to be confirmed," said Dr. JoAnn Manson, of Brigham and Women's Hospital in Boston, who helped research the Women's Health Initiative.
She said replacement hormones may preserve blood circulation in the brain.
FDA seeks antidepressant suicide warning
Thu, 03 May 2007 02:51:35 GMT
By ANDREW BRIDGES, Associated Press Writer
WASHINGTON - Young adults face an increased risk of suicidal thoughts and behavior when they first begin taking antidepressants and should be warned about the danger, federal health officials said Wednesday.
The
http://www.fda.gov/cder/drug/antidepressants/default.htm
Studies tie drugs unusual heart rhythms
Thu, 03 May 2007 02:51:18 GMT
By JEFF DONN, Associated Press Writer
BOSTON - Two research reports suggest a possible link between two bone-building drugs and irregular heart rhythms in a small number of women who take the medicine.
The signs of a problem were more pronounced with Reclast, a drug made by Novartis AG and given through a once-a-year, 15-minute intravenous infusion. But there was a hint of similar trouble in a few women who took the leading osteoporosis pill, Fosamax by Merck & Co. The two drugs are in the same class.
The safety question caught researchers by surprise. While uncertain how big a worry it might be, they agreed the overall risk is small. Specialists said women at high risk for bone breaks — the main target of these osteoporosis drugs — should keep taking them as prescribed.
But several experts said they'd be cautious about those who also are at risk for a condition called atrial fibrillation, an irregular heart rhythm that can cause strokes.
The two separate reports published Thursday in The
New England Journal of Medicine point to elevated rates of serious episodes of that heart condition in women who took Reclast and Fosamax.
"For the first time, there may be a side effect," said a researcher involved in both studies, Dr. Steven Cummings of California Pacific Medical Center Research Institute. Until now, people have assumed Fosamax "was completely safe and could be given to almost anybody."
Fosamax, the Merck brand name for alendronate, is now used by an estimated 1.8 million American women. In a letter to the medical journal, Cummings reported evidence of the heart problem found in a recent review of a 1997 Merck-sponsored study of postmenopausal women on Fosamax.
There appeared to be 50 percent more risk of the serious heart rhythm in women who took the daily pill than among those who didn't take it. About half of the 6,459 women took Fosamax, and 47 developed atrial fibrillation, compared to just 31 cases among the other women.
However, the finding, while not statistically definitive for Fosamax, worried some researchers because it is in line with the results of a new study published in the same issue of the medical journal.
This study of 7,736 postmenopausal women with bone-thinning osteoporosis focuses on Reclast. Novartis recently won approval to sell Reclast, known generically as zoledronic acid, for Paget's disease, another bone condition. The company hopes to get an OK later this year to sell it for osteoporosis use.
The new study, funded by Novartis, shows that Reclast works at least as well as existing drugs in the same class, researchers say. However, the risk of a serious case of irregular heart rhythm was more than double that in the other patients — 50 cases in the drug-taking half, compared to 20 cases in the others.
Researchers cautioned about overestimating the importance of the heart rhythm problem. The Reclast study showed little apparent difference in overall cardiac deaths and the overall risk of the rhythm condition remained small.
Doctors made available by Merck and Novartis said the side effect could be a statistical fluke or just a product of aging. They said earlier studies showed no sign of the possible side effect.
For now, it's unknown if the possible risk applies to other drugs in the class known as biphosphonates. Future studies are expected to help clarify the risk.
Canada confirms new mad cow case
Thu, 03 May 2007 03:45:11 GMT
VANCOUVER, British Columbia - Canadian authorities said Wednesday they had confirmed the country's 10th case of mad cow disease since 2003.
In the latest case, the disease was discovered in a dairy cow in the western province of British Columbia. The Canadian Food Inspection Agency said no part of the animal entered the human food or animal feed systems.
The agency said it appears the 5 1/2-year-old cow was infected during its first year of life. It is now checking other animals born around that time to try to track down the source of the infection.
Nine previous cases of mad cow, or bovine spongiform encephalopathy, have been detected in Canadian cattle since May 2003, when the discovery of an Alberta cow with the disease caused the United States to slam the border shut to cattle exports entirely.
Eating meat products contaminated with
BSE has been linked to more than 150 human deaths, mostly in Britain, from variant
Creutzfeldt-Jakob Disease, a rare and nerve disease.
There have been three confirmed cases of mad cow disease in U.S. animals.
Diet drug may be of little benefit in obese teens
Thu, 03 May 2007 17:39:39 GMT
NEW YORK - Obese adolescents who are put
on a low-calorie diet and exercise program do not seem to
derive any additional benefit from taking the diet drug
sibutramine, sold in the United States under the trade name
Meridia, according to a Dutch study.
In previous studies, sibutramine resulted in weight loss
and enhanced the effects of a low-calorie diet for up to 2
years in obese adults, note Dr. Edgar G. A. H. Van Mil, of the
VU University Medical Center, Amsterdam, and colleagues in the
Journal of Clinical Endocrinology and Metabolism.
In adults, sibutramine reduces calorie intake by increasing
the feeling of fullness and increasing the metabolic rate, so
more calories are burned. But it is unclear if the drug has the
same effects on obese adolescents.
The researchers therefore conducted a study with 24 obese
teens who were randomly assigned to sibutramine or a placebo.
Both groups also where given a low-calorie diet and physical
exercise program to follow. After 12 weeks, the teens stayed on
their diet and exercise program, but stopped taking the drug.
The weight of the patients was comparable in both groups
after the 12-week trial, the researchers report. However, the
weight loss concluded after the placebo was discontinued,
whereas weight loss only stabilized in teens who discontinued
sibutramine.
The team also measured the subjects' body composition and
metabolic rate using underwater weighing and special X-ray
imaging techniques. The changes in the percentage of fat mass
were not different between the sibutramine and placebo groups
and there were no significant changes in metabolism, the
investigators found.
The researchers then measured basal metabolic rate, the
amount of calories the body burns while at rest. They found
that it initially decreased in the placebo group and remained
constant in the sibutramine group. However, during the
follow-up period, the basal metabolic rate increased in the
placebo group and decreased in the sibutramine group.
It's possible, the team speculates, that the effect of
sibutramine was masked by the effects of diet and exercise.
SOURCE: Journal of Clinical Endocrinology and Metabolism,
April 2007.