Zetia and Vytorin have no net benefit : says study FINALLY.

A study (called Enhance) conducted mainly in the Netherlands on 720 people with high cholesterol showed that atherosclerotic plaques grew twice as fast when a person was on a Zetia (ezetimibe) and Zocor (simvastatin) combination (in the form of Vytorin pills) - than when on Zocor alone. The NY times article reporting the entire mess is here. Another article covering the same is here.

Some shocking facts:

A) the FDA approved Zetia in November 2002 and Vytorin (a combination drug) in August 2004.

B) the study in question ( Enhance : a two year trial) concluded in April 2006. That's right - almost 2 years ago. Both companies : Merck and Schering "repeatedly missed their own deadlines for reporting the results, leading cardiologists around the world to wonder what the study would show."

C) Both drugs in question cost around $3 a day. Worldwide, about one million prescriptions are written for Zetia and Vytorin each week, and about five million people are now taking the drugs worldwide.

Technorati Tags: Zetia,Zocor,Vytorin,Enhance,Merck,Schering

Zetia

Possible targets for future AIDS drugs found

In a recent study at Harvard medical school, researchers have identified 273 human proteins that have some role in HIV survival in human cells. This study is relevant because, as explained in the article :

1. these are new targets to work on in future AIDS drug development
2. these are human proteins - so it will hopefully be harder for the virus to mutate via adaptation to malfunction/nonfunctioning of the proteins as compared to absent/malfunctioning viral proteins.

Interestingly, this study was headed by Dr. Stephen J. Elledge, a geneticist who is researching HIV for the first time. An erstwhile cancer researcher, he conducted this study as a collaborative effort. This supports my long standing suspicion that specialization of any sort is counterproductive because it so severely limits a working field and hence limits imagination. Case in point : a cancer researcher changed his focus of research, brought in new viewpoints, a new approach and voila! headed a discovery which has the potential to change the face of HIV/AIDS pharmacology and research.

Technorati Tags: HIV,drugs

Some other news :

1. The FDA has approved a rapid MRSA test. This test takes about 2 hours and has been shown to pick up 100% of MRSA cases in the clinical trial.
2. Pot (cannabis) has been shown to slow the growth of cervical and lung cancers in vitro
3. Testosterone supplementation over a 6 month period in "older men" i.e. men between 60 to 80 years of age, showed no benefit in cognitive ability, physical mobility or bone mineral density. There was some increase in lean mass and decrease in fat mass - but an increased risk (not considered statistically significant) of metabolic syndrome in the testosterone supplemented group. All in all : testosterone supplementation had no net benefit in the tested group.
4. Outcomes of care by hospitalists, general internists and family physicians. Hospitalists were shown to reduce the length of hospital stay plus reduce costs as compared to internists.

 

Technorati Tags: clinical trial,News,MRSA,Pharmaceuticals,Pot,Marijuana,Cannabinoids,Hospitalists,internists,family physicians

Is it really safe to have a heart attack in a hospital ?

A new study has uncovered some "shocking" news : hospitals are not necessarily the safest places to have heart attacks. Why is it shocking? Because at least one third of the hospitals do not "shock" in time to save a patient who has a correctable arrhythmia. So maybe its not shocking enough that is the problem ..?!

Anyway, this anonymous study, "the largest ever" to look at cardiac outcomes of "shockable" abnormalities in cardiac rhythm is even more shocking (bear with me) because the hospitals included in the study were part of a national registry for cardiac arrests, meaning that they were probably already working better than average.

Factors named in this deplorable outcome (1/3rd cardiac cases not treated in time) are :

1. When the patient has the heart attack (nights and weekends being the worst time)
2. the size of the hospital ( <250 beds associated with unfavorable outcomes)
3. absence of cardiac monitors (obviously)
4. not enough cardiac monitoring of non-cardiac patients
5. the race of a person (black people for e.g. mostly because of living near hospitals with problems like 2 and 3 )
6. not enough people trained to use defibrillators
7. not enough automatic defibrillators
8. not enough nurses/ doctors
9. not enough training - for e.g. rapid response teams and mock resuscitation drills to keep personnel sharp

Dr. Saxon of the University of Southern California lightly comments that a heart attack may have better chances of being noticed in the middle of a mall rather than in an understaffed, unprepared and/or unmonitored hospital setting.

Technorati Tags: heart attack,in the news,defibrillator

Whites more likely to get prescription narcotics

A study of over 150,000 ER visits in rural and urban areas has found that while the prescription of narcotics has increased from 23% in 1993 to 37% in 2005, doctors are more likely to prescribe oxycodone or morphine to whites than to non-whites.

Factors contributory are suspected substance abuse liability in Blacks and Hispanics and possibly that minorities may "be less likely to keep complaining about their pain or "feel they deserve good pain control".

One statement I did not quite understand is that "Blacks are the least likely group to abuse prescription drugs." Linda Simoni-Wastila of the University of Maryland, Baltimore, School of Pharmacy further states that "Hispanics are becoming as likely as whites to abuse prescription opioids and stimulants". I don't think I could accept this as a blank statement without hard fact or explanations.

Technorati Tags: Emergency room,Narcotics,Prescription,Racial disparity

Free drugs come with hidden costs

An article in USA today talks about how free samples given to doctors by pharma representatives most often go to rich insured patients instead of poor uninsured patients. Why should that be so surprising? How many poor uninsured patients actually visit doctors? Or at least the doctors in clinics that get frequented by drug reps ? Anyway, it seems that only 28% of poor people leave the doctor's office with free drug samples. For the purpose of this study poor was defined as an annual income of less than $18,400 for a family of four.

A more interesting problem discussed in the article and one I too have seen in a free clinic is : once the patient is hooked onto/ dependent on the expensive drugs, who really can guarantee a continuous supply of the same ? Most times, even if the drug is a miracle cure and just what the patient needed (an objective which itself is hard to achieve) - the doctor is forced to sooner or later (when supplies run out) change the prescription to a more economical or sometimes an older generation drug. Doctors working at free clinics for the poor/uninsured need continuous updates that would help them make wiser choices for their patients.

This study, says a professor from the University of Wisconsin, "debunks" the theory that stopping the supply of free samples will hurt the uninsured.

Technorati Tags: Free clinics,In the news,Pharmaceuticals,Poor/uninsured patients,Prescription,public health