"Titrated oral doses of misoprostol (Cytotec) may be as effective as intravenous oxytocin in speeding labor in women who have inadequate contractions, according to" a study published in J. Obstetrics & Gynecology. Taiwanese researchers found that in "a randomized trial of more than 200 Chinese women, the median times from treatment to vaginal delivery were virtually identical at 5.2 hours whether oral misoprostol or intravenous oxytocin was used." They also noted that there "were also no differences in adverse effects and birth outcomes, allaying concerns that oral misoprostol might not be as safe as intravenous oxytocin."
Trastuzumab May Help Extend Stomach Cancer Patients' Survival By Nearly Three Months.
Patients with HER2-positive advanced gastric cancer might benefit from a drug produced by Roche Holding AG. “Use of the drug trastuzumab in addition to chemotherapy can extend stomach cancer patients' survival by nearly three months," researchers in Seoul found after evaluating "584 patients at 122 centers in 24" nations. The "addition of trastuzumab to standard cisplatin/fluoropyrimidine chemotherapy resulted in a median survival of 13.8 months, compared with 11.1 months for patients who received chemotherapy alone -- a 26 percent difference." But, an editorial accompanying The Lancet paper questions the cost-effectiveness of that treatment.
"In the 24 countries that contributed to the study, yearly health expenditure per citizen varies from $40 (£25) to $5,500, which reiterates the important moral question -- what is the justification for introducing a treatment that might enable one individual to live a few months longer, but will consume, for each person treated, the total yearly health expenditure for scores of their fellow citizens?"
Breast Cancer Drug Fulvestrant Appears More Effective In The Presence Of CK8 And CK18.
Women’s responsiveness to the second-line breast cancer drug fulvestrant may depend on whether the cancer cells are expressing two key proteins, Indiana University Bloomington scientists report in this month’s Cancer Biology & Therapy.
Fulvestrant appeared to exert maximum anti-cancer effects in vitro when cells produced normal or elevated quantities of the cytokeratins CK8 and CK18, structural proteins that help give the nucleus its shape.
For fulvestrant to work well, the cells must also be responsive to estrogen, and producing the estrogen receptor ER-alpha. ER-alpha’s importance to fulvestrant’s anti-estrogenic action had been established in previous reports. The present study confirms fulvestrant’s binding relationship to ER-alpha, while also showing two other proteins, cytokeratins 8 and 18, can strongly enhance fulvestrant’s anti-estrogenic activity. Testing for the presence of these three proteins, and perhaps many others, could help doctors decide whether fulvestrant should be prescribed to their patients.
Eprotirome May Lower Cholesterol Levels Without Feared Side Effects Of Thyroid-Based Drugs.
"A thyroid-derived cholesterol-lowering drug," called eprotirome, "that could be an alternative to the widely used statin medications has done well in a small, early trial, Swedish and American researchers report." For the 12-week trial, various doses of eprotirome "were added to statin treatment for 168 people whose high levels of LDL cholesterol had not been lowered by previous use of statins," and the combination was found to "lower cholesterol levels" and "did not cause the feared side effects...that have plagued similar thyroid-based treatments." Eprotirome, which is still several years away from the market, is unlikely to replace statins.
Third Study Shows Bisphosphonates May Cut Risk Of Breast Cancer.
According to a study appearing in the British Journal of Cancer, researchers "found a reduction in the risk for breast cancer among postmenopausal women taking bisphosphonates for the treatment of osteoporosis." The study showed that "the use of bisphosphonates was associated with a 30% reduction in the risk for breast cancer." The findings back results "reported in two other studies." Still, researchers remain unclear "how bisphosphonates could prevent breast cancer."
Intravitreous Dexamethasone Effective Treatment For DME.
According to a study published in the Archives of Ophthalmology, "intravitreous treatment with dexamethasone is well tolerated and significantly improves visual acuity in patients with persistent diabetic macular edema (DME)." In a trial in which 315 DME patients were randomized to intravitreous "dexamethasone 700 µg (n=105) or 350 µg (n=105) to one eye, or observation (n=105)," researchers found that "at day 90, a BCVA improvement of 10 letters or more was seen in 33.3%, 21.1%, and 12.3% of the dexamethasone 700 µg, 350 µg, and observation groups, respectively."
Anti-TNF Therapy For Psoriatic Arthritis May Improve Physical Disability, Quality Of Life.
According to a study published in the March issue of Arthritis Care & Research, "treatment with anti-tumor necrosis factor (TNF) agents can significantly improve physical disability and quality of life for patients with psoriatic arthritis." In a study of 596 patients, researchers found that "at six months, patients undergoing anti-TNF therapy had improved on the physical component scale of the Short Form (SF)-36 health survey instrument from a mean score of 19.1 to a mean of 29.3." In addition, scores "on the mental component scale...had risen from a mean of 41.7 to 48.8." Anti-TNF therapy drugs included in the study were etanercept, infliximab, and adalimumab.
Combination Therapy For Some Alzheimer's Patients May Help Ease Caregiver Distress.
According to research presented at a geriatric psychiatry meeting, "caregiver distress is significantly attenuated when patients with moderate to severe Alzheimer's disease (AD) are treated with a combination of extended-release memantine plus a cholinesterase inhibitor (ChEI) vs. ChEI monotherapy." Researchers came to this conclusion after randomizing "335 patients with a diagnosis of probable AD who had been undergoing stable ChEI therapy for at least three months...to extended-release memantine, 28 mg daily, and another 342 patients" to placebo, then following them for 24 weeks.
Quetiapine Associated With More Rapid Onset Of Metabolic Disturbances In Elderly Patients.
According to a study presented at a geriatric psychiatry meeting, "the antipsychotic quetiapine (Seroquel, AstraZeneca) is associated with a more rapid onset of metabolic disturbances than other antipsychotics in elderly patients with no baseline metabolic abnormalities before treatment initiation." In a study of 231 outpatients aged 70 and older treated for "psychosis, depression, bipolar disorders, or dementia," researchers found that "time to onset of hyperglycemia was significantly shorter among patients treated with quetiapine at 17.5 months, compared with patients who were treated with olanzapine at 32.6 months or risperidone at 36.3 months."