Contents:
ITP Research and Treatments
- Evans Syndrome is Often Associated With Other Disorders
- Romiplostim May Temporarily Alter Bone Marrow
- Cleveland Clinic Names TPOs in Top 10 Medical Innovations for 2010
- UK National Health Services May Drop Nplate Coverage For ITP Patients
- Corticosteroid Use May Increase Risk for Heart Arrhythmias
Hospitals, Insurance, and Medical Care
- Alcohol Linked to Autoimmune Reactions in Alcoholic Liver Disease
- Rapid Flu Test Often Fails to Detect The H1N1 Virus
General Health and Medicine
- Endocrine Disruptor BPA Still Widely Found in Packaged Foods
- Web Surfing Benefits Adult Brain Function
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ITP Research and Treatments
EVANS SYNDROME IS OFTEN ASSOCIATED WITH OTHER DISORDERS
Evans Syndrome (ES) is the combination of ITP and autoimmune hemolytic anemia (low red cell count) and/or neutropenia (low white cell count). In a survey of 68 patients with ES, researchers found that half of the cases were associated with an underlying disorder including lupus, lymphoproliferative disorders (high white cell count) or common variable immunodeficiency. All ES patients were given corticosteroids, but 73% required at least one additional treatment.
Michel, M, et al. “The spectrum of Evans syndrome in adults: new insight into the disease based on the analysis of 68 cases.” Blood. 2009 Oct 8;114 (15):3167-72
http://www.ncbi.nlm.nih.gov/pubmed/19638626
ROMIPLOSTIM MAY TEMPORARILY ALTER BONE MARROW
In a study of six patients taking romiplostim (Nplate™) who received both pre-treatment and on-treatment bone marrow biopsies, only one showed an increase in bone marrow reticulin (fibrous structures). In another study of 271 patients, 10 had increased reticulin deposition. In another study rats given two to four times the normal dose of romiplostim, showed a dose and time-dependant increase in reticulin. In both people and animals, the reticulin decreased after the treatment was discontinued. This research supports the clinical practice of using the minimally effective dose of romiplostim.
Kuter, DJ, et al. “Evaluation of bone marrow reticulin formation in chronic immune thrombocytopenia patients treated with romiplostim.” Blood. 2009 Oct 29;114 (18):3748-56
http://www.ncbi.nlm.nih.gov/pubmed/19671919
CLEVELAND CLINIC NAMES TPOs IN TOP 10 MEDICAL INNOVATIONS FOR 2010
Of the top10 medical innovations for 2010 chosen by a committee of doctors at the Cleveland Clinic, “Oral Thrombopoeitin (TPO) Receptor Agonist That Stimulates Platelet Production”, a new treatment for ITP, was number 8. Number one on the list was a new hearing communication device that transmits sound via the teeth. The awards, based on patient benefit, clinical impact, probability of success, and research data, were given at the Clinic’s 2009 Medical Innovation Summit in early November.
http://www.clevelandclinic.org/innovations/summit/top10_2010.htm
UK NATIONAL HEALTH SERVICES MAY DROP NPLATE COVERAGE FOR CHRONIC ITP PATIENTS
The National Institute for Health and Clinical Excellence in the UK is leaning toward barring patient access to Nplate™ (romiplostim) through the National Health Service (NHS). While there is evidence showing that Nplate is clinically effective for adults patients with chronic ITP and has advantages over other treatments, the NHS indicated that it is just too expensive when looking at the cost-per-quality-of-life-year gained.
CORTICOSTEROID USE MAY INCREASE RISK FOR HEART ARRHYTHMIAS
Use of corticosteroids (ex. prednisone or dexamethasone) was associated with almost twice the risk for heart arrhythmias or flutter concluded researchers in Denmark after reviewing the hospital records for patients admitted with those diagnoses. Former corticosteroid use or the presence of lung or cardiovascular disease was not a factor. Corticosteroids are also associated with an increased risk of heart attacks, stroke, and heart failure.
Christiansen CF. “Glucocorticoid use and risk of atrial fibrillation or flutter: a population-based, case-control study.” Arch Intern Med. 2009 Oct 12;169 (18):1677-83.
http://www.ncbi.nlm.nih.gov/pubmed/19822824
Hospitals, Insurance, and Medical Care
ALCOHOL LINKED TO AUTOIMMUNE REACTIONS IN ALCOHOLIC LIVER DISEASE
Alcohol can trigger an inflammatory response and an autoimmune reaction that may promote the development of alcoholic liver disease. While it is unclear how alcohol triggers an immune response, the presence of antibodies and pro-inflammatory cytokines have been measured in heavy drinkers and alcohol-fed rats and are associated with an increase in liver inflammation.
Albano E. “Immune mechanisms in alcoholic liver disease,” Genes Nutr. 2009 Oct 7
http://www.ncbi.nlm.nih.gov/pubmed/19809845
RAPID FLU TEST OFTEN FAILS TO DETECT THE H1N1 VIRUS
The rapid flu test, using a sample swabbed from the nose with results available in one-half hour, did not detect the H1N1 virus in one-third of California patients hospitalized with H1N1. The rapid flu test looks for the influenza A virus but doesn’t always detect it in people who have H1N1, especially adults who may not shed as much viral material. A more definitive test for H1N1, the PCR (polymerase chain reaction) test, provides results in six to eight hours. Dr. Laurie Heim, family practice doctor, suggests it is important to “treat the patient, not the test.”
http://www.usatoday.com/news/health/2009-11-09-flurapidtests09_ST_N.htm
General Health and Medicine
ENDOCRINE DISRUPTOR BPA STILL WIDELY FOUND IN PACKAGED FOODS
Bisphenol A (BPA), a chemical found in some plastic and food-can liners, is an endocrine disruptor, linked to reproductive problems and cancer. Consumer Reports tested 19 name-brand canned foods and found BPA in nearly all of them, including some labeled “organic” or “BPA-free”. While the BPA levels found were below those considered a problem by the FDA, there have been studies that suggest the current FDA guidelines for the chemical are too high. The BPA in canned food is especially problematic for children who have multiple servings per day.
WEB SURFING BENEFITS ADULT BRAIN FUNCTION
Searching the Web triggers the centers of the brain that control decision-making and complex reasoning in older adults report researchers at the University of California after studying 24 men and women, ages 55 to 78. The study subjects showed an immediate increase in brain activity and, according to the research team, this cognitive exercise could help preserve brain health.
http://www.worldhealth.net/news/web-surfing-increases-brain-function
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