PDSA E-News: June 30, 2014

ITP & PLATELET DISORDERS RESEARCH & TREATMENTS

Positive Results for Pediatric Study of Eltrombopag in Children with Chronic ITP

GlaxoSmithKline (GSK) announced results from the Phase III PETIT2 study that evaluated efficacy of eltrombopag (Promacta® in the U.S., Revolade® in Europe and other countries) vs. placebo in children with chronic ITP. Eltrombopag caused significant increase in platelet counts for 6 to 8 weeks in about 40% of patients treated with eltrombopag compared to those who received the placebo (3.4%). GSK reported the results at the 19th European Haematology Association (EHA) Annual Congress, June 12-15, in Milan, Italy. The children, from 12 countries, with chronic ITP had previously failed other standard therapies. No new safety concerns were observed. Eltrombopag is not approved or licensed for pediatric use anywhere in the world. GSK will continue assessing the potential of eltrombopag in child ITP patients and plans to move forward with regulatory submissions for pediatric indication in chronic ITP later this year.

GSK announces results of Phase III PETIT2 study of eltrombopag (Promacta™/Revolade™) in paediatric patients with chronic immune thrombocytopenia. Press Briefing, 19th European Haematology Association Annual Congress, Milan, Italy, June 12-15, 2014.
http://www.gsk.com/media/press-releases/2014/gsk-announces-results-of-phase-iii-petit2-study-of-eltrombopag--.html

High-Dose Dexamethasone and Eltrombopag Combo Raised Platelets in Adults with ITP

Gómez-Almaguer D, Herrera-Rojas M, Jaime-Pérez J C, Gómez-De León A,, et al. "Eltrombopag and high-dose dexamethasone as frontline treatment for newly diagnosed immune thrombocytopenia in adults." Blood. 2014, May 6.
http://www.ncbi.nlm.nih.gov/pubmed/24802773

HOSPITALS, INSURANCE & MEDICAL CARE

Emergency Rooms More Crowded Since the Affordable Care Act Took Effect in January 2014

U.S. emergency rooms are reporting increases of 10% or more in patients using emergency rooms, rather than going to primary care doctors.   A goal of the Affordable Care Act (also called Obamacare) was to reduce pressure on the nation's emergency rooms by expanding Medicaid and offering poor people better access to primary care.  Half of the ER doctors responding to an American College of Physicians survey said they have seen more ER visits since Jan. 1.  A majority expected visits to continue rising the next three years.  A major cause has been shortage of primary care doctors, with too few to handle all the newly insured patients.  Almost half of physicians do not accept Medicaid patients.    Also, poor people often cannot take time from work to get to primary care offices open only during the day while ERs operate around the clock.  Many uninsured patients are accustomed to getting care in the ER setting and haven't taken steps to find a primary care doctor.  For a number of years crowding and wait times may increase for everyone.  Average cost of an ER visit is $580 more than a trip to the doctor's office.

Ungar, L. "More patients flocking to ERs under Obamacare." The (Louisville, KY) Courier-Journal, June 8, 2014...
http://www.usatoday.com/story/news/nation/2014/06/08/more-patients-flocking-to-ers-under-obamacare/10173015/

GENERAL HEALTH & MEDICINE

Experts Urge Changes in Lifestyle Behaviors to Prevent Cancer

The World Cancer Report 2014 issued this spring by the International Agency for Research on Cancer (IACR) emphasized the need for prevention and changes in the lifestyle behaviors that lead to cancers.  These behaviors include smoking tobacco, drinking alcohol, being overweight/obese, and not exercising.  The report included contributions from more than 250 scientists worldwide and emphasized that cutting tobacco use was the single most important way to prevent many deadly cancers.  Obesity was also shown to be a modifiable risk factor for many types of cancer.  To avoid cancer, the report urged people to eat a diet high in fruit and vegetables, decrease consumption of sugar, avoid alcohol and tobacco, and increase physical activity.

Chustecka, Z. "Cancers caused by lifestyle behaviors: experts urge action."  www.medscape.com  2014, Feb. 6.

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