Drug for Anemics Disappointing
A drug designed to prevent the potentially fatal accumulation of iron in people who need repeated blood transfusions may not work as well as it should, doctors warn in Thursday’s New England Journal of Medicine. The drug is deferiprone, made by Apotex Inc. of Weston, Canada. It has been approved for use in India but is still regarded as experimental in the United States and many other countries.
The multinational team of researchers said they have discontinued deferiprone therapy in all patients including those for whom conventional treatment does not work.
The drug was given to people with thalassemia major, an inherited form of anemia that is extremely serious. It is treated with blood transfusions that, as a side effect, cause iron to accumulate in the body. The excess iron can lead to heart and liver damage.
For years, doctors have used the drug deferoxamine to pull the iron from the body. Unfortunately, deferoxamine, sold under the brand name Desferal by Novartis Pharmaceuticals Corp., must be injected into the body over a 12-hour period, four to six days a week, which limits its usefulness. It can also produce hearing loss, kidney and lung problems, growth retardation and nerve problems.
Deferiprone appeared to be an attractive alternative because it could be given orally. But in tests on 18 volunteers with thalassemia major, who took the drug for about five years, the researchers found that seven still had unhealthy concentrations of iron.
Sleep Apnea Sufferers More Prone to Strokes
People who suffer from obstructive sleep apnea, a condition that affects as many as 18 million Americans, have nearly 10 times the normal risk of suffering a stroke, UCLA researchers report in the August Journal of Oral and Maxillofacial Surgery. “When persons with sleep apnea fall asleep, their tongue falls back into their throat, blocking their airway,” said Dr. Arthur H. Friedlander of UCLA and the Sepulveda VA Medical Center. “As they struggle for breath, their blood pressure soars,” increasing stroke risk.
To test the hypothesis, Friedlander’s group took X-rays of the necks of 47 male veterans with sleep apnea and compared them to 891 control subjects. They found that 21% of those with sleep apnea had calcified plaques blocking their carotid arteries--a strong indicator of stroke risk--compared to only 2.5% of those in the control group.
Birth Control Pill Puts New Moms at Risk for Diabetes
A birth control pill often prescribed to breast-feeding mothers puts them at a higher risk of developing chronic, noninsulin dependent (type 2) diabetes, according to a report in Tuesday’s Journal of the American Medical Assn. “It appears that progestin-only oral contraceptives increase risk by nearly threefold,” said Dr. Siri Kjos of USC. He warned against prescribing the progestin-only “mini-pill” to mothers with a history of developing diabetes during pregnancy.
This pill typically is prescribed to breast-feeding mothers because it doesn’t interfere with milk production.
USC researchers followed 904 women who developed gestational diabetes mellitus during pregnancy, a condition that went away after they delivered. “We found that the longer a woman used the progestin-only oral contraceptive, the higher her risk of later getting diabetes,” Kjos said.
When School’s Out, Kids Remove Their Thinking Caps
Young children learn faster while at school and tend to stagnate intellectually during summer vacation, a finding that researchers argued points to nurture, not nature, as the key determinant of achievement. “The study shows a substantial connection between the environment and intellectual growth in ways that have not been revealed by other studies,” commented study author Janellen Huttenlocher, a psychologist at the University of Chicago.
Children in kindergarten and first grade were tested four times, six months apart, in four categories of intelligence. The children came from public, private and parochial schools from throughout the United States, with sample sizes ranging from 1,652 to 2,387 students. The researchers tested the children in the categories of language; spatial operations, such as reading maps and charts; concepts, such as how objects are related; and memory.
Of particular concern was evaluating growth in language and spatial skills to test the view of many child development experts who believe these areas reflect innate ability rather than the environmental influence.
They reported in the August issue of Child Development that, regardless of the students’ backgrounds or schools, there was a slowing in the rate of growth in learning abilities during the months from April to October, when the children were generally out of school. In the area of language and development of syntax, or sentence structure, the children’s growth slowed markedly during the vacation period compared with the school year.
New Heart Drug Reduced Deaths Among Patients
An international study of heart patients has found that a newly approved drug, called eptifibatide, trade named Integrilin, can reduce the rate of heart attacks and death during the critical month following hospitalization for unstable angina, also known as “acute coronary syndrome.” As many as 35,000 Americans annually suffer from this condition, which occurs when blood clots form around ruptured bits of plaque in the arteries, reducing blood flow to the heart. The condition causes chest pains and, if untreated, can lead to heart attacks and death.
A team led by Dr. Robert Harrington of Duke University studied 10,948 patients in 27 countries. They reported in Thursday’s New England Journal of Medicine that the drug reduced heart attacks and deaths by 3.5% in the United States and by 1.5% worldwide. The team speculated that the geographic differences were due to widely divergent clinical practices among countries and to differences in patient populations.
*
--Compiled by THOMAS H. MAUGH II
