A drug presently used for treating cancer patients could be used to treat patients with lupus and suffering from complications of the central nervous system, as per rheumatologists at the Annual European Congress of Rheumatology in Vienna, Austria.

The drug, Rituximab, is effective to provide relief to patients afflicted with lupus and could be considered as a gentle form of treatment that can last up to a period of six months with little to no side effects, according to Clinical professor Michael Neuwelt, at the University of California San Francisco and Stanford University.

From News-Medical.Net:

Professor Neuwelt specialises in diagnosing and treating patients with CNS lupus. “It can be difficult to disentangle psychiatric disorders that arise from other causes,” he states. In a portion of patients, depression, seizures, verbal comprehension, perception and memory will be associated with lupus. People are understandably afraid to admit that their IQ has gone down or that they cannot read any more in fear of losing their job,” he continued. A careful history, ruling out other causes such as infection and drug side effects has improved diagnostic accuracy.

Professor Neuwelt, like others using this well-tested oncological drug in other forms of lupus, is concerned about the depletion of the B cells by rituximab for the long term. However, the risk/benefit ratio from this new treatment in its early stages is extremely promising. “It is the first drug in my 26 years of treating patients with severe central nervous system lupus, used alone or in combination with other therapies that has not only significantly boosted the quality of life for patients with this dreadful disease, but also reduced the burden of side effects of standard treatment with steroids and cyclophosphamide. However, we desperately need randomized-controlled trials.” he concluded.

Lupus is a health complication characterized by reduced quality of life and symptoms such as pain, inflammation, and diffused damage to many body organs.

Tags: lupus, rituximab, steroids

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Random drug testing has been instituted beyond sanctions by a high proportion of public school districts as set by the U.S. Supreme Court on their high school students, as per a study led by the Pacific Institute for Research and Evaluation (PIRE).

Dr. Chris Ringwalt, Senior Research Scientist at PIRE said that he believed that the study will have implications to monitor the happening of random drug testing for preventing the use of steroids in sports and schools in the coming times.

From News-Medical.Net:

Nearly all school districts that implemented random drug testing procedures subjected their athletes to the possibility of being tested, and two-thirds randomly tested high school students who participated in other extracurricular activities. More than a quarter of the districts that implemented random drug testing subjected all their high school students to the possibility of being tested.

The Supreme Court ruled in 1995 that testing student athletes for drugs is constitutional, even in the absence of any suspicion of substance use. In a subsequent case, the Court extended its ruling to include students participating in extracurricular activities.

“Random student drug testing will likely continue to be controversial and the practice is likely to be contested, just as we saw with the recent ruling by the Washington State Supreme Court,” said Dr. Chris Ringwalt, Senior Research Scientist at PIRE. The Washington State Supreme Court ruled on March 13, 2008, based on a lawsuit that student athletes brought against a local school district, that random drug testing of student athletes is not allowed under the state’s constitution, despite the U.S. Supreme Court’s 1995 ruling (Supreme Court of the State of Washington. York v. Wahkiakum School District No. 200. Docket No: 99-2-00075-6, March 13, 2008).

It is worth nothing here that more and more young people are using anabolic steroids to buildup solid muscles and enhance performance levels.

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Individuals using injectable growth hormone (GH) for buildup of solid muscles or improve physical performance do not find any benefit, as per a dissertation from the Sahlgrenska Academy at Göteborg University in Sweden.

Dr. Christer Ehrnborg remarked that there is an instant effect when growth hormone is injected into the body and sportsmen perceive this effect to be good enough to enhance performance but that’s not the case.

From News-Medical.Net:

“Many of those who abuse anabolic steroids regard growth hormone as the Rolls Royce of doping agents: it is significantly more expensive to use than anabolic steroids. There is, however, no scientific evidence that it increases performance when used alone as a doping agent”, says Dr. Christer Ehrnborg.

Christer Ehrnborg has studied 30 well-trained people living in Göteborg. Twenty of these injected large doses of growth hormone each day for a month, while the other 10 believed that they also were receiving growth hormone but received injections of harmless saline solution instead. Tests of the participants’ physical performance on an exercise cycle showed that the participants receiving growth hormone did not perform better than those receiving saline solution.

“It has been a matter of controversy whether growth hormone actually causes an effect or whether it is a matter involving mass psychology. Both our study and studies carried out by others suggest that taking growth hormone will not make you a better athlete”, says Christer Ehrnborg.

It is worth noting here that use of GH does not bring the same benefits as that from use of anabolic steroids. Moreover, GH abuse can lead to fatal side effects such as damage to the heart and blood vessels.

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According to a government audit, more than half of all adults in the United States, or at least 14 million people, make use of dietary supplements like herbs, diet pills, vitamin pills, and energy drinks.

But the FDA doesn’t have enough control to ensure that these products are safe and more oversight power is required to put things in the right place.

From NYTimes.com:

Although the G.A.O. cannot compel the drug regulators to act, an F.D.A. spokeswoman said her agency welcomed the report as a way of “calling attention to the challenges that the agency faces with respect to regulating dietary supplements.”

The audit of dietary supplements was commissioned by several members of Congress, including Representative Henry A. Waxman, a Democrat of California who has been investigating the safety of certain prescription drugs as chairman of the House Committee on Energy and Commerce.

The market for dietary supplements is growing. Americans spent an estimated $25 billion on such products last year — up from about $23.7 billion in 2007 — according to Nutrition Business Journal, which covers the industry.

The F.D.A. currently regulates dietary supplements as ingestible nonfood substances, but it does not have the same authority over the products as it does with drugs. The agency, for example, lacks basic information about the supplement industry: although dietary supplement makers are required to register with the F.D.A. as food manufacturers, they do not have to identify themselves as makers of specific supplements or supply the agency with product information, the report said.

The new report from the Federal Government Accountability Office acknowledged that the FDA had indeed taken some steps in the past few years for supervising the supplement industry more closely, but those steps didn’t go far enough.

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A football program was suspended by a leading Canadian University after nine players were found violating anti-doping policy during a special investigation.

The University of Waterloo in Ontario placed coaches of the team on paid leave besides canceling football for the coming season while it conducts a review.

From NYTimes.com:

The university called in the Canadian Centre for Ethics in Sport, the country’s antidoping agency, in March after the police charged a football player, Nathan Zettler, with trafficking a wide array of anabolic steroids as well as human growth hormone and tamoxifen, a breast cancer treatment often used to offset undesirable effects of steroids.

College football in Canada, though not as popular as it is in the United States, is the only college sport in Canada that serves as a training ground for a professional league, the Canadian Football League.

The C.F.L. is negotiating its first antidoping program with its players.

Copeland said the large number of positive results from the testing of the entire team suggested that Canada’s regular drug-testing program for university athletes can be easily evaded.

Bob Copeland, the university’s director of athletics, remarked that he was surprised and disappointed at the same time and considers this as a wake-up call for people across Canada.

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Black teenagers are more likely to develop steroid-resistant asthma than their white counterparts, according to a research conducted at the National Jewish Medical and Research Center.

It was disclosed in the study that black asthmatic teens are more likely to be sick and suffer from a higher mortality rate than white teens with asthma.

From News.Bio-Medicine.Org:

“Our results suggest that children with steroid-resistant asthma are more likely to be African-American, to have required treatment with oral steroids at an earlier age and to require larger amounts of oral steroids for only marginal control of their asthma,” said Joseph Spahn, M.D., a pediatric allergist and director of the Immunopharmacology Lab at National Jewish.

Other recent epidemiological studies have shown that blacks with asthma are sicker and have a higher mortality rate than whites with asthma. Doctors at National Jewish now are trying to determine whether blacks have a more vigorous immune response to airway inflammation–which means that higher doses of steroids must be used to control inflammation–or a poor response to steroids secondary to a genetic resistance to the drugs.

“The theory is that with ongoing airway inflammation you get worsening asthma and diminished steroid sensitivity,” Dr. Spahn said.

This study of 164 teen-agers treated at National Jewish also showed that 25 percent of the group was steroid resistant. Children with less than a 15 percent improvement in lung function following a “burst” of inhaled steroids–high doses over seven days–were considered steroid resistant.

“Twenty-five percent of the kids admitted to National Jewish have steroid-resistant asthma, which is much greater than anyone thought,” Dr. Spahn said.

African-American children are prone to steroid-resistant asthma, according to Joseph Spahn, M.D., a pediatric allergist and director of the Immunopharmacology Lab at National Jewish.

The study was published in the Journal of Allergy and Clinical Immunology.

Tags: Asthma, Inhaled steroids, Oral Steroids, steroid

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Once-a-day dose of Pirfenidone could prove effective for patients struggling with idiopathic pulmonary fibrosis (IPF), according to researchers from Japan.

Daily doses of the drug can be useful to slowdown progression of idiopathic pulmonary fibrosis and reducing the loss of lung capacity, as per the Phase III, double-blind, placebo-controlled clinical trial.

From News-Medical.Net:

“The most common treatment for IPF is anti-inflammatory agents such as steroids,” said lead researcher Takashi Ogura, M.D., of Kanagawa Cardiovascular and Respiratory Center in Yokohama, Japan. “However our study confirmed that pirfenidone, the main action of which is thought to be antifibrotic, achieved a therapeutic effect on IPF. I expect that our study will serve as a guide to develop a new therapy for IPF in the future.”

The researchers recruited a total of 275 Japanese patients with mild to moderate IPF and randomized them to a high dose pirfenidone (1,800 mg/day) group, a low dose pirfenidone group (1,200 mg/day) and a placebo group. They measured lung capacity (vital capacity or VC) and progression-free survival, defined as a period without death or a greater than 10 percent decrease in VC, to determine the effectiveness of the regimens.

At the end of one year, they found that patients who had been randomized to the high dose regimen had significantly lower loss of VC than the placebo group. Furthermore, pirfenidone slowed the overall deterioration of IPF compared to the placebo.

“Taken altogether, our study demonstrated positive clinical effects of pirfenidone that suppresses the progress of IPF and potentially contributes to improving the outcomes of patients with IPF,” said Dr. Ogura.

Results of the trial were presented at the American Thoracic Society’s International Conference in Toronto.

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In a bid to highlight the dangers of purchasing drugs online, Operation Pangea II was coordinated by INTERPOL and the World Health Organization’s International Medical Products Anti-Counterfeiting Taskforce (IMPACT). This joint operation was exercised to curb the supply of dangerous and illegal medicines.

The global initiative, lasting for a week, was marked by a series of arrests and seizure of thousands of potentially harmful medical products.

From News-Medical.Net:

During the operation, Internet monitoring revealed 751 websites engaged in illegal activity, including offering controlled or prescription only drugs, 72 of which have now been taken down. In addition, more than 16,000 packages were inspected by regulators and customs, 995 packages were seized and nearly 167,000 illicit and counterfeit pills – including antibiotics, steroids and slimming pills, confiscated.

Twenty-two individuals are currently under investigation for a range of crimes including illegally selling and supplying unlicensed or prescription-only medicines.

“As the very positive results of this global effort are made public, INTERPOL and its member countries will prove again that the Internet is not an anonymous safe haven for those who use it for criminal purposes. We hope that by raising public awareness about the dangers of illegal internet pharmacies, consumers will exercise greater care when purchasing medicines on the Internet,” added Secretary General Noble.

“Our thanks go to the police, customs and regulatory officials in the 24 participating countries as well as to our partner international organizations such as the World Health Organization’s IMPACT, the World Customs Organization and Universal Postal Union whose tireless efforts and dedication have made Operation Pangea II such a success,” Noble concluded.

The operation received significant support from the Permanent Forum on International Pharmaceutical Crime (PFIPC) the World Customs Organization, the UK’s Medicines and Health Care products Regulatory Agency (MHRA), the US Food and Drug Administration (FDA) and Immigration and Customs Enforcement (ICE), the Royal Canadian Mounted Police, and Health Canada.

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A forensic pathologist from the University of Adelaide has sounded a worldwide warning about potential fatal conditions that may get associated with herbal medicines when taken in large quantities, combined with prescription drugs, or injected.

In a paper by Professor Roger Byard that was published in the US-based Journal of Forensic Sciences, the highly toxic behavior of herbal medicines, most of which were considered to be safe by many, was outlined.

From News-Medical.Net:

In his paper he cites the case of an epileptic patient on prescription medicine who had also ingested a Chinese herbal preparation and lapsed into a coma. Cushing syndrome, a hormonal disorder, has also been linked to the ingestion of steroids and herbal cures mixed together.

Some herbal medicines may also have a variety of effects on standard drugs, according to Professor Byard. St John’s Wort can reduce the effects of warfarin and cause intermenstrual bleeding in women taking the oral contraceptive pill.

Gingko and garlic also increase the risk of bleeding with anticoagulants and certain herbal remedies such as Borage Oil and Evening Primrose Oil lower the seizure threshold in epileptics.

Professor Byard says the American Society of Anesthesiologists has recommended its patients discontinue using herbal medicines at least two weeks before surgery because of the risks of herbal and drug interaction, including an increased chance of hemorrhaging.

It was remarked by Professor Byard that individuals combining herbal medicines with standard drugs for optimizing efficacy may face devastating results.

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The manner in which genes are expressed in rodents is affected by intermittent signaling by steroid hormones, according to a research by scientists at the University of Bristol and the National Cancer Institute (NCI), USA.

The research appeared online and appeared in the September 2009 issue of Nature Cell Biology.

From News-Medical.Net:

In this new study, the researchers demonstrate that ultradian hormone stimulation induces the pulsed expression of genes (known as gene pulsing) over the same period, both in cultured cells and in animal models. Initially, the researchers administered corticosterone, a naturally occurring glucocorticoid hormone in rodents, in a pulsed manner to cultured mouse cells and then observed that the levels of newly synthesized RNA from glucocorticoid receptor-regulated genes tracked precisely with the hormone pulses.

The reported research results argue that gene pulsing regulated by glucocorticoid receptors is directly linked to varying levels of gene activity. Professor Stafford Lightman, head of the Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, at the University of Bristol, said: “We have previously shown that the hormone cortisol is released in pulses in man as well as rodents. The present results now show that this pattern of hormone release is critical for good health and provides a novel concept for new drug design.”

The finding is expected to have implications for understanding how steroids work and can help in opening up novel avenues for development of new therapies.

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