Drug (Alemtuzumab) that can reverse the effects of MS

By: Jeremy Laurance, Health Editor, The Independent
Thursday, 23 October 2008

Scientists have made a dramatic leap forward in the treatment of multiple sclerosis with the discovery of a drug that not only halts the disease but can also reverse it.

The discovery is being hailed as the biggest advance against the debilitating neurological condition for more than a decade and could prove effective against other, similar diseases. The MS Society said it was “delighted” by the results.

Scientists believe the drug, alemtuzumab, may also be effective in other conditions. Further studies are under way into its use in autoimmune conditions such as rhemumatoid arthritis, in which the immune system attacks itself, and in transplant surgery.

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Ignored: the mentally ill killed by drugs that are meant to help them

By: Nina Lakhani, The Independent
Sunday, 5 October 2008

Campaigners plan to use World Mental Health Day to highlight discrimination within the medical profession against some of its most vulnerable patients.

Daniel Galvin died of a heart attack in August. He was six stone overweight and had high blood pressure; his hair was falling out and he was incapacitated by trembling legs. He was 29.

Daniel’s family believe his symptoms, and his untimely death, were caused by side effects from the powerful psychiatric drugs he had been taking for 14 years. He is, they think, one of thousands of people with mental health problems who have died prematurely because their physical health was neglected.

Rufus May, a clinical psychologist, said yesterday: “The real tragedy about Daniel’s death is that it symbolises how little things have changed in psychiatry. Young lives are still being wasted because we fail to listen to people and simply prescribe powerful drugs with little regard for their physical well being.

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Fears over internet sales of DIY abortion pills

By: James Watson, PA, The Independent
Friday, 11 July 2008

Women living in countries where abortion is restricted – including Northern Ireland – are using the internet to buy medication enabling them to perform an abortion at home, it emerged today.

Women in more than 70 countries, including Northern Ireland, have used the internet site Women on Web to purchase the drugs for £55 a time.

Women on Web is available in five languages and offers the drugs mifepristone and misoprostol. It says a combination of the pills causes the non-surgical termination of a pregnancy and can be used up to the ninth week.

But the BBC reports a study published in the British Journal of Obstetrics and Gynaecology found that 11% of 400 customers went on to need a surgical procedure – either because the drugs had not completed the abortion or because of excessive bleeding.

Of 200 women who answered questions about their experiences, almost 60% said they were just grateful to have been able to have an abortion in this way, and 30% said it had been stressful but they found the experience acceptable.

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Rimonabant, a controversial weight-loss drug, has been approved for use in the NHS

By: Jane Kirby, PA, The Independent
Wednesday, 25 June 2008

A controversial weight-loss drug has been approved for use on the NHS, it was announced today.

Rimonabant will be made available to overweight or obese patients who cannot take, or who have had no success with, two other drugs, orlistat and sibutramine.

It comes after concerns about rimonabant’s side-effects, including suicidal thoughts and depression.

Today’s news comes after the medicines watchdog said last month that it had received 720 reports of adverse drug reactions (totalling 2,123 individual reactions) in the UK since the drug launched in 2006.

Five resulted in death (one suicide, one from infection, one sudden death from an unknown cause and two heart attacks), the data, from the Medicines and Healthcare products Regulatory Agency (MHRA), showed.

Of the total number of reactions, 974 involved psychiatric disorders, of which 48 reports involved suicidal thoughts.

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Online contraceptive pill service launched

PA, The Independent
Monday, 23 June 2008

Women will be able to get the Pill online without having to visit their doctor under a new service being launched today. The medical website DrThom is offering three months’ supply for £29.99.

The service will initially be offered to women already on the Pill but will soon be expanded to those who have never taken it before.

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Breakthrough in migraine therapy ???

By: Jeremy Laurance, Health Editor, The Independent
Wednesday, 11 June 2008

New anti-migraine drugs that have fewer side effects than existing treatments could be on the market within three years, scientists said yesterday.

They have been developed thanks to improved understanding of the mechanism that makes the brain over-react to stimuli and will usher in a new era in management of the condition, experts say.

Migraine is a hereditary illness which affects an estimated six million Britons – or 15 per cent of all adults. It is caused by an “oversensitive” brain.

One of the new drugs – a rescue treatment known only by its code MK0974 – interrupts the sequence of chemical reactions in the brain that cause a migraine at a different point from existing drugs.

Studies have shown that the brain releases the chemical calcitonin gene-related peptide (CGRP) during a migraine. Existing drugs, called triptans, block the release of the chemical. The new drug, known as a CGRP antagonist, blocks uptake of the chemical by neighbouring nerve cells.

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Antidepressants an untold story?

BMJ 2008;336:532-534 (8 March)(published 27 February 2008)
By: Jeanne Lenzer, medical investigative journalist, New York.

• New generation antidepressants aren’t all they’re cracked up to be.
• That seems to be the central message in the meta-analysis published this week by Irving Kirsch and colleagues in PLoS-Medicine, and it was this message that made the headlines.
• Kirsch’s conclusion follows on the heels of similar studies showing that statins are useful in only a small subset of patients taking the drugs and earlier studies showing that the safety and performance of cyclo-oxygenase-2 inhibitors seemed better than proved to be the case, further reinforcing previous criticisms that regulators in the United Kingdom and the United States are not doing their duty to protect the public from useless and dangerous drugs.
• But there’s another, deeper problem here—a problem that, ironically enough, was highlighted by GlaxoSmithKline’s news release stating that Kirsch’s conclusions are “incorrect” because he evaluated only a “small subset of the total data available.”
• How can regulators, the public, and doctors know how useful (or how potentially dangerous) drugs really are unless outside researchers have access to all the data?

But do we know the truth about antidepressants even now? Or statins? Or any one of many other drugs currently on the market?

• The answer to that isn’t as simple as it might seem.
• Firstly, there’s the problem of publication bias, the tendency for positive studies to get published and negative studies to be filed away in a drawer. In the case of antidepressants, a 2008 analysis by Erick Turner and colleagues published in the New England Journal of Medicine found that only 8% of antidepressant trials with negative findings were reported as negative, while positive trials were reported as such 97% of the time.
• The problem is not limited to antidepressants, says Turner. A former medical examiner for the FDA, Turner recently told the BMJ that it is critical for researchers to be able to obtain complete study protocols and full datasets to be able determine whether a study’s conclusions are valid.
• His concerns were highlighted by a 1999 study showing that in five top medical journals the authors’ conclusions as stated in journal abstracts either were not supported or were contradicted by data given in the body of the article in 18% to 68% of articles (depending on journal).

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MPs criticise influence of pharmaceutical industry on GP prescribing

Zosia Kmietowicz – BMJ News, 18 January 2008

Too many GPs are influenced by the pharmaceutical industry, says a report from the Public Accounts Committee.

And the NHS spends at least £200m more than it should on medicines because GPs do not heed official guidelines and continue to prescribe branded medicines rather than generics, says the report.

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Rapid Responses to: Doctors must not be lapdogs to drug firms

“Of course Adriane Fugh-Berman is correct that we need to bite something tender and to get out of that lap.

But we are fighting the wrong beast. The beast is not the pharmaceutical industry – it is ourselves.

We, as doctors, have created the atmosphere which has allowed companies to malfunction. We have allowed industry to subvert the rules of science . We have watched quietly as governments and academics have colluded with industry to hide information critical to our patients. We have remained silent as our medical schools have churned out graduates who have no knowledge of the dilemmas and scandals of medicine. We have allowed many of our medical journals to become corrupted and timid. We have remained silent as the General Medical Council and other bodies charged with maintaining integrity have taken action against doctors for raising questions of integrity, while ignoring serious concerns brought to their attention. We have failed to support our colleagues who have raised concerns.

The soft parts that need biting may well be our own.”

BY: Dr Aubrey Blumsohn. Consultant, Sheffield Teaching Hospitals, UK

http://www.bmj.com/cgi/eletters/333/7576/1027#149035

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Doctors as lapdogs to drug firms

Drug representatives are paid to be nice to us, as long as we cooperate, sustaining our market share of targeted drugs and limiting our continuing medical education lectures to messages that increase drug sales. This is an unspoken agreement, but no less clear for being covert.

The drug industry is happy to play the generous and genial uncle until physicians want to discuss subjects that are off limits, such as the benefits of diet or exercise, or the relationship between medicine and pharmaceutical companies. Any subject with the potential to reduce drug sales is anathema. Fair enough. He who pays the piper calls the tune.

BY: Adriane Fugh-Berman

http://www.bmj.com/cgi/content/full/333/7576/1027?ijkey=g0spTSn4hbnro4G&keytype=ref

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