Teriparatide better than alendronate for treating steroid-induced osteoporosis

When it comes to treating steroid-induced osteoporosis, Teriparatide is superior to alendronate. This finding was disclosed in a recent study that was published in the November 2009 issue of Arthritis & Rheumatism, a journal of the American College of Rheumatology (ACR).

It was noted that Teriparatide, a synthetic form of the human parathyroid hormone, is effective for treating glucocorticoid-induced osteoporosis (OP).

From Sciencedaily.com:

Results show at 36 months the BMD for lumbar spine was 11% higher than baseline in the teriparatide group compared with 5.3% in the alendronate group. The BMD (teriparatide versus alendronate) for total hip was 5.2% versus 2.7% and 6.3% versus 3.4% for femoral neck. Researchers also observed fewer vertebral fractures in subjects taking teriparatide (1.7%) than those administered alendronate (7.7%). Higher levels of calcium concentrations were noted in the teriparatide group (21%) than in the alendronate group (7%).
"There is a significant number of individuals who are regularly treated with steroids to control inflammation which puts them at risk for developing osteoporosis. A need for therapies that mitigate this side-effect of steroid use and substantially improves bone mass is vital," commented Dr. Saag. The ACR estimates that diseases commonly treated with (cortico) steroids may affect more than 30 million Americans. "Our research shows that teriparatide is a safe and effective treatment for patients with steroid-induced OA and should be considered as a therapeutic option for those at high risk of bone fracture," recommended Dr. Saag.

It was noted by the involved researchers that patients with OP and treated with Teriparatide for a period of 36 months experienced greater increase in bone mineral density (BMD) and fewer new vertebral fractures than those treated with alendronate.

Book on steroids by brother brings sadness to McGwire

Mark McGwire, who was identified as one of the many baseball sluggers making use of steroids in the past, was recently saddened by hearing about a book on steroids by his brother with chronicles on use of performance enhancing drugs.

Mark said that he was upset over his brother, Jay, choosing the subject of steroids and said that reconciliation between the two brothers is just not possible.

From Sportsillustrated.CNN.com:

Last month, McGwire admitted taking steroids and human growth hormone during the 1990s, but said he only did so to recover from injuries -- not to improve his performance.

Jay McGwire says recovering from injuries was the primary reason for his brother's decision to use drugs but that Mark McGwire also knew the steroids were helping him gain size and strength.

"He had to do something to try to sell a book," Mark said. "I know the reason why I did it. I know it from the heart and I told you guys that already back in January."

Jay McGwire says in the book that he persuaded his brother to start using steroids regularly in 1994 and set him up with a supplier. He says Mark regularly used an array of drugs through 1996 that included Deca-Durabolin, human growth hormone, Dianabol, Winstrol and Primobolan. McGwire later used androstenedione, a steroid precursor that wasn't banned by baseball until 2004, when it became a controlled substance.

"I've already come out and said what I've done and apologized," Mark said. "As far as I'm concerned there's really nothing new. It's kind of sad as a brother what he's done, but I've moved on from it."

Jay McGwire, a former bodybuilder who turns 40 on May 5, said he was introduced to steroids by friends in 1989, beginning with pills of Anavar. He says his brother only gave in to using steroids after an injury-filled 1993 season.

Jay is the youngest of five McGwire brothers and his book, Mark and Me: Mark McGwire and the Truth behind Baseball's Worst-Kept Secret, is considered by many to dent Mark's image further.

Tumor progression possible of being delayed by Avastin

Treatment with Avastin is safe and effective for a subgroup of recurrent Grade 3 brain tumors, according to a retrospective study of 22 patients conducted by a researcher at the Seattle Cancer Care Alliance.

Generically known as bevacizumab, Avastin is the first approved therapy for inhibiting angiogenesis.

Angiogenesis is the process by which the new blood vessels build up and transport critical nutrients to a tumor.

From News-Medical.Net:

Chamberlain said he expects that patients treated with the drug will have a marked improvement in their quality of life because the use of steroids, a common treatment that has significant side effects, can be greatly reduced or even eliminated.
"While treatment with Avastin does dramatically improve survival time, the time that patients have left is of better quality and less about living with the disease itself," Chamberlain said. In this study, the patients, ages 24-60, received an infusion of bevacizumab every two weeks for an average of 14.5 cycles (range was two to 39 cycles). Fourteen (64 percent) patients showed a partial response to the medicine as shown on radiographic scans. Two patients had stable disease and six had progressive disease. Progression-free survival ranged from three to 18 months and survival for the entire group of patients was three to 19 months.

Marc Chamberlain, who is director of the Neuro-oncology Program at the SCCA and a professor of neurology and neurological surgery at the University of Washington School of Medicine and author of the study, remarked that Bevacizumab emerged as the most promising of all the targeted therapies for gliomas.

Toxic behavior of herbal medicines under scrutiny

A forensic pathologist from the University of Adelaide has issued a global warning about the potential fatal complications of herbal medicines if administered in large quantities, injected, or combined with prescription drugs.

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

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 individual following a combination of herbal medicines with standard drugs to optimize the effectiveness can face devastating results.

Entest BioMedical files third patent application

A third patent application was recently filed by Entest BioMedical Inc. (OTC Bulletin Board: ENTB) in concern to COPD (chronic obstructive pulmonary disease).

COPD is believed to affect more than 5 million people in the United States alone and claims around 120,000 deaths every year.

It is important to note here that a recent article "Immunologic aspects of chronic obstructive pulmonary disease" by Cosio et al in the June 4th, 2009 issue of New England Medical Journal had suggested that COPD is not just a disease of inflammation but more of an active immunological attack.

From News-Medical.Net:

"To date Entest has filed two previous patent applications covering use of fat stem cell components in COPD and methods of using photoceuticals to enhance stem cell therapy. The current patent application has a variety of derivative uses outside of COPD including treatment of transplantation rejection, and other disease in which the immune system has gone awry," stated David Koos, Entest's CEO.

The essence of the technology is the use of existing implantable devices to deliver chemical/protein signals that specifically stop inflammatory reactions in a manner that is more in tune with biological processes. Instead of us "telling the body" what it should do with a blunt-force approach, as is the standard of care, the current invention uses more natural and slow acting interventions.

Dr. Stephen Josephs, inventor of the technology, said that significance of the inflammatory process in COPD is exemplified by use of broad-acting steroids used to reduce inflammation but they can bring adverse effects.

Decline of lung function can be halted with Vitamin D

Vitamin D emerges as an effective option for slowing down the progressive decline in the ability to breathe in asthmatic people due to human airway smooth muscle (HASM) proliferation.

The finding was reported by researchers at the University of Pennsylvania. It was remarked by the researchers that calcitriol, a form of vitamin D synthesized within the body, can prove effective to reduce growth-factor-induced HASM proliferation in cells isolated from both persons with asthma and from persons without the disease.

From Sciencedaily.com:

"Calcitriol has recently earned prominence for its anti-inflammatory effects," said Gautam Damera, Ph.D., who will present the research at the American Thoracic Society's 105th International Conference in San Diego on May 20. "But our study is the first to reveal the potent role of calcitriol in inhibiting ASM proliferation."
The experiments were conducted with cells from 12 subjects, and the researchers compared calcitriol with dexmethasone, a corticosteroid prescribed widely for the treatment of asthma. Although, dexmethasone is also a powerful anti-inflammatory agent, the researchers found that it had little effect on HASM growth.
Dr. Damera and his colleagues found calcitriol inhibits HASM in a dose-dependent manner, with a maximum inhibitory effect of 60 percent ± 3 percent at 100nM.

The irreversible decline in breathing leading to vulnerable health in asthmatics is possible of being prevented or forestalled by slowing airway remodeling, as per the researchers.

Guidelines for curing hoarseness released

Guidelines for healthcare practitioners to discover and manage patients with hoarseness, also known as dysphonia, have been released by the American Academy of Otolaryngology – Head and Neck Surgery Foundation (AAO-HNSF). The guidelines will be the first-and only-national clinical practice guideline for hoarseness.

The guidelines would be stressing upon evidence-based hoarseness management by clinicians besides educating patients on the prevalence of the common vocal health complication.

From Sciencedaily.com:

Key features of the new guideline include:

* Most, but not all, hoarseness is the result of benign underlying or self-limiting factors; however, clinicians should consider the possibility of a serious underlying condition (growth or tumor of the larynx) or medication side effects as a cause.

* Laryngoscopy is an office procedure to visualize the larynx (voice box and vocal cords) that should be performed if hoarseness persists or if the cause is uncertain.

* Imaging studies, such as a CT or MRI scans, should not be obtained for a primary complaint of hoarseness prior to visualizing the larynx; laryngoscopy is the primary diagnostic modality and should be done first.

* Anti-reflux medicines should not be prescribed for hoarseness unless there are (a) signs or symptoms of gastroesophageal reflex disease (GERD), such as heartburn or regurgitation, or (b) signs of inflammation of the larynx seen during laryngoscopy.

* Steroids or antibiotics given by mouth are not recommended for hoarseness and should not be used routinely.

Richard M. Rosenfeld, MD, MPH, an author of the guideline and chair of the AAO-HNSF Guideline Development Task Force, remarked that hoarseness affects approximately 20 million people in the U.S. alone at any given time.