Tuesday, May 10, 2011

Hepatitis News: New Hepatitis C Drugs Approaching Finish Line/Also DDW

New Hepatitis C Drugs Approaching Finish Line
RTTNews) - Hepatitis C, an infection of the liver, is caused by the deadly hepatitis C virus. This contagious liver disease can be either acute or chronic. Currently there is no vaccine to prevent hepatitis C. But there are approved anti-viral medications to treat hepatitis C.

The current standard treatment is a combination of pegylated interferon-alpha-2a or pegylated interferon-alpha-2b (brand names: Pegasys or PEG-Intron) given as a shot and antiviral drug ribavirin ( brand names: Copegus, Rebetol, Ribasphere, Vilona and Virazole) given in pill form, for a period of 24 or 48 weeks, depending on the hepatitis C virus genotype.


Video Report: Digestive Disease Week 2011

Here is a roundup of the latest news presented Sunday, May 8, at Digestive Disease Week 2011. Heidi Splete reports.

University of North Carolina School of Medicine
UNC research highlights at 2011 Digestive Disease Week

Digestive Disease Week (DDW) is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases, the American Gastroenterological Association (AGA) Institute, the American Society for Gastrointestinal Endoscopy and the Society for Surgery of the Alimentary Tract, DDW takes place May 7-10, at McCormick Place in Chicago, Ill. The meeting showcases approximately 5,000 abstracts and hundreds of lectures on the latest advances in GI research, medicine and technology.
The following are a selection of oral presentations given at this year's DDW by University of North Carolina at Chapel Hill School of Medicine researchers.

1. Meditation offers relief for people with irritable bowel syndrome
This first-ever randomized controlled trial of the effect of mindfulness meditation training on irritable bowel syndrome found that the behavioral technique could significantly reduce the severity of symptoms. Dr. Olafur Palsson, associate professor of medicine, division of gastroenterology and hepatology, and UNC co-investigators also found that over time mindfulness training also reduced psychological distress associated with IBS. The study was led by Susan Gaylord, PhD, director of the University of North Carolina Program on Integrative Medicine.

2. Tough economic times affect colonoscopy screening rates even among the insuredThis study sought to determine if the recent economic recession had an impact on the use of screening colonoscopy among people with health insurance. Dr. Spencer D. Dorn, assistant professor of medicine and co-investigators in the division of gastroenterology and hepatology at UNC found that it did. Colonoscopy rates decreased among insured Americans during the recession, with high out-of-pocket costs a major factor. The findings support policies aimed at reducing costs for the procedure.

3. Diets high in fiber won't protect against diverticulosisPeople whose diets are low in fiber are thought to be at greater risk for developing the diverticular disease of the large intestine than those who eat high-fiber diets. The disease, in which pouches develop in the colon wall, affects about one-third of adults over age 60 and often occurs without symptoms. But complications can be severe and resultant U.S. health expenditures very high, an estimated $2.5 billion per year. A study of more than 2,000 people reported by Anne Peery, MD, fellow in the gastroenterology and hepatology division at UNC, could change dietary recommendations regarding the problem. Rather than a decrease, Peery and co-investigators found an increased risk of diverticulosis in people whose diets are high in fiber and who have more frequent bowel movements.

Off The Cuff

A glimpse into the future of mobile-social computing

Healthy You

Even Short-Term NSAID Use Raises Death/Recurrent MI Risk

For patients with a history of myocardial infarction, any length of treatment with nonsteroidal anti-inflammatory drugs poses an unacceptably high risk for death or recurrent heart attack, based on findings from a Danish study using hospital and pharmacy registry data and published online May 9 in Circulation.
The risk elevation began during the first week of therapy and continued throughout the course of treatment, with some differences in the magnitude of risk between NSAIDs.
"These results challenge the view that NSAIDs are not harmful during short-term [1-week] treatment and indicate that a revision of current recommendations regarding NSAID treatment in patients with established cardiovascular disease is required," concluded Anne-Marie Schjerning of the department of cardiology, Copenhagen University Hospital in Gentofte, Denmark, and her coauthors. (Circulation 2011 May 9 [doi: 0.1161/CIRCULATIONAHA.110.004671]).
The significant increase in death and recurrent myocardial infarction associated with the use of NSAIDs in a study of people with a history of myocardial infarction indicates that current recommendations regarding NSAID use in patients with cardiovascular disease need to be revised, the study authors concluded.
Although international guidelines state that NSAID use should be discouraged in people with established cardiovascular disease, they say that if such use is unavoidable, the duration of NSAID treatment "should be as short as possible," the authors pointed out.
The investigators conducted the study to address the paucity of information on the association between the duration of treatment with NSAIDs and the risk of cardiovascular disease, in this population of patients. Of the 83,675 people aged 30 years and older who had had their first MI from 1997 through 2006 identified in the national registries (mean age, 68 years), 42% had received NSAIDs.
Overall, treatment with NSAIDs was associated with a 45% greater risk of death/recurrent MI during the first 7 days of treatment, which persisted and was increased by 65% over a 30- to 90-day period of treatment.
The greatest risk identified was with diclofenac (hazard ratio, 3.26; 95% confidence interval, 2.57-3.86 for death/MI at day 1-7 of treatment). Diclofenac is available over the counter in many countries, the authors noted.
A significant increase in risk was seen after 1 week of treatment with ibuprofen, in the first week of treatment with rofecoxib (which has been withdrawn from the market), and after 14-30 days with celecoxib. The risk associated with ibuprofen was lower than the risk associated with the two cyclo-oxygenase-2 (COX-2) selective inhibitors, rofecoxib and celecoxib, and it was lower than the risk associated with the use of diclofenac. There was no increased risk of death or recurrent MI associated with naproxen for the entire treatment duration, which exceeded 90 days in some cases. However, naproxen has been associated with an increased risk of GI bleeding, compared with rofecoxib, in one study, the authors noted.
The results of the study "challenge" American Heart Association recommendations regarding NSAID treatment in patients with established cardiovascular disease "because we demonstrate that even short-term NSAID treatment is associated with increased cardiovascular risk in patients with prior MI," the authors stressed.
Despite some limitations of the study, namely the observational design and the possible effects of information bias, and the need for randomized clinical studies, the investigators added: "The accumulating evidence suggests that we must limit NSAID use to the absolute minimum in patients with established cardiovascular disease."
The authors said they had no relevant financial disclosures.

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