Study Ties Infant Birth Weight to Mothers' Breast Cancer Risk

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Drug Widely Used to Treat MS May Not Slow Progression

HealthDay – 3 mins 47 secs ago TUESDAY, July 17 (HealthDay News) -- Interferon beta, a widely used treatment for multiple sclerosis, does not stave off the time to disability, new research finds.

However, prior studies have found that interferon beta does reduce MS flare ups, so patients should continue taking it, researchers said.

The new study is published in the July 18 issue of the Journal of the American Medical Association.

In multiple sclerosis, the body's immune system attacks myelin, or the substance that insulates nerve fibers of the central nervous system. The damage disrupts nerve signals traveling to and from the brain, which can lead to numbness, movement difficulties, blurred vision, fatigue and eventually, problems with thinking and memory.

About 85 percent of those with multiple sclerosis start with a relapsing-remitting course, in which attacks are followed by partial or total recovery, according to the National Multiple Sclerosis Society. More than half go on to develop a more progressive form of the disease, in which symptoms worsen over time and there are fewer, shorter periods without symptoms. Over time, the disease can lead to loss of vision and paralysis.

The study included data on nearly 2,700 multiple sclerosis patients from British Columbia, Canada, with relapsing-remitting MS who were followed for four to 11 years. About one-third of the patients were treated with interferon beta after it became available in the early 1990s and one-third were not treated with interferon beta. The researchers also examined data on a third group of MS patients who were diagnosed and followed before interferon beta was a treatment option.

The investigators found no statistically significant difference in how long it took for patients prescribed interferon beta to become disabled, defined as needing a cane to walk 330 feet.

"We were not able to find a significant association between interferon beta exposure and progression to disability," said Helen Tremlett, an associate professor of neurology at the University of British Columbia.

Most patients with multiple sclerosis, though not all, develop severe disability 10 to 20 years after diagnosis, according to background information in an accompanying editorial. Several studies have suggested that interferon beta, by reducing relapses, could also prolong progression to disability, Tremlett said. Still other research has found that brain scans of people taking interferon beta show less damage.

Though the exact mechanism of how interferon beta benefits multiple sclerosis patients isn't fully understood, the drug acts on the immune system and reduces inflammation.

"What the field pretty strongly believed is if you reduced relapse rate, surely that should translate into beneficial impact on disease progression," Tremlett said. "Subsequent studies seem to indicate there is disassociation between relapses and long-term irreversible disease progression."

Interferon beta is typically given by injection when people are first diagnosed.

That shouldn't change as a result of these findings, said Timothy Coetzee, chief research officer for the National MS Society. The new study doesn't negate prior studies that have found that the drugs reduce the frequency of relapses.

"If patients are taking the existing disease-modifying therapies

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FDA Approves 2nd New Weight-Loss Drug

HealthDay – 6 mins ago TUESDAY, July 17 (HealthDay News) -- For the second time in less than a month, U.S. drug regulators on Tuesday approved a new weight-loss medication.

Qsymia -- formerly dubbed Qnexa -- is a combination of the drugs phentermine and topiramate, and is manufactured by the pharmaceutical firm Vivus Inc.

"Obesity threatens the overall well being of patients and is a major public health concern," Dr. Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research, said in an agency news release issued late Tuesday. "Qsymia, used responsibly in combination with a healthy lifestyle that includes a reduced-calorie diet and exercise, provides another treatment option for chronic weight management in Americans who are obese or are overweight and have at least one weight-related comorbid condition."

The drug is approved only for the obese (people with a body-mass index, or BMI, of 30 or above) or overweight people (body mass 27 or higher) who also suffer from conditions such as hypertension, type 2 diabetes or high cholesterol. It will be available in a standard dose but also a higher dose "for select patients," the FDA said.

Last year, a study funded by Vivus found that obese patients taking Qsymia lost an average of 22 pounds over a year, while also lowering their blood pressure and cholesterol levels.

On June 27, the FDA gave its OK to another weight-loss drug, Belviq (lorcaserin), which was approved for obese adults who have high blood pressure, high cholesterol or type 2 diabetes, and is to be used in combination with a low-calorie diet and exercise.

The back-to-back approvals followed a 13-year stretch in which the FDA did not approve any new medications to help people struggling with overweight or obesity to lose unwanted and unneeded pounds.

In May, a study presented at the European Congress on Obesity in Lyon, France, found that volunteers who took Qsymia experienced substantial weight loss, even if they had many weight-related health problems. The 56-week clinical trial included 994 patients who took a placebo, 498 who took a medium dose of Qsymia, and 995 who took a high dose of the drug.

Back in February, an FDA advisory panel recommended that the agency approve Qsymia for the treatment of obesity. The advisers concluded that Vivus, based in Mountain View, Calif., had supplied enough clinical data about the drug's benefits and risks.

While effective at reducing weight, Qsymia was initially denied FDA approval in 2010 because of potential side effects, including heart palpitations and birth defects -- such as cleft lip in babies -- if taken by pregnant women.

In fact, the FDA is stressing that "Qsymia must not be used during pregnancy because it can cause harm to a fetus." The drug is also not recommended for people with either glaucoma or hyperthyroidism, and because it can boost the heart rate it should not be taken by people who have had a stroke or unstable heart disease within the past six months, the FDA said.

Qsymia also comes with a special Risk Evaluation and Mitigation Strategy (REMS), which includes an education guide for patients and providers. The drug can only be sold and dispensed by specially certified drug stores, the FDA added.

Before making its decision in February, the FDA advisers reviewed two years of data on the drug; when advisers previously voted on Qsymia, only one year's worth of follow-up data was available.

Qsymia combines the appetite suppressant phentermine (Adipex-P) and the anti-seizure/migraine medication topiramate (Topamax). Phentermine once was prescribed widely as the "phen" part of the fen-phen weight-loss drug, which was withdrawn from the market in 1997 after its use was linked to both high blood pressure in the lungs and heart valve disease. The problems were related to the "fen," or fenfluramine, part of the combination, not the phentermine, scientists said.

Belviq was also initially denied FDA approval. Manufactured by Arena Pharmaceuticals of Switzerland, the drug maker first sought approval in 2010 but was turned down because animal studies showed the drug was associated with tumor growth.

New data supplied to the FDA that allayed these fears led to the drug's approval last month.

Doctors and other health professionals agree that the best way to keep off unwanted weight is through a healthy lifestyle that includes proper nutrition and exercise. Still, the new drugs should benefit some of the estimated two-thirds of Americans who are either overweight or obese, experts said.

Samantha Heller, an exercise physiologist and clinical nutrition coordinator at the Center for Cancer Care at Griffin Hospital in Derby, Conn., told HealthDay that "obesity is often associated with alterations in endocrine function, metabolism, hormones that regulate appetite and more."

For many people struggling with weight, these disruptions in the balance of hormones and metabolism make it difficult to lose weight, she said. People may feel hungry all the time, fatigued or lethargic. Losing weight for people who are obese is rarely as simple as eating less, she added.

"People need to understand that lifestyle modifications are essential for successful weight loss, weight maintenance and fitness programs. The weight loss reported in the studies is modest and the placebo group lost weight too, indicating that ongoing lifestyle counseling and support have a positive impact with and without medication," she said.

More information

Learn more about weight-loss medications at the U.S. National Institutes of Health.

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Can a Parent's Job Raise Odds for Birth Defects in Baby?

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London 2012 breaks promise to get Britons active

Britons may be watching lots of Olympic athletes this summer but they sure aren't moving more themselves.

When London was awarded the 2012 Summer Olympics seven years ago, officials promised they would get 2 million more people physically active in time for the opening ceremonies.

But when the torch is lit July 27, the government will not only have failed, it will have backed away from its pledge entirely. Last year, the U.K. quietly dropped its aim to get 1 million more Britons into sports; the pledge to get another 1 million people more active through things like biking or walking to work has also been scrapped.

Britain's strategy was based largely on providing free school sports programs for children. While numbers grew in the first few years, they have since flat lined, according to national surveys. As the government cut spending amid Europe's debt crisis, it also slashed sports programs for adults, including free swimming for Londoners.

With a population of about 60 million, Britain is western Europe's fattest country. Soccer is wildly popular, but Britons are more likely to cheer on their favorite teams from the local pub rather than emulating them on the pitch.

Olympics secretary Jeremy Hunt said the government was looking for other ways to measure people's activity levels and insisted it was still working with local sports clubs to boost participation. A government spokesman called the original target "arbitrary."

"The Olympics do inspire people, but there is no evidence there are increased physical activity levels afterwards," said Bill Kohl, director of the physical activity epidemiology program at the University of Texas School of Public Health. "Most people realize they will never be (track star) Usain Bolt."

On Wednesday, Kohl authored a paper that labeled low levels of physical activity worldwide a "pandemic." It was published in the Lancet medical journal as part of a series on physical activity.

Another study concluded being a couch potato was as potentially lethal as smoking or being obese. Researchers estimated that a lack of physical activity causes about 1 in 10 deaths worldwide and is responsible for about 7 percent of type 2 diabetes cases and 10 percent of breast cancer and colon cancer cases.

"For the individual, it is certainly more dangerous to smoke than to be physically inactive," Kohl said. "But on a population level, the impact of physical inactivity is equal to smoking."

Critics have slammed London 2012 chairman Sebastian Coe for his failure to deliver on organizers' physical activity pledge.

"We are way off target," said Mike Weed, director of the Centre for Sport, Physical Education and Activity Research at Canterbury Christ Church University. Based on current numbers, he said the promise to get 2 million more people active wouldn't happen until about 2035.

No host country of the Olympics has ever been able to convert enthusiasm for the games into a sporty population.

Weed said elite Olympians weren't the best role models for average Britons and cited a much less athletic example: chunky London mayor Boris Johnson, who has introduced a popular bike rental system in the British capital.

"If you see somebody in Lycra at the Olympics on a 10,000-pound ($15,600) bike, that says this is not for you," Weed said. "But if you see Boris Johnson in a suit riding along on an obviously unsporty bike, the message is that if he can do it, anyone can."

___

Online:

www.lancet.com

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UNAIDS welcomes US approval of drug to stop HIV

"The UN agency tasked with fighting AIDS welcomed the decision by the United States to allow the use of Truvada, an HIV prevention pill for the first time. (AFP Photo/Justin Sullivan)" title

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Physical inactivity kills 5 million a year: report

"A third of the world's adults are physically inactive, and the couch potato lifestyle kills about five million people every year, experts said in the medical journal The Lancet on Wednesday. (AFP Photo/Chip Somodevilla)" title

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Hepatitis C Virus Levels Higher in Certain Injection Drug Users

HealthDay – Fri, Jul 13, 2012 FRIDAY, July 13 (HealthDay News) -- Among injection-drug users in the United States infected with hepatitis C, virus levels are highest among blacks, males and those who are also infected with HIV, the virus that causes AIDS, a new study finds.

A 2010 report from the U.S. Centers for Disease Control and Prevention estimates that up to 3.9 million Americans have chronic hepatitis C infection, which is a leading cause of liver cancer, end-stage liver disease and liver transplantation.

The study was published in the July issue of the journal Hepatology.

Previous research indicates that one-third of injection-drug users aged 18 to 30 -- and up to 90 percent of older users -- are infected with the hepatitis C virus. With such high rates, it's important to learn more about the characteristics of infection in this group of people, Dr. Thomas O'Brien, of the Division of Cancer Epidemiology and Genetics at the U.S. National Cancer Institute, said in a journal news release.

O'Brien also noted that hepatitis C virus levels predict treatment response in people with chronic hepatitis C.

O'Brien and colleagues looked at approximately 1,700 black, Hispanic and white injection-drug users in San Francisco. Nearly 75 percent of the participants were men. Their average age was 46 and the average age at which they first used injection drugs was 18.

"We know that the level of

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Colorado says dentist put thousands at HIV risk from reused syringes

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Scientists see AIDS vaccine within reach after decades

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German doctors seek urgent action on circumcision row

"A rabbi carries an eight-day-old baby during a 2004 circumcision ceremony in Jerusalem. German doctors are seeking an urgent clarification from the government over religious circumcision after a court ruling calling it a criminal act prompted an international outcry. (AFP Photo/Menahem Kahana)" title

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Drugs 'arsenal' could help end AIDS: WHO

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