Medications to treat cardiovascular risk factors do not impact erectile function

Erectile dysfunction (ED) is a major public health problem. Men being treated for cardiovascular risk factors such as high blood pressure and high cholesterol are at increased risk of developing ED and often consider this condition a side effect of their medications. However, a new study into the effects of cholesterol-lowering statins and blood-pressure lowering candesartan/HCTZ concludes that these medications do not negatively affect erectile function.
Visit the Source Site

Powered by WPeMatico

Blood pressure and cholesterol lowering drugs do not negatively affect erectile function, study says

January 29, 2018

New study provides reassurance for men taking blood pressure and cholesterol modifying medications, reports the Canadian Journal of Cardiology.

Erectile dysfunction (ED) is a major public health problem. Men being treated for cardiovascular risk factors such as high blood pressure and high cholesterol are at increased risk of developing ED and often consider this condition a side effect of their medications. However, a new study into the effects of cholesterol-lowering statins and blood-pressure lowering candesartan/HCTZ concludes that these medications do not negatively affect erectile function. The study is published in the Canadian Journal of Cardiology.

“Previous research suggests that cardiovascular risk factors such as high blood pressure and cholesterol increase the risk of ED, but there has been little research examining whether modifying these risk factors can impact its development,” explained lead investigator Philip Joseph, MD, Assistant Professor of Medicine at McMaster University, Hamilton, Ontario, Canada.

Investigators evaluated the consequences of cholesterol lowering with a statin, pharmacologic blood pressure reduction, and a combination of the two, on erectile function. This was a substudy of the Heart Outcomes Prevention Evaluation – 3 (HOPE-3) randomized controlled trial, a 2×2 factorial randomized controlled trial testing candesartan/HCTZ versus placebo, rosuvastatin versus placebo, and the combination of these medications versus double placebo. Erectile function was measured using a questionnaire (the International Index of Erectile Function [IIEF] questionnaire) completed by more than 2,000 men at the beginning of the study and again at a mean follow-up of 5.8 years. The IIEF is a validated, 15-item questionnaire to assess five domains of ED over the previous four-week period.

During the study, none of the treatment groups were associated with a significant change in erectile function when compared to their respective placebo groups. Neither blood pressure lowering with candesartan/HCTZ nor cholesterol lowering with a statin showed an impact on erectile function. Importantly, taking these medications were not associated with the development of ED.

Related Stories

“This study shows that lowering these critically important cardiac risk factors using these medications has little impact on changes in erectile function,” commented Dr. Joseph. “Men who develop ED while on such medications commonly attribute their symptoms to the medications. Our findings suggest that these two medications do not negatively impact erectile function, which should be reassuring to men who are taking them.” This is an important finding, because doctors can reassure patients that their ED is almost certainly not related to these medications, which have been well-shown to prevent major complications of heart disease, and encourage them to continue to take them.

“Patients who express concern about ED should be reassured about the lack of impact with statins or the combination of angiotensin receptor blocker/thiazide,” wrote G.B. John Mancini, MD, FRCPC, FACC, Professor of Cardiology in the Department of Medicine, University of British Columbia, Canada, in an accompanying editorial. “But, perhaps more importantly, they need to be assessed more comprehensively and directed to and/or instructed in the safe use of phosphodiesterase-5 inhibitors when appropriate and when nitrates are not being used. The current study provides strong motivation for cardiologists to develop confidence and competence in the overlap between quality of life as reflected by male sexual health and reduction of cardiovascular risk.”

Erectile dysfunction (ED) affects about 40 percent of men over 50 years old and is more common in men with cardiovascular risk factors.

Source:

https://www.elsevier.com/

Visit the Source Site

Powered by WPeMatico

Rheumatoid arthritis found to worsen during and after menopause, study says

January 29, 2018

A new study published in Rheumatology identified a deteriorated physical functioning among post-menopausal women with rheumatoid arthritis.

Credit: Hriana/ Shutterstock.com

Researchers examined 8,189 women with rheumatoid arthritis and observed an increased physical decline in post-menopausal women, compared to pre-menopausal women.

Physical functioning is considered an important study aspect in patients with rheumatoid arthritis, since it affects their quality of life. Women with rheumatoid arthritis are subjected to a threefold increased risk of the disease along with increased severity and disability than men. However, the sex-based differences in the condition are still unclear.

Related Stories

Former studies have identified that women with rheumatoid arthritis suffer changes in their disease surrounding reproductive and hormonal life events like childbirth.

During pregnancy, women have decreased incidences of rheumatoid arthritis; however, they are more likely to develop the disease and flare during the post-partum period. Likewise, women who encounter early menopause are more prone to risks of rheumatoid arthritis, compared to those with normal or late menopause.

Based on these correlations between reproductive or hormonal life events and rheumatoid arthritis in women, scientists carried out an observational study to explore the link between menopause and physical functioning in women with the disease.

Further study is needed as to why women with rheumatoid arthritis are suffering a greater decline in function after menopause. Not only is this decline causing suffering for women, it is costly to both individuals and the healthcare system as a whole.

Research is specifically needed on the mechanism connecting these variables with the eventual goal of identifying interventions that can maintain or improve function in postmenopausal women with rheumatoid arthritis.”

Dr. Elizabeth Mollard, University of Nebraska medical centre

The study findings showed a significant impact of menopause on the level and rate of functional decline in women with rheumatoid arthritis. In addition, the results indicted the association of menopause with a worsening progression of the effects of the disease.

Source:

https://www.eurekalert.org/pub_releases/2018-01/oupu-mft012618.php

Visit the Source Site

Powered by WPeMatico

Trump wants U.S. Health Secretary to get tough on drug prices, opioids

WASHINGTON (Reuters) – President Donald Trump on Monday charged the new U.S. health secretary with bringing down drug prices and to be tough on pharmaceutical companies about the widespread abuse of prescription opiates.

“He’s going to get those prescription drug prices way down,” said Trump at a swearing-in ceremony for Health and Human Services Secretary Alex Azar, adding that Azar would be “very tough” on drug companies and doctors about prescribing opioids.

Reporting by Lisa Lambert and Steve Holland

Our Standards:The Thomson Reuters Trust Principles.

Visit the Source Site

Powered by WPeMatico

Takeda’s Zika vaccine gets U.S. FDA’s ‘fast track’ status

(Reuters) – Japan’s Takeda Pharmaceutical Co Ltd said on Monday the U.S. Food and Drug Administration had granted ‘fast track’ status to its vaccine for the mosquito-borne Zika virus, which erupted as a major public hazard in Brazil three years ago.

The drug, TAK-426, is currently being tested on 240 patients between the ages of 18 and 49 and is in early stages of development.

The virus might be responsible for an increase in birth defects in the United States and its territories, the U.S. Centers for Disease Control and Prevention said in a report last week.

The Zika outbreak was declared an international public health emergency by the World Health Organization in 2016 due to linkages found between the virus and severe birth defects.

The FDA’s ‘fast track’ designation aims to facilitate the development and expedite the review process for certain drugs and vaccines for serious conditions with unmet medical need.

Reporting by Divya Grover in Bengaluru; Editing by Maju Samuel

Our Standards:The Thomson Reuters Trust Principles.

Visit the Source Site

Powered by WPeMatico

Women with rheumatoid arthritis suffer greater decline in physical function after menopause

January 29, 2018

A recent study published in Rheumatology suggests that women with rheumatoid arthritis suffer a greater decline in physical function following menopause. After studying 8189 women with rheumatoid arthritis, researchers found that pre-menopausal women experienced a slower physical decline than those that were post-menopausal.

Physical function is an important aspect of study in patients with rheumatoid arthritis as it impacts their quality of life. Women experience rheumatoid arthritis at a rate three times greater than men, and also have more severe decline and increased disability, yet the sex-based differences in the condition remain poorly understood.

Related Stories

Previous studies have shown that women with rheumatoid arthritis experience shifts in their disease surrounding reproductive and hormonal life events, such as childbirth. During pregnancy, women have decreased incidence of rheumatoid arthritis, yet they have an increased incidence of disease development and flare during the post-partum period. Similarly, women who experience early menopause are more likely to develop rheumatoid arthritis compared to those who experience normal or late menopause.

Given these connections between hormonal or reproductive life events and rheumatoid arthritis in women, researchers conducted an observational study to investigate the association of menopause with functional status in women with the disease. The results indicate that menopause has a significant impact on the level and rate of functional decline in women with rheumatoid arthritis and is associated with a worsening progression of the effects of the disease.

“Further study is needed as to why women with rheumatoid arthritis are suffering a greater decline in function after menopause,” said the paper’s lead author, Elizabeth Mollard. “Not only is this decline causing suffering for women, it is costly to both individuals and the healthcare system as a whole. Research is specifically needed on the mechanism connecting these variables with the eventual goal of identifying interventions that can maintain or improve function in postmenopausal women with rheumatoid arthritis.”

Source:

https://global.oup.com/academic/

Visit the Source Site

Powered by WPeMatico

Arizona governor signs opioid crackdown legislation

PHOENIX (Reuters) – Arizona Republican Governor Doug Ducey on Friday signed into law legislation intended to crack down on opioid abuse, calling it vital to combat an epidemic felt statewide and across the nation.

“We’ve all heard the first person stories of individuals who have been impacted,” Ducey said at a signing ceremony. “But there are so many other stories we haven’t heard because the individuals impacted didn’t survive. This bill is for them.”

The legislation includes new regulations that will limit initial opioid prescriptions to five days and set a maximum of 30 days for certain patients receiving highly addictive painkillers.

State officials blame opioids for more than 800 overdose deaths in Arizona since June.

Other measures call for $10 million to be spent treating opioid abusers who are underinsured and ineligible for Medicaid. A controversial provision holds harmless those reporting potential overdoses.

Ducey called the package a comprehensive model for other states looking to address what has become a nationwide crisis.

The plan was unanimously approved by state lawmakers late on Thursday, in a rare bi-partisan manner, after Ducey called legislators into special session on Monday.

The final measure was nearly identical to one proposed by the governor, who has made opioid abuse and overdoses a focus of his administration. Last June, Ducey declared opioids a public health emergency and asked state health officials to study ways to address the problem.

Despite the unanimous final vote, some lawmakers raised concerns about the unintended consequences of the state becoming more involved in doctor-patient issues, fearing it may hurt individuals needing opioids.

Also at issue was the impact of a so-called Good Samaritan law that will grant immunity to people who call 911 to report a potential overdose.

Arizona’s effort is the latest in a multi-pronged attack nationwide to combat a problem that claimed more than 42,000 lives in 2016, according to U.S. Centers for Disease Control and Prevention figures.

In a flurry of lawsuits, drug makers have been accused by U.S. governments of pushing addictive painkillers through deceptive marketing and wholesale distributors of failing to report suspicious drug orders.

A multi-state investigation by attorneys general was launched to determine whether companies that manufacture and distribute prescription opioids have engaged in unlawful practices.

New York City on Tuesday joined the battle, filing suit against eight companies that make or distribute prescription opioids, blaming them for fueling a deadly epidemic afflicting the city.

Reporting by David Schwartz in Phoenix; Editing by Dan Whitcomb and Tom Brown

Our Standards:The Thomson Reuters Trust Principles.

Visit the Source Site

Powered by WPeMatico

Roche hemophilia drug lowers costs despite high price: ICER

(Reuters) – A costly new Roche Holding AG drug to treat the bleeding disorder hemophilia A could significantly reduce healthcare expenses for certain patients, a draft report from an independent U.S. nonprofit organization that evaluates clinical and cost effectiveness of new medicines said on Friday.

The drug, Hemlibra, or emicizumab, was approved by the Food and Drug Administration in November as a once-weekly injection for adults and pediatric patients with hemophilia A who have developed inhibitors, or resistance, to other treatments. Roche’s medicine is required to carry a black box warning, the most serious, about the risk of blood clots.

The Institute for Clinical and Economic Review (ICER) found that, for such patients aged 12 years and older, emicizumab at current wholesale prices would reduce spending by around $1.85 million per patient annually. In patients under 12 years of age, emicizumab would reduce costs by about $720,000 per patient annually.

Hemophilia is a rare bleeding disorder in which a clotting protein is missing or does not function normally. Roche plans to charge about $482,000 for the first year of treatment and $448,000 a year after that.

To avoid joint damage and other complications, patients with severe hemophilia need regular infusions of very expensive clotting factors. About 25 percent of people with severe hemophilia A develop factor antibodies, called inhibitors, at some point, making it difficult to control bleeding without very high doses of clotting factors or other expensive treatments known as bypassing agents.

Hemlibra is an antibody designed to activate the natural coagulation cascade and restore the blood clotting process for hemophilia A.

ICER noted in its analysis that hemophilia is a lifelong disease that creates substantial burdens for patients.

Reporting By Deena Beasley; Editing by Cynthia Osterman

Our Standards:The Thomson Reuters Trust Principles.

Visit the Source Site

Powered by WPeMatico

Another Alzheimer’s Drug Fails: What Makes This Disease So Tough to Fight?

News Picture: Another Alzheimer's Drug Fails: What Makes This Disease So Tough to Fight?By Dennis Thompson
HealthDay Reporter

Latest Alzheimers News

THURSDAY, Jan. 25, 2018 (HealthDay News) — As more experimental drugs fail to stop Alzheimer’s from destroying human memory, experts now wonder whether research into the devastating brain disease has been marching in the wrong direction.

In recent weeks, a pair of high-profile disappointments have been reported, including one just announced on a trial of the Eli Lily drug solanezumab.

Now, researchers are trying to figure out what might have been missed in the search for an Alzheimer’s cure.

Did errors occur in the clinical trials of these drugs, creating the failure of potentially promising therapies? Or has there been a fundamental misunderstanding of the complex nature of Alzheimer’s disease?

Until now, research has focused mainly on treating or preventing Alzheimer’s by attacking the clumps of amyloid beta protein that form in patients’ brains, potentially blocking signals sent between brain synapses. Amyloid plaques are one of the hallmarks of the disease.

“The overriding hypothesis for many years has been the amyloid hypothesis — the idea if you can stop, slow or clear the formation of amyloid plaques from the brain you will be able to treat the disease and see marked improvements in cognition,” said James Hendrix, director of global science initiatives for the Alzheimer’s Association. “So far, that hasn’t worked out.”

Solanezumab binds with amyloid beta, and was intended to help the body flush the protein out of the brain before it could form damaging plaques.

But the drug failed to significantly slow thinking declines, Columbia University researchers reported in the Jan. 25 issue of the New England Journal of Medicine.

Those results came on the heels of a trio of failed trials of the drug idalopirdine, which was intended to help treat Alzheimer’s by promoting production of serotonin and other essential brain chemicals. A team of researchers reported in the Journal of the American Medical Association earlier this month that the drug failed to improve thinking or memory in Alzheimer’s patients.

Are amyloid plaques the wrong target?

During the past decade, Alzheimer’s research has focused on amyloid plaques out of financial necessity, Hendrix explained.

“Ten years ago, there was very little funding for Alzheimer’s disease,” Hendrix said. “When you don’t have a lot money for funding, you tend to go for the most obvious approach, and that was amyloid.”

But one early hurdle may have tripped up many of the long-term clinical trials that are now coming to fruition, said Dr. Ronald Petersen, director of the Mayo Clinic Alzheimer’s Disease Research Center in Rochester, Minn.

Back then, there was no way to tell whether a person diagnosed with Alzheimer’s disease actually had amyloid plaques in their brains. These plaques could only be observed during an autopsy.

Scientists now can see amyloid in the brain thanks to PET, an imaging technology that observes metabolic processes in the body. As a result, scientists have learned that about a third of people who appear to have Alzheimer’s disease do not have high levels of amyloid in their brains, Hendrix said.

“If 30 percent of the people in your anti-amyloid clinical trial don’t have amyloid in their brain, right off the bat your trial is probably going to fail because 30 percent of the people aren’t going to respond to your therapeutic,” he said.

The basic assumption that removing amyloid will automatically lead to an improvement in Alzheimer’s patients needs to be re-evaluated, said Michael Murphy, an associate professor with the University of Kentucky’s Sanders-Brown Center on Aging.

Although the genetic evidence has been convincing that amyloid drives the disease, that doesn’t mean that removing the protein from people already in the throes of Alzheimer’s is going to help them, Murphy said.

“I think really it might be fairer to think that what happens is amyloid pathology is more like a trigger in the disease,” he said.

“Once you get that thing going, you can think about it almost like a freight train. You get this going, and it’s awfully hard to stop,” Murphy said. “You might have removed the trigger, but once you remove the trigger you haven’t dealt with the consequences of the events that have been set into motion.”

Other factors at play in Alzheimer’s

Seniors’ brains also are vulnerable to other problems of aging known to contribute to Alzheimer’s and dementia, such as high cholesterol and elevated blood pressure, Murphy said.

So researchers have started thinking that any successful treatment for Alzheimer’s will resemble the “cure” that HIV patients are given — a multi-pronged drug and lifestyle regimen that keeps their illness at bay.

“I think that five to eight years from now, you’ll have someone who’s just a little memory-impaired at age 75, you do an array of biomarker tests on them to see what’s contributing to their cognitive decline,” Petersen said. “Then you develop therapies that are targeting those individual components.”

Funding for Alzheimer’s research has improved during the past decade, and so money is now available to tackle a number of factors that likely contribute to the disease, Hendrix said.

For example, another hallmark of Alzheimer’s is tangles of Tau protein, which also show up in the brains of football players with chronic traumatic encephalopathy (CTE), Hendrix noted.

“An interesting thing we’re learning from Tau PET imaging is that Tau shows up very close to when symptoms occur. That makes it a tantalizing drug candidate as well,” Hendrix said.

Inflammation of the neurons also plays a role in Alzheimer’s, leading some researchers to study that, he said.

And yet others are investigating the way the brain uses energy.

“The brain is about 3 percent of our body weight, but it uses about 23 percent of our body’s energy,” Hendrix said. “If the brain isn’t processing energy efficiently, it could be reasoned we start to decline. If we can tweak the way our brains are processing energy, then maybe we can have an impact on the disease.

“If we can just run out the clock on Alzheimer’s disease and slow it down enough that we die of something else with our memories intact, that looks like a cure to me,” he said.

MedicalNews
Copyright © 2018 HealthDay. All rights reserved.

SOURCES: James Hendrix, Ph.D., director, global science initiatives, Alzheimer’s Association; Ronald Petersen, M.D., Ph.D., director, Mayo Clinic Alzheimer’s Disease Research Center, Rochester, Minn.; Michael Murphy, Ph.D., associate professor, University of Kentucky’s Sanders-Brown Center on Aging; Jan. 25, 2018, New England Journal of Medicine; Jan. 9, 2018, Journal of the American Medical Association

Visit the Source Site

Powered by WPeMatico