Women taking highly effective once-monthly oral Bonviva(R) (ibandronic acid) for postmenopausal osteoporosis were more likely to stay on treatment during the first six months relative to those on a weekly bisphosphonate (alendronate or risedronate) according to findings presented today at the 28th Annual Meeting of the American Society for Bone Mineral Research (ASBMR)1.
The ongoing real-life study, conducted by Silverman and colleagues at Cedars-Sinai/ University of California, Los Angeles, US, was based on two managed care databases called HealthCore and i3 Innovus, which include prescription and health information on approximately 17.5 and 16 million lives respectively. These two analyses assessed the actual time patients stayed on treatment and were controlled for factors that could affect persistence, including age, other medical conditions, and out-of-pocket costs for the medications,1 as recommended by leading health and pharmacoeconomic research organisations. [ISPOR and WHO 2003] It showed that women taking Bonviva were approximately 25% more like to keep taking their pills relative to those on a weekly bisphosphonate.
Growing wealth of evidence demonstrates important role of once monthly Bonviva in helping patients stay on treatment
The results of the study are consistent with previous findings linking the once-monthly oral Bonviva treatment programme with improved persistence in a real-life setting.2 Furthermore, patients have also stated a clear preference (71%) for the once-monthly oral Bonviva regimen 3,4 over a weekly treatment regimen in clinical trials. Further information presented at ASBMR indicates that the convenience of once-monthly dosing and the reduced exposure to the potential gastrointestinal side effects associated with bisphosphonate therapy, are the main reasons for this preference.5
With up to 69% of new patients on a weekly bisphosphonate stopping within a year, 6 this growing wealth of evidence suggests that monthly dosing is set to play an important role in helping to address the issue of non-persistence to osteoporosis treatments.
Stuart L. Silverman, M.D., lead investigator and clinical professor of medicine and rheumatology at Cedars-Sinai/ University of California, Los Angeles, said: "Treatment with bisphosphonates clearly reduces the risk of fractures, but only if patients keep taking their treatment. Osteoporosis is a disease that often shows no symptoms, which reduces a patient's motivation to stay on treatment and, thereby, increases their risk of breaking bones. The greater persistence seen with once-monthly compared to once-weekly bisphosphonates is very encouraging, particularly because the findings were consistent across two large and robust U.S. claims databases."
Improved persistence leads to fewer fractures and lower healthcare costs
Also at ASBMR, a three-year retrospective analysis found that improved persistence with bisphosphonate treatment is linked with lower rates of osteoporosis-related hospitalisation, shorter hospital stays and significantly reduced healthcare costs. 7,8 These findings emphasise the importance of a newly published study showing that women who were persistent in taking daily or weekly bisphosphonate treatments had significantly fewer fractures. 9
Peyman Hadji, M.D., Head of the Department of Endocrinology, Osteoporosis and Reproductive Medicine at Philipps-University of Marburg, Germany, said: "With the number of osteoporosis-related fractures in Europe estimated at 3.79 million, 10 improvements in the management of this disease are essential. These findings presented at ASBMR show that getting a patient's treatment right first time can not only improve their quality of life, but also have a significant positive outcome for healthcare services. Taking a bisphosphonate treatment for the long-term clearly reduces this risk, which is why persistence and patient preference need to be major considerations when prescribing osteoporosis treatments."
About the Persistence Data
The study showing greater persistence with once-monthly oral Bonviva was based on two managed care databases called HealthCore and i3 Innovus, which contain prescription and health information on approximately 17.5 and 16 million patients, respectively.
The HealthCore and i3 Innovus analyses included data for 6,127 and 10,526 women respectively, 45 years of age or older, who received a prescription for bisphosphonate treatment for postmenopausal osteoporosis (277 and 1,025 took once-monthly oral Bonviva and 5,850 and 9,501 took a once-weekly bisphosphonate).
Unlike other studies comparing persistence among monthly versus weekly treatment regimens, this study uses rigorous criteria for defining persistence for both once-monthly oral Bonviva and weekly treatments, as recommended by the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) and the World Health Organisation.
Patients were considered persistent if the time between prescription refills was more than 45 days for once-monthly oral Bonviva or more than 30 days for a weekly bisphosphonate.
To further ensure the validity of the results, study authors adjusted the data for potential confounding factors - including age, other medical conditions, and out-of-pocket costs for the medications - as recommended by the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) and the World Health Organisation.
At six months, once-monthly Bonviva users were 27.2% and 21.7% more likely to persist with therapy versus weekly users (p = 0.0002 and p
вторник, 24 апреля 2012 г.
вторник, 17 апреля 2012 г.
Periodic Problems; Saying Goodbye To PMS
Most women experience some unpleasant or uncomfortable symptoms during their menstrual cycle. For some women, the symptoms can be significant, but are usually of short duration and not disabling.
"Premenstrual Syndrome (PMS) is a medical condition with symptoms of bloating, headaches, mood swings, and depression," says W. Paul Dmowski, M.D. of Good Samaritan Hospital in Downers Grove and the Oak Brook Fertility Center in Oak Brook.
Although the symptoms usually cease with onset of the menstrual period, in some women, symptoms may last through and after their periods, says Dmowski.
Get moving
Dietary modification and physical activity are traditionally among the first recommendations for PMS therapy. Making simple lifestyle changes helps to reduce the occurrence of PMS symptoms.
These changes include regular exercise (30 to 60 minutes a day, 3 to 5 times each week); adequate sleep and rest; and a well-balanced diet, such as an increase in whole grains, vegetables, and fruit, and a decrease in salt, sugar, caffeine, and alcohol.
Don't overdo it
Exercise is can help manage stress, often a component of PMS. It also increases the metabolism and improves cardiovascular circulation. When exercising, more oxygen and nutrients are flowing throughout the body, helping to increase feelings of well-being.
"But don't go overboard," says Dmowski. "Vigorous workouts, such as running or doing step aerobics for two hours a day, may exacerbate rather than relieve some symptoms."
Talk to your doctor
Although no drug has received Food and Drug Administration (FDA) approval as a PMS treatment, many PMS sufferers find relief by taking drugs approved for other disorders.
"We now better understand the emotional and physical effects of cyclical hormone changes," says Dmowski. "Therefore, first-line drug therapy often involves the use of antidepressants."
Any woman who suspects she has PMS or other discomfort related to her menstrual cycle, should mention it to her doctor at her next visit. Often women with PMS do not have symptoms that can be measured with standard lab tests. Because of this, many women suffer in silence, having been told for many years that their problems were emotional.
For more information on women's health topics, including PMS, visit the web site of the National Women's Health Information Center at womenshealth.
For a physician referral, visit advocatehealth.
For a medical practice devoted to reproductive endocrinology, infertility, and assisted reproductive technology, visit oakbrookfertility
W. Paul Dmowski, M.D. Ph.D., is board certified in Reproductive Endocrinology; and is on the medical staff of Advocate Good Samaritan Hospital in Downers Grove.
The Good Samaritan Health and Wellness Center is a 90,000 square foot fitness center with three indoor pools, a track, an extensive fitness floor and weight room, three group exercise studios (including Yoga and Pilates studios) and a basketball court, located in Downers Grove, Illinois. Serving the western suburbs of Chicago, the Wellness Center is the only advisory member of the Medical Fitness Association in DuPage County. As part of Advocate Health Care, Good Samaritan Health and Wellness Center can be reached by visiting advocatehealth/goodsam.
Article Diane Ahern, Good Samaritan Health and Wellness Center.
"Premenstrual Syndrome (PMS) is a medical condition with symptoms of bloating, headaches, mood swings, and depression," says W. Paul Dmowski, M.D. of Good Samaritan Hospital in Downers Grove and the Oak Brook Fertility Center in Oak Brook.
Although the symptoms usually cease with onset of the menstrual period, in some women, symptoms may last through and after their periods, says Dmowski.
Get moving
Dietary modification and physical activity are traditionally among the first recommendations for PMS therapy. Making simple lifestyle changes helps to reduce the occurrence of PMS symptoms.
These changes include regular exercise (30 to 60 minutes a day, 3 to 5 times each week); adequate sleep and rest; and a well-balanced diet, such as an increase in whole grains, vegetables, and fruit, and a decrease in salt, sugar, caffeine, and alcohol.
Don't overdo it
Exercise is can help manage stress, often a component of PMS. It also increases the metabolism and improves cardiovascular circulation. When exercising, more oxygen and nutrients are flowing throughout the body, helping to increase feelings of well-being.
"But don't go overboard," says Dmowski. "Vigorous workouts, such as running or doing step aerobics for two hours a day, may exacerbate rather than relieve some symptoms."
Talk to your doctor
Although no drug has received Food and Drug Administration (FDA) approval as a PMS treatment, many PMS sufferers find relief by taking drugs approved for other disorders.
"We now better understand the emotional and physical effects of cyclical hormone changes," says Dmowski. "Therefore, first-line drug therapy often involves the use of antidepressants."
Any woman who suspects she has PMS or other discomfort related to her menstrual cycle, should mention it to her doctor at her next visit. Often women with PMS do not have symptoms that can be measured with standard lab tests. Because of this, many women suffer in silence, having been told for many years that their problems were emotional.
For more information on women's health topics, including PMS, visit the web site of the National Women's Health Information Center at womenshealth.
For a physician referral, visit advocatehealth.
For a medical practice devoted to reproductive endocrinology, infertility, and assisted reproductive technology, visit oakbrookfertility
W. Paul Dmowski, M.D. Ph.D., is board certified in Reproductive Endocrinology; and is on the medical staff of Advocate Good Samaritan Hospital in Downers Grove.
The Good Samaritan Health and Wellness Center is a 90,000 square foot fitness center with three indoor pools, a track, an extensive fitness floor and weight room, three group exercise studios (including Yoga and Pilates studios) and a basketball court, located in Downers Grove, Illinois. Serving the western suburbs of Chicago, the Wellness Center is the only advisory member of the Medical Fitness Association in DuPage County. As part of Advocate Health Care, Good Samaritan Health and Wellness Center can be reached by visiting advocatehealth/goodsam.
Article Diane Ahern, Good Samaritan Health and Wellness Center.
вторник, 10 апреля 2012 г.
Semen May Aggravate Cervical Cancer And Uterine Cancer
The high levels of prostaglandin, a hormone-like molecule found in semen, may fuel cervical and womb (uterine) cancers in women, say scientists from the Medical Research Council, UK. They say women with either womb or cervical cancer should seriously consider asking their partners to use a condom.
You can read about this in the journal Human Reproduction.
The cells in the lining of the female reproductinve organs contain prostagrandin - it regulates cell growth and makes the womb thicken and also shed during the menstrual cycle. However, prostaglandin levels in semen are about one thousand times higher.
By exposing cervical and uterine cell receptor molecules to prostaglandin, the scientists found that the signalling between the cells increased - leading to faster tumour growth.
The scientists say that by preventing prostaglandin from reaching the tumour cell receptors, there may be treatment one day to undermine the tumour's growth.
Team leader, Dr. Henry Jabbour, said "Sexually active women who are at risk of cervical or uterine cancer should encourage their partners to wear a condom to prevent increased exposure to the prostaglandins that might make their condition worse. This also highlights the potential for a new therapeutic approach that will tackle both possible sources of prostaglandin - those produced naturally by women and those introduced to the body by sperm.''
Jabbour believes it is quite possible that pre-cancerous cells may also have prostaglandin receptors. He said further research is needed.
Cervical cancer is more common in the developing world where screening programmes are less common. In the United Kingdom, for example, screening programmes detect most abnormal cell changes before the cancer progresses. Cervical cancer is usually triggered by long-term human papilloma virus (HPV) infection. Prostaglandins do not cause the cancer - they fuel tumour growth, say the researchers.
"Seminal plasma and prostaglandin E2 up-regulate fibroblast growth factor 2 expression in endometrial adenocarcinoma cells via E-series prostanoid-2 receptor-mediated transactivation of the epidermal growth factor receptor and extracellular signal-regulated kinase pathway"
S. Battersby, K.J. Sales, A.R. Williams, R.A. Anderson, S. Gardner 1, and H.N. Jabbour 1
Human Reproduction, doi:10.1093/humrep/del328
View The Abstract Online
Medical Research Council
You can read about this in the journal Human Reproduction.
The cells in the lining of the female reproductinve organs contain prostagrandin - it regulates cell growth and makes the womb thicken and also shed during the menstrual cycle. However, prostaglandin levels in semen are about one thousand times higher.
By exposing cervical and uterine cell receptor molecules to prostaglandin, the scientists found that the signalling between the cells increased - leading to faster tumour growth.
The scientists say that by preventing prostaglandin from reaching the tumour cell receptors, there may be treatment one day to undermine the tumour's growth.
Team leader, Dr. Henry Jabbour, said "Sexually active women who are at risk of cervical or uterine cancer should encourage their partners to wear a condom to prevent increased exposure to the prostaglandins that might make their condition worse. This also highlights the potential for a new therapeutic approach that will tackle both possible sources of prostaglandin - those produced naturally by women and those introduced to the body by sperm.''
Jabbour believes it is quite possible that pre-cancerous cells may also have prostaglandin receptors. He said further research is needed.
Cervical cancer is more common in the developing world where screening programmes are less common. In the United Kingdom, for example, screening programmes detect most abnormal cell changes before the cancer progresses. Cervical cancer is usually triggered by long-term human papilloma virus (HPV) infection. Prostaglandins do not cause the cancer - they fuel tumour growth, say the researchers.
"Seminal plasma and prostaglandin E2 up-regulate fibroblast growth factor 2 expression in endometrial adenocarcinoma cells via E-series prostanoid-2 receptor-mediated transactivation of the epidermal growth factor receptor and extracellular signal-regulated kinase pathway"
S. Battersby, K.J. Sales, A.R. Williams, R.A. Anderson, S. Gardner 1, and H.N. Jabbour 1
Human Reproduction, doi:10.1093/humrep/del328
View The Abstract Online
Medical Research Council
вторник, 3 апреля 2012 г.
Triple Threat To Health; Lifelong Abuse Creates Serious Consequences For Older African American Women
Older African American women who have experienced high levels of family violence throughout their lives are more likely to suffer worse physical and mental health than their counterparts, found a Temple researcher in the February issue of the Journal of Women's Health.
"In general, there is a higher incidence of mental health issues such as depression and anxiety, and more chronic pain syndromes," said lead author Anuradha Paranjape, M.D., M.P.H., an associate professor of medicine at Temple University School of Medicine and Hospital.
"I think this is an issue for all older women. I have focused on African American women because of my experiences as a busy clinician in downtown Atlanta and now at Temple, where most of my patients are African American. This is an underserved community that experiences health disparities," Paranjape said.
National data shows older African American women are at risk for experiencing poorer health status by virtue of their age, race, and gender. Given this triple threat to their overall health, examining the effect of family violence in this particular demographic group is particularly important, she noted.
These older women have unique service needs since their history of abuse can span across the spectrum of intimate partner violence to other types of abuse later on in life.
"Clinicians caring for older African American women need to be cognizant of the role both current and prior violence exposure may play in their patients' current health status," Paranjape said.
Paranjape advises primary care physicians "to empathize and validate the patient's experiences, and refer them to social support organizations if needed." More importantly, physicians need to know that there may be non-medical reasons why a patient doesn't feel well. If a patient is over the age of 60, it's mandatory for the heath care provider to report the abuse, in Pennsylvania.
For the study, 158 African American women, age 50 or older, were interviewed in ambulatory clinics of a large public hospital. Study participants were asked about the presence and severity of family violence relating to physical violence, emotional, financial, and sexual abuse, neglect, and coercion. Lifetime family violence exposure as well as an adult physical and mental health status were then measured and analyzed by the researchers.
The results found significant differences in scores reflecting poorer health for women who had reported high levels of family violence compared to those who reported low levels or no history of abuse. Unemployment was also found to be strongly associated with worse health status, Paranjape said.
"The next step is to look at what differentiates the women who do better from those who do worse. It is possible that women who do better have better coping skills. In that case, programs that are designed to help survivors of abuse cope in a healthy way need to be funded, implemented and assessed for efficacy," she said.
Temple University
301 University Services Bldg.1601 N Broad St.
Philadelphia
PA 19122
United States
www.temple.edu
"In general, there is a higher incidence of mental health issues such as depression and anxiety, and more chronic pain syndromes," said lead author Anuradha Paranjape, M.D., M.P.H., an associate professor of medicine at Temple University School of Medicine and Hospital.
"I think this is an issue for all older women. I have focused on African American women because of my experiences as a busy clinician in downtown Atlanta and now at Temple, where most of my patients are African American. This is an underserved community that experiences health disparities," Paranjape said.
National data shows older African American women are at risk for experiencing poorer health status by virtue of their age, race, and gender. Given this triple threat to their overall health, examining the effect of family violence in this particular demographic group is particularly important, she noted.
These older women have unique service needs since their history of abuse can span across the spectrum of intimate partner violence to other types of abuse later on in life.
"Clinicians caring for older African American women need to be cognizant of the role both current and prior violence exposure may play in their patients' current health status," Paranjape said.
Paranjape advises primary care physicians "to empathize and validate the patient's experiences, and refer them to social support organizations if needed." More importantly, physicians need to know that there may be non-medical reasons why a patient doesn't feel well. If a patient is over the age of 60, it's mandatory for the heath care provider to report the abuse, in Pennsylvania.
For the study, 158 African American women, age 50 or older, were interviewed in ambulatory clinics of a large public hospital. Study participants were asked about the presence and severity of family violence relating to physical violence, emotional, financial, and sexual abuse, neglect, and coercion. Lifetime family violence exposure as well as an adult physical and mental health status were then measured and analyzed by the researchers.
The results found significant differences in scores reflecting poorer health for women who had reported high levels of family violence compared to those who reported low levels or no history of abuse. Unemployment was also found to be strongly associated with worse health status, Paranjape said.
"The next step is to look at what differentiates the women who do better from those who do worse. It is possible that women who do better have better coping skills. In that case, programs that are designed to help survivors of abuse cope in a healthy way need to be funded, implemented and assessed for efficacy," she said.
Temple University
301 University Services Bldg.1601 N Broad St.
Philadelphia
PA 19122
United States
www.temple.edu
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