Arthritis
Arthritis drug reduces heart attack risk
A study published in the journal Arthritis & Therapy has found that methotrexate, a drug commonly used to treat rheumatoid arthritis (RA), significantly reduces the risk of heart attack and stroke.
The study looked at more than 4,300 people in 15 countries who were using methotrexate to treat RA symptoms. The drug, which alters the body's use of folic acid, is usually taken once a week to treat RA. It's also used as part of chemotherapy regimens for people with cancer.
The study, which adjusted for traditional risk factors such as exercise, smoking, and diabetes, found that patients using methotrexate for 1 year to treat RA cut their risk of heart attack by 18% and their risk of stroke by 11%. The results underscore the importance of prescribing the drug early when RA is diagnosed.
Pregnancy
Excess caffeine linked to increased miscarriage risk
Pregnant women may want to reduce or completely stop their intake of caffeine, say the authors of a study in the January 2008 issue of the Journal of Obstetrics and Gynecology. They interviewed 1,063 pregnant women about their caffeine intake, and found that the 164 women who said they drank 200 mg of caffeine per day (the amount in 10 ounces of coffee or 25 ounces of tea) had a miscarriage rate of 24.5%. The miscarriage rate for the 264 women who said they consumed no caffeine was 12.5%. The increased risk was associated with caffeine intake, not other known risk factors such as smoking or advanced age of the mother. As a result, the study authors suggest that pregnant women should try to give up caffeine for at least the first 3 or 4 months of pregnancy.
After the study was published, the March of Dimes revised its stance on caffeine intake during pregnancy. Previously advising women that the amount of caffeine found in 8 to 16 ounces of coffee per day was safe, the March of Dimes now advises women who are pregnant or trying to get pregnant to limit caffeine intake to less than 200 mg a day.
Pain management
Bisphosphonates may cause severe musculoskeletal pain
The U.S Food and Drug Administration warns of the possibility of severe musculoskeletal pain in patients taking bisphosphonates, a class of drug used to strengthen bone. (Actonel, Aredia, Boniva, and Fosamax are some commonly prescribed bisphosphonates.) Although this warning is provided in the prescriber information, health care providers may overlook it.
Musculoskeletal pain may occur within days, months, or even years after the start of bisphosphonate therapy and may or may not resolve after the patient discontinues the drug. This pain is in contrast to the acute phase response, characterized by fever, chills, bone pain, myalgias, and arthralgias that sometimes accompanies initial administration of intravenous or oral bisphosphonates and usually resolves after several days of drug use.
Health care providers should consider whether bisphosphonate therapy is responsible when patients present with severe musculoskeletal pain and consider temporarily or permanently discontinuing the drug.
Did you know?
Tattooing may be a more effective way to deliver vaccines. Scientists in Germany have been experimenting on mice to see if delivering vaccines through a vibrating needle into the skin-like giving a tattoo-is a more effective way to deliver vaccines than standard injections into muscle. They tested tattooing by vaccinating mice with a protein fragment of human papillomavirus (HPV) and found that three doses of the vaccine given by tattooing produced at least 16 times higher antibody levels than three intramuscular injections. Ink wasn't used in the test, so the tattoo didn't leave any permanent marks.
The scientists believe that the increased effectiveness is due to the fact that the vibrating needle causes a wound and inflammation. This tissue damage alerts the immune cells to look out for antigens. Unfortunately, the tattoo is more painful than a regular injection but could be valuable for delivering certain therapeutic vaccines to fight cancer or other serious conditions where some pain is acceptable.