CNIO researchers discover a new therapy that prevents lung cancer growth in mice

The discovery, which is already being tested in co-clinical trials, brings new clues for the treatment of this disease

Lung cancer is one of the most aggressive types of cancer and the most common cause of death from this disease worldwide. Despite the progress in the molecular biology of lung cancer achieved in recent years, the mechanisms used by tumor cells to grow and spread throughout the body are not yet completely understood. This lack of information is responsible for the limited range of available therapeutic possibilities and their undesirable side effects.

The Tumour Suppression Group of the Spanish National Cancer Research Centre (CNIO), led by Manuel Serrano, has deciphered one of the molecular pathways behind lung cancer. Using this information, the authors have identified an experimental drug, which blocks lung cancer growth in mice. This work is published today in the scientific journal Cancer Cell.

Standing up to lung cancer

Notch was identified in 2004 as an important oncogene for the development of leukemias and, since then, intense efforts have been devoted to study the role of Notch in other cancers. At the end of the last decade it was found that Notch is also involved in the development of pancreatic and lung cancer.

In this study, Serrano's team has identified the molecular pathways by which Notch regulates cell proliferation in lung cancer. "We have found that this protein cooperates with the Ras oncogene, a key element in the formation of these tumors", states Serrano.

Researchers have also discovered the therapeutic effect of a specific experimental drug which blocks Notch efficiently, named GSIs (Gamma-Secretase Inhibitors). To this end, scientists used genetically modified mice previously developed by Mariano Barbacid, head of the Experimental Oncoloy Group at the CNIO, that faithfully recapitulate human lung cancer. "After 15 days of treatment, lung tumors failed to grow without treatment-related side effects", says Antonio Maraver, the first author of the study.

Co-clinical trials both in humans and mice

GSIs were developed over 15 years ago to treat Alzheimer's disease. Although now it is well established that GSIs are not useful to stop this neurodegenerative disease, the discovery that these drugs block Notch has stirred the interest in their possible application for cancer. The accumulated knowledge acquired over the years on the pharmacological properties of GSIs has permitted their immediate use in clinical trials for cancer.

Mouse therapeutic trials performed in parallel with humans clinical trials are called coclinical trials, and are at the cutting edge of biomedical research. These trials allow the transference of information from mice to humans in a very short period of time. A clear example is this research, which is being accompanied by a human clinical trial led by Manuel Hidalgo, director of the Clinical Research Program at the CNIO.

"The assays developed by Serrano led us to believe that blocking Notch could be beneficial for treating lung cancer. We have already treated a dozen patients with an agent directed at the blocking of this protein. We are expanding the study, but I can anticipate that the results are very promising", says Hidalgo.

Weight-Loss Surgery May Prevent Diabetes

For people who are extremely overweight and likely to develop diabetes, surgery may be the best form of prevention.

A new study shows that weight-loss surgery not only produced sustained weight loss in obese men and women but substantially reduced their odds of developing Type 2 diabetes. Over the course of a roughly 15-year period, those who had one of three types of bariatric procedures were 80 percent less likely to develop the disease than people who tried losing weight with diet and exercise advice from their doctors.

In fact, those who had the worst blood sugar levels at the start of the study, putting them in a high-risk category called prediabetes, benefited the most from surgery. Their risk of becoming diabetic fell by nearly 90 percent.

“The message is that bariatric surgery works,” said Dr. Claude Bouchard, an author of the study and a professor at the Pennington Biomedical Research Center in Louisiana. “You can take people on their way to becoming diabetic, and you intervene with bariatric surgery and weight loss, and you have a very, very strong protective effect against Type 2 diabetes.”

The findings add to a growing body of literature supporting bariatric surgery as a means for combating diabetes. This year, two studies showed that for people who are obese and already have diabetes, weight-loss surgery was more effective than drugs, diet and exercise in causing a remission of the disease. The new report, published on Wednesday in The New England Journal of Medicine, is the first large study to show a long-term preventive effect of surgery in people who are not yet diabetic but well on their way.

Experts who were not involved in the research said it could have tremendous public health implications. Nationwide, more than 20 million Americans have diabetes, most of them Type 2, the form linked to obesity. But almost three times that number are prediabetic, with blood sugar levels that are higher than normal but not quite high enough for a diagnosis of diabetes. Prediabetes is also referred to as impaired fasting glucose.

“Prediabetics almost always develop diabetes, and this showed that surgical treatment could put them on a new pathway away from the disease,” said Dr. Philip Schauer, a professor of surgery at the Cleveland Clinic who led one of the earlier studies looking at bariatric surgery in diabetics. “An 80 percent risk reduction is huge, particularly in light of the fact that Type 2 diabetes is a very deadly disease.”

The new study had its genesis in the 1980s, when scientists in Sweden set out to study the long-term effects of bariatric surgery on health. For ethical reasons at the time, the researchers did not randomly assign people to undergo weight-loss surgery. Instead, they enrolled extremely overweight people who had chosen on their own to undergo it, and then matched them to a control group of obese people who wanted to lose weight through nonsurgical means, including standard exercise and dieting advice.

For both groups, the median body mass index was just above 40, indicating morbid obesity. But no one was diabetic when the study began.

The surgical group consisted of 1,658 people who had one of three kinds of bariatric surgery. Most underwent banding procedures that restrict food intake but do not interfere with the normal digestive process. About 10 percent had gastric bypass, a more radical operation that involves shrinking the stomach and rearranging the bowels.

After following the groups for up to 15 years, the researchers found that those who had surgery lost an average of about 45 pounds, while those in the control group lost significantly less.

By the end of the study, about 10 out of 13 patients in the surgery group managed to avoid a diagnosis of diabetes, about double the reduction in risk normally seen in obese prediabetics who rely on lifestyle changes to lose weight. Dr. Bouchard speculated that in some cases, the operations helped avert diabetes not just through weight loss, but also through anatomical changes in the gut, which affect the production of hormones that play a role in things like appetite and metabolism.

Most of the patients in the new study, however, underwent banding procedures, which, unlike gastric bypass, do not significantly alter the anatomy of the digestive tract, said Dr. Rudolph Leibel, co-director of the Naomi Berrie Diabetes Center at Columbia University Medical Center. He said it was more likely that the improvements seen in the surgical group, in this case, were a result of their significant and sustained weight loss, something that is hard for many people to achieve through diet and exercise.

“I would predict that if you got the same amount of weight loss with lifestyle interventions and you could sustain it,” he added, “you would see quite comparable results.”

New AIDS-like disease in Asians, not contagious

Researchers have identified a mysterious new disease that has left scores of people in Asia and some in the United States with AIDS-like symptoms even though they are not infected with HIV.

The patients' immune systems become damaged, leaving them unable to fend off germs as healthy people do. What triggers this isn't known, but the disease does not seem to be contagious.

This is another kind of acquired immune deficiency that is not inherited and occurs in adults, but doesn't spread the way AIDS does through a virus, said Dr. Sarah Browne, a scientist at the National Institute of Allergy and Infectious Diseases.

She helped lead the study with researchers in Thailand and Taiwan where most of the cases have been found since 2004. Their report is in Thursday's New England Journal of Medicine.

"This is absolutely fascinating. I've seen probably at least three patients in the last 10 years or so" who might have had this, said Dr. Dennis Maki, an infectious disease specialist at the University of Wisconsin in Madison.

It's still possible that an infection of some sort could trigger the disease, even though the disease itself doesn't seem to spread person-to-person, he said.

The disease develops around age 50 on average but does not run in families, which makes it unlikely that a single gene is responsible, Browne said. Some patients have died of overwhelming infections, including some Asians now living in the U.S., although Browne could not estimate how many.

Kim Nguyen, 62, a seamstress from Vietnam who has lived in Tennessee since 1975, was gravely ill when she sought help for a persistent fever, infections throughout her bones and other bizarre symptoms in 2009. She had been sick off and on for several years and had visited Vietnam in 1995 and again in early 2009.

"She was wasting away from this systemic infection" that at first seemed like tuberculosis but wasn't, said Dr. Carlton Hays Jr., a family physician at the Jackson Clinic in Jackson, Tenn. "She's a small woman to begin with, but when I first saw her, her weight was 91 pounds, and she lost down to 69 pounds."

Nguyen (pronounced "when") was referred to specialists at the National Institutes of Health who had been tracking similar cases. She spent nearly a year at an NIH hospital in Bethesda, Md., and is there now for monitoring and further treatment.

"I feel great now," she said Wednesday. But when she was sick, "I felt dizzy, headaches, almost fell down," she said. "I could not eat anything."

AIDS is a specific disease, and it stands for acquired immune deficiency syndrome. That means the immune system becomes impaired during someone's lifetime, rather than from inherited gene defects like the "bubble babies" who are born unable to fight off germs.

The virus that causes AIDS - HIV - destroys T-cells, key soldiers of the immune system that fight germs. The new disease doesn't affect those cells, but causes a different kind of damage. Browne's study of more than 200 people in Taiwan and Thailand found that most of those with the disease make substances called autoantibodies that block interferon-gamma, a chemical signal that helps the body clear infections.

Blocking that signal leaves people like those with AIDS - vulnerable to viruses, fungal infections and parasites, but especially micobacteria, a group of germs similar to tuberculosis that can cause severe lung damage. Researchers are calling this new disease an "adult-onset" immunodeficiency syndrome because it develops later in life and they don't know why or how.

"Fundamentally, we do not know what's causing them to make these antibodies," Browne said.

Antibiotics aren't always effective, so doctors have tried a variety of other approaches, including a cancer drug that helps suppress production of antibodies. The disease quiets in some patients once the infections are tamed, but the faulty immune system is likely a chronic condition, researchers believe.

The fact that nearly all the patients so far have been Asian or Asian-born people living elsewhere suggests that genetic factors and something in the environment such as an infection may trigger the disease, researchers conclude.

The first cases turned up in 2004 and Browne's study enrolled about 100 people in six months.

"We know there are many others out there," including many cases mistaken as tuberculosis in some countries, she said.

By MARILYNN MARCHIONE
AP Chief Medical Writer

Restaurant Gives Woman Discount for Having the “Best Butt”

A woman who ordered a veggie bowl and fried pickles was awarded a special two-cent discount by Texas-based burger chain Twisted Root Burger Company for having the “best butt” and being the “best looking.”

Apparently, the restaurant is known for its “jokey service shtick,” as noted by eater.com. For example, customers are often assigned celebrity or cartoon character nicknames when they order, and there are at least 20 or so set goofy discounts in the computer that servers can give out, and “Best Butt” and “Best Looking” are among them.

“We have these random discounts we can give out for fun,” a purported Twisted Root employee said in a comment on Reddit.

Hey, it could have been worse. They could have called her “lady chinky eyes,” or something equally racist.

Male birth control pill may soon be a reality

A new compound found to be effective in male mice for birth control could pave the way for a contraceptive pill for men. Among American women who use contraceptives today, the largest proportions use the Pill – 28 percent – according to the Guttmacher Institute. Here, birth control bills are distributed to women in the Philippines.

Does Eating Junk Food Cause Acne?

Asked Dr. Dave Margolius, a physician in San Francisco, California. He is originally from Cleveland, Ohio, and attended Brown University for undergrad and med school. He is currently doing his residency in internal medicine at UCSF. His main interests are in health policy, improving primary care, and healthcare for all.

Does Eating Junk Food Cause Acne?

In my esteemed medical opinion, the worst kind of zit is the big volcano one on the tip of the nose. The most dreadful part might be that you always know when it’s coming.

First, the whole nose has this uncomfortable feeling that you can’t quite place. Next, on the very front of the nose, it begins to really hurt when you touch it. After that, the redness comes and you know you’re in for seven to 10 days of wondering if people are staring at your mysterious eyes or that huge pimple that shines like a beacon.

You head to your local drugstore and buy all the acne soaps off the shelf. After a week of three-a-day face washings, warm compresses and dark lighting, the zit disappears and your mind returns to wondering how synchronized divers earn a living.

Some believe that eliminating junk food can prevent, or at least reduce, acne breakouts. Can it be that eating healthier not only improves your weight, self-esteem and sex life, but also help prevent pimples and the embarrassment of the nose volcano?

The answer to this question is maybe. Numerous studies have linked a Western diet (i.e. junk food) to high prevalence of acne. Specifically, both foods with lots of sugar (those with a high glycemic load) and dairy products might lead to more acne.

Scientists have even figured out the mechanism by which this association may occur: Eating lots of sugar means your body produces more insulin, and more insulin causes your body to release hormones that lead to more androgens, hormones that factor into acne production. Milk from cows actually contains those hormones that lead directly to more androgens.

You probably remember from high school: androgens mean more pimples. That’s why puberty sucks. So what’s with all the maybes, mights and mays? While many retrospective studies have shown an association between a junk food diet and acne, no studies have shown that eating better or differently can prevent acne in the future.

In other words, it’s really cool that we’ve isolated all these hormones and stuff, but so far we haven’t proven that changing your diet improves acne.

Eating junk food is bad for you. It also may cause you to have more acne. Do you really need another excuse to eat less of it? For those of us with the occasional forehead zit, it probably has more to do with genetics than diet, so don’t despair. Just blame your parents on your next trip to your local drugstore.

PTSD improves when substance abuse also treated

Combining treatments for post-traumatic stress disorder and substance abuse resulted in improved PTSD symptoms without worsening symptoms of substance abuse, according to a study released Tuesday in the Journal of the American Medical Association.

The findings, explain the Australian researchers, are contrary to conventional wisdom on how to treat PTSD and substance abuse, which commonly co-exist in patients. The common belief, they explain, has been that using the so-called "gold standard" of PTSD treatment might exacerbate substance abuse by resurfacing negative memories.

Therefore, people with substance abuse and PTSD have commonly been excluded from prolonged exposure therapy-based PTSD treatments and clinical trials using exposure therapy.

Prolonged exposure therapy is considered one of the most effective PTSD treatments. In fact, prolonged exposure therapy is the only "treatment for PTSD endorsed in a U.S. Institute of Medicine study as evidence based," according to corresponding study author Katherine L. Mills of the University of New South Wales.

During the therapy, patients work with therapists to go back to their traumatic event and describe it in present tense, allowing the person to relive the trauma. By repeating this process, the brain reacts less severely over time, making the memory seem less traumatic.

University of New South Wales researchers enrolled 103 participants in their trial. All participants met the diagnostic criteria for both PTSD and substance abuse. The subjects were randomly selected to either receive both prolonged exposure therapy and treatment for substance abuse, or to only receive treatment for substance abuse.

At the nine-month mark, while both groups experienced reductions in PTSD symptoms, the subjects in the combined treatment group also showed a reduction in the severity of their PTSD symptoms without any increase in the severity of their substance abuse.

Barbara Rothbaum, a professor of psychiatry and PTSD expert at Emory University, calls the study results "practice-changing."

"So many therapists are scared, because treating PTSD is a painful, grieving process," for patients, she says, and this study provides evidence-based data that there is no increase in substance abuse when both treatments are combined. Rothbaum says these findings will benefit therapists who treat PTSD and patients who have both conditions.

Post-traumatic stress disorder is a mental health condition that occurs after a person is exposed to a terrifying event. PTSD, while often associated with veterans who've been exposed to the trauma of combat, can be experienced by anybody who's been exposed to a traumatic event including natural disasters, assaults, a heart attack, the death of a loved one, or a major injury or accident.

PTSD symptoms include anxiety, experiencing nightmares or flashbacks, and its common for people with PTSD to avoid situations that will remind them of the frightening experience. Another common coping mechanism is self-medication leading to substance abuse in an effort to dull the devastating thoughts that PTSD can bring to its victims.

LuxeYard Unveils First Flash Sales Site Targeted For Latinos

A leading luxury fashion and home flash sales site, LuxeYard, Inc. (OTCQB: LUXR), announced the soft launch of a new division and website, De La Fashion (www.delafashion.com) today. The site, which will also feature Spanish and Portuguese translations, offers Latino and Hispanic shoppers access to curated luxury apparel and home decor online at discounted prices.

Founded in New York City on July 1, 2012, the members-only site is a reconceptualization of its predecessor, Eopulence.com, and offers consumers direct access to unique, curated luxury merchandise at 20% to 70% off retail prices. De La Fashion will feature men's and women's fashions, top cosmetics and beauty essentials and unique finds for home, garden and backyard needs. Featured brand offerings on the site will include Roberto Cavalli sunglasses, Soho Hearts jewelry, Tripsciusive iPhone cases and Kitsch scarves.

The new division and site will be helmed by recently promoted De La Fashion president and site director, Christian Vega, who was formerly Chief of Business Development for LuxeYard.

"De La Fashion is the ideal luxury style destination for savvy Latin American and Hispanic shoppers who enjoy living a lavish lifestyle, who fill their homes with distinct furniture and decor and fill their closets with on-trend fashions that epitomize luxury and a life well-lived," said Vega.

A robust member incentive program will be implemented the first few weeks following initial launch, rewarding members who invite their friends to join the site with cash payments once their friend makes an initial purchase. The money goes straight to their PayPal account, or other suitable payment account, and there is no limit on how much cash each member can accrue from converted referrals.

Among the highly coveted luxury apparel items offered on the site is the bespoke "De La Suit". De La Fashion allows online shoppers to design their own custom suit and choose the exterior color, inseam and cut of the one-of-a-kind piece. Pricing for a bespoke suit is between $400 and $2,500 and the custom order is cut and delivered within 5-8 weeks.

De La Fashion will also feature a special online Media section that will be curated through media partner Latin Connoisseur Magazine, and will host interviews and articles on Latin celebrities and news and offer Home/Living Do-It-Yourself tips and videos.

"We've experienced considerable success with the social e-commerce model that has pushed LuxeYard to the forefront of the flash sales market and we look forward to replicating that success with De La Fashion, expanding our reach and making luxury truly accessible for all," said LuxeYard, Inc. CEO Braden Richter. "We're proud to be the first luxury flash sales site to bring this new paradigm shift to the Latino and Hispanic audiences, who have a deep appreciation for living a Luxe life."

ABOUT LUXEYARD, INC.
LuxeYard is a members-only flash sale site for luxury home furnishings, decor and fashion that offers access to unique products sourced from an experienced team at prices up to 70 percent off retail. LuxeYard is the pioneer of Concierge Buying, which gives members the power to determine the items sold on the site, and Group Buy that allows them to lower the price by sharing sale items with friends. With a veteran retail, ecommerce and digital marketing management team, LuxeYard partners with trendsetters and industry insiders to deliver interactivity and content on its pages. To become a member, visit www.LuxeYard.com.

Fashion’s Night Out 2012 Events Listings Announced Ahead Of Mercedes-Benz Fashion Week, Full Schedule

From SoHo to Harlem and in more than 500 U.S. cities, Fashion's Night Out (FNO 2012) is making its return this year on Sept. 6 with more than 4,500 events nationwide.

Fashion's finest, including designers, editors, models and celebrities like Kim Kardashian and Nicole Ritchie, will rub elbows -- and shopping bags -- for a night for the annual shopping extravaganza.

The definitive guide was released on the official Fashion's Night Out website Monday, listing the full schedule of participating stores around the globe. The event runs from 6 to 11 p.m. Sept. 6.

This year marks the fourth year of Fashion's Night Out, kicking off the first official day of Mercedes-Benz Fashion Week in New York. The first fashionable fete, spearheaded by Vogue, the Council of Fashion Designers of America (CFDA), New York City and NYC & Company to boost sales during the recession, began in 2009 in just 300 stores around the city.
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According to the website, "Fashion's Night Out is an unprecedented global initiative created in 2009 to celebrate fashion, restore consumer confidence, boost the industry's economy during the recession, and put the fun back in shopping!"

Last year, Fashion's Night Out extended to 18 countries. The events will feature sales and deals for shopping, entertainment, freebies and refreshments in most locations.

Participating retailers will have the official collection of 2012 Fashion's Night Out Merchandise for sale, with T-shirts and bags starting at $25, some of which will be donated to an AIDS charity.

The evening is expected to be star-studded, with celebrities attending various events. Kim Kardashian will be at Lord & Taylor's Fifth Avenue flagship store. Jennifer Hudson and Nicole Richie are expected to appear as a part of QVC's broadcast in downtown Manhattan while Alexa Chung will spin at Moschino. Others on hand will include Alessandra Ambrosio at Victoria's Secret, Whitney Port at What Goes Around Comes Around, Rachel Zoe and Thakoon Panichgul at Bergdorf Goodman and Solange Knowles at Diane von Furstenberg.

Cirque du Soleil will perform at Henri Bendel as well as free food from some of New York's famed food trucks and cocktails from The Mulberry Project. Maybelline will host free makeup application sessions at the Color Studio Lounge in the Meatpacking District. Michael Kors will also host a fashion trivia night at Macy's in Herald Square on the new and improved shoe floor while Scott Disick will be present on the men's floor. Azealia Banks will perform at MAC's SoHo store.

On the other side of the country., Kendall Jenner is expected to be present at her family's Dash store in West Hollywood.

Avastin combo can help in brain tumour treatment, claims Roche

Basel - Swiss pharma major Roche Holding AG said a new study has revealed that adding cancer drug Avastin to radiation and chemotherapy significantly reduce the progression of an aggressive form of brain cancer.

In a statement Friday, Basel headquartered company, which has focuses on cancer drugs, said its Phase III AVAglio study met one of its main targets of improving progression-free survival in people with glioblastoma compared to those treated with radiation and temozolomide chemotherapy plus placebo.

"This study showed that people with glioblastoma, a particularly devastating and aggressive cancer without many treatment options, lived significantly longer without their disease worsening when Avastin was added to radiation and temozolomide chemotherapy," said Hal Barron M.D.,

Chief Medical Officer and Head Global Product Development.

Glioma (cancer of the glial cells) is the most common type of malignant primary brain tumour (a tumour that originates in the brain), accounting for approximately one third of all cases diagnosed.

Glioblastoma (or glioblastoma multiforme) is the most common and the most aggressive type of glioma which affects approximately 13,000 people per year in the EU.

Data for final overall survival, the study's other main endpoint, is expected in 2013, the company said.

No new safety findings were observed in the study and the adverse events were consistent with those seen in previous trials of Avastin across tumor types for approved indications, the company stated.

Last year Avastin sales were hit when the United States revoked its conditional approval as a treatment for breast cancer.

Roche's other cancer drugs Rituxan and Herceptin, instead saw sales growth accelerate to 9 per cent and 11 per cent respectively in the first half.

Avastin is currently approved in the United States and over 30 countries worldwide for the treatment of glioblastoma as a single agent and in some countries in combination with irinotecan for adult patients with progressive disease following prior therapy (relapsed setting).

The approval in the US was granted under the Food and Drug Administration's (FDA) accelerated approval programme.

Roche plans to discuss these phase III results with global regulatory authorities, including the European Medicines Agency (EMA) and the U.S. Food and Drug Administration (FDA).

With the initial approval in the USA for advanced colorectal cancer in 2004, Avastin became the first anti-angiogenic therapy made widely available for the treatment of patients with an advanced cancer.

Avastin is currently used for treatment across several types of cancer. In Europe it is approved for the treatment of advanced stages of breast cancer, colorectal cancer, non-small cell lung cancer, kidney cancer and ovarian cancer, and is available in the USA for the treatment of colorectal cancer, non-small cell lung cancer and kidney cancer.

In addition, Avastin is approved in the USA and over 30 other countries for the treatment of patients with progressive glioblastoma following prior therapy. Avastin is approved in Japan for the treatment of the advanced stages of colorectal, non-small cell lung cancer and breast cancer.

Black arthritis patients get fewer potent drugs

Black people with rheumatoid arthritis are less likely than whites to be on powerful drugs that ward off further joint damage and disability, according to a new study from California.

Even when they took into account the severity of patients' arthritis, researchers found blacks with the condition were half as likely to be on so-called biologic disease-modifying anti-rheumatic drugs (DMARDs), compared to the less-potent standard drugs.

"Biologics in (rheumatoid arthritis) are generally very potent and effective treatments to prevent disease progression but are quite expensive," Aniket Kawatkar, from Southern California Permanente Medical Group in Pasadena, told Reuters Health in an email.

Those drugs are typically delivered via subcutaneous injections, whereas standard DMARDs can be taken by mouth.

People with rheumatoid arthritis have worsening inflammation in the joints that leads to pain, stiffness and loss of function. According to the Arthritis Foundation, 1.3 million people in the United States have the disease. It is much less common than osteoarthritis, the common "wear-and-tear" type of joint disease.

Although rheumatoid arthritis isn't curable, anti-rheumatic drugs can keep joint damage and related symptoms from progressing.

Kawatkar, who worked on the new study, said there are a few reasons why blacks with rheumatoid arthritis might be less likely to be on more powerful drugs, even if their disease is just as severe.

"If patients do not have accesses to physician specialists who are better at management of (rheumatoid arthritis), this can affect the choice of DMARDs they are receiving," he said.

"Secondly, ethnic and cultural beliefs may hinder certain minorities from seeking care immediately."

Some drugs are generally considered to have a "window of opportunity" when they provide the most benefit.

"If cultural beliefs inhibit an (rheumatoid arthritis) patient for seeking care immediately, the window of opportunity for treatment may be lost," Kawatkar said.

RESULTS ‘UNSETTLING'

All 5,385 rheumatoid arthritis patients analyzed for the new study were on Medicaid, the government health program for the poor, so income wasn't a major difference between patient groups. The patients - in their 50s and 60s, on average - were treated with at least one anti-rheumatic drug in California between 1998 and 2005.

Overall, 16 percent of white patients took biologic DMARDs, which include etanercept (marketed as Enbrel) and adalimumab (Humira). The rest took standard DMARDs, such as methotrexate (Rheumatrex) and leflunomide (Arava).

In comparison, about nine percent of black patients took the more potent drugs.

Hispanic rheumatoid arthritis patients were most likely to be on biologic DMARDs: 20 percent of them took those medications during the study period. They also tended to have more severe joint pain and activity limitations than whites.

Dr. Kenneth Saag, an immunologist from the University of Alabama at Birmingham, called the findings "unsettling."

He said black people with rheumatoid arthritis may know fewer members of their community who are on biologic DMARDs, and so aren't as comfortable trying them. Or, doctors could have misconceptions about arthritis not being as severe in certain types of patients.

"Regrettably, there may be elements of discrimination in terms of what therapies are offered to people," Saag, who wasn't involved in the new study, told Reuters Health.

He said that in some practices, as many as 60 percent of rheumatoid arthritis patients are taking the more potent drugs.

The researchers wrote in the journal Arthritis Care & Research that there's no consensus opinion on which drugs are best for which rheumatoid arthritis patients.

"This determination should always be made by the rheumatologist based on their assessment of the patient's condition," Kawatkar said.

"In general though, these drugs are given to patients who have active and aggressive (forms) of the disease and/or patients who are more likely to progressive to a more severe stage relatively quickly."

Standard DMARDs typically cost a few hundred dollars per year, he said - while biologic drugs can cost between $15,000 and $25,000. Such drugs are typically covered by Medicaid with prior approval.

SOURCE: http://bit.ly/O2gAHJ Arthritis Care & Research, online July 17, 2012.

New Pill Might Relieve Severe Rheumatoid Arthritis

A new oral medication may be available soon for people with rheumatoid arthritis who have not gained relief from other medicines.

As rheumatoid arthritis progresses, people often struggle with everyday tasks and find walking difficult. To help combat those issues, patients with severe forms of the disease often need drugs that must be injected, typically twice a month.

The new drug, tofacitinib, was approved by an advisory panel of the U.S. Food and Drug Administration in May and could be green-lighted by the FDA this month. However, the drug carries the risk of serious side effects, as do injectable treatments. The risks include blood and lymphatic system disorders, infections, and cancer.

"This is an advance, but it's not a cure-all," said Dr. Roy Fleischmann, study author and clinical professor of medicine at the University of Texas Southwestern Medical Center, in Dallas. "We have not cured rheumatoid arthritis."

Rheumatoid arthritis, which differs from age-related osteoarthritis, is a debilitating autoimmune disorder, meaning the body attacks its own tissues. It is characterized by inflammation of the lining, or synovium, of the joints.

The new drug, called a JAK inhibitor, blocks signals that activate inflammatory immune responses involved in the disease.

The FDA is not required to follow its panel's recommendations, but it usually does. Further evidence supporting the benefits of the drug comes in two studies published Aug. 9 in the New England Journal of Medicine.

Fleishmann explained that while people with the disease have benefitted from the discovery of "biologic" drugs such as Humira (adalimumab), Enbrel (etanercept) and Remicade (infliximab), many patients don't find relief from these medications. Biologic products are large proteins that are available only by injection or intravenous administration. The hope, he said, is that JAK inhibitors will help improve the lives of those not getting enough relief from other medications.

Both studies were phase 3 clinical trials, used to test the effectiveness and safety of potential drug therapies in large groups of people.

In Fleischmann's research, about 700 patients who had been taking methotrexate -- a commonly used drug for rheumatoid arthritis -- with inadequate relief were randomly assigned to take either 5 milligrams (mg) or 10 mg of tofacitinib twice daily, 40 mg of Humira every two weeks, or an inactive placebo.

Patients in the placebo group who didn't see notable improvement in their joint pain were switched after three months to get either 5 mg or 10 mg of tofacitinib. Participants were rated on a commonly used index of disability and checked for clinical signs of disease activity. The 12-month study showed that tofacitinib was superior to placebo and similar to Humira in its effectiveness.

The second study involved about 610 patients who had had an inadequate response to methotrexate. Tofacitinib was found to be associated with reductions in symptoms of rheumatoid arthritis and improvement in physical functioning.

Experts not associated with the study think the new drug, if approved by the FDA, would be a positive treatment option.

"It looks like tofacitinib could be used as a first-line agent, before taking a patient to a biologic," said Dr. Ernest Brahn, professor of medicine and rheumatology training program director at University of California, Los Angeles School of Medicine.

However, he noted that the studies involved a relatively small number of patients and no long-term data.

Dr. David Fox, of the rheumatology division at University of Michigan, Ann Arbor, writes in an accompanying journal editorial that a better understanding of the drug's safety picture is needed to determine at what point patients might turn to tofacitinib.

The cost of the drugs, if approved, is unknown. "My guess is that it will be close to the price of the biologics," said Brahn. Fleischmann estimated that the current cost of those drugs to a consumer without insurance is about $25,000 a year.

Tofacitinib would be manufactured by Pfizer Inc., which funded both studies.

Rheumatoid arthritis affects about 1.3 million Americans, according to the Arthritis Foundation.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about rheumatoid arthritis.

~ Barbara Bronson Gray
HealthDay Reporter

Do Diet Drugs Really Work?

Qsymia

Two new diet drugs are the first to be approved in more than a decade. Both Belviq and Qsymia helped people lose weight in clinical studies, but they do it in very different ways.

Qsymia will be available the fourth quarter of this year, and it looks like Belviq with be available first quarter of next year.

Qsymia combines an appetite suppressant and a medication for seizures and migranes. The drug is known to increase feelings of fullness, make foods taste less appealing and increase calorie burning.

Belviq

Belviq causes weight loss by turning on a specific switch that increases levels of serotonin.

The drugs are not for everyone. They will only be prescribed to obese adults or overweight adults who have at least one additional health-related issue. Those include Type 2 Diabetes, high blood pressure, or high cholesterol.

There are risks associated with both drugs. Qsymia has particular risks for pregnancy. It can cause birth defects if taken in the first months of pregnancy, so women prescribed the drug must also be on birth control.

Pregnant or nursing women also cannot take Belviq.

At this point, there’s no way to know for sure which one works better. They haven’t been tested in a head-to-head clinical trial.

People taking Belviq had an average weight loss that was 3 to 3.7 percent greater than people taking placebo.

People taking Qsymia for up to one year had an average weight loss of 8.9 percent over those taking an inactive placebo.

However, these numbers cannot be used to compare the two drugs, as the clinical trials had different designs. Also, the drugs were effective only when given along with a balanced diet and exercise.

Beauty blogger gets screaming reception

Teenage girls erupted in squeals and one even broke down in tears as video beauty blogger Michelle Phan greeted them in Sydney.

The American was treated to a Hollywood starlet reception when she appeared at Myer to host a make-up masterclass on Thursday.

Shouts of 'I love you' were yelled from a 200-strong audience as smartphones went into the air to capture the action.

The turnout wasn't a surprise - Phan is an online beauty phenomenon, with more than 600 million hits on her video tutorials.

She is also ranked No. 10 in the world for most visits on YouTube, and was aptly introduced to her fans by beauty and lifestyle expert Paula Joye as a 'rock star with a mascara wand'.

The 25-year-old is in Australia on behalf of Lancome and is keen to share her trade secrets.

At her Sydney masterclass she told the crowd she had seen a lot of girls embracing natural beauty in Australia and that she was a huge fan of the bronzed look.

Australian beauty, she said, was about glowing skin and because we love bronzers we should wear fun blood-orange lip colour.

Loren Yuen, 17, was in the audience and told AAP that she followed Phan because of her natural way of teaching how to apply make-up.

Chloe Wong, also 17, said Phan's tutorials were fun to watch and she enjoyed learning about her DIY facial masks.

Watch one of Michelle's make-up video tutorial.

Alzheimer's-Linked Protein Shows Promise Against MS

The amyloid beta protein, long tied to Alzheimer's disease, may actually help reverse paralysis and inflammation in people with multiple sclerosis (MS).

So finds a study involving mice, conducted by researchers at Stanford University School of Medicine. While attempting to slow the progression of Alzheimer's disease, they unexpectedly stumbled upon this promising new avenue for the treatment of MS.

"There probably is a multiple sclerosis drug in all this somewhere down the line," study senior author Dr. Lawrence Steinman speculated in a university news release.

The study is published online Aug. 1 in the journal Science Translational Medicine.

Amyloid beta is the chief component of the plaques that accumulate in the brains of people with Alzheimer's disease. This substance builds up during the normal aging process or following a brain injury. It is also found in MS-linked brain lesions.

In conducting the study, the scientists injected amyloid beta directly into the bellies of mice with an MS-like syndrome. They report that injections delivered before the mice developed symptoms seemed to prevent or delay paralysis. The researchers added that even after symptoms appeared, the injections significantly reduced the severity of the mice's paralysis. In some cases, they noted, the amyloid beta injections actually reversed it.

The researchers repeated their experiment to confirm their results. They concluded that amyloid beta's influence on the paralysis and inflammation associated with MS is related to its effect on immune cells before they penetrate the brain.

"This is the first time [amyloid beta] has been shown to have anti-inflammatory properties," Steinman noted.

After examining the central nervous systems of the mice with the MS-like syndrome, the researchers found the animals treated with amyloid beta had fewer brain and spinal cord lesions than the untreated mice. They noted there were also no increases in Alzheimer's-like plaques in the mice treated with amyloid beta.

"We weren't giving the mice Alzheimer's disease" by injecting amyloid beta into their bellies, study first author Jacqueline Grant explained in the news release.

Although amyloid beta has been shown to be toxic inside the brain, its function outside the brain could be vastly different, the researchers concluded.

The protein "is made throughout our bodies all of the time. But even though it's been studied for decades, its normal function remains to be identified," Dr. Lennart Mucke, director of the Gladstone Institute of Neurological Disease in San Francisco and an Alzheimer's researcher who is familiar with Steinman's study, said in the news release. "Most intriguing, to me, is this peptide's potential role in modulating immune activity outside the brain."

Another expert agreed that the research has potential, but hazards remain.

"These are very impressive results that could lead to the development of new therapeutics for MS derived from the A-beta [amyloid beta] peptide," said Philippe Marambaud, an Alzheimer's researcher at the Feinstein Institute for Medical Research in Manhasset, N.Y.

"We have, however, to keep in mind that A-beta toxicity is not limited to the presence of plaques in the brain," he said. "A-beta can lead to dramatic cognitive impairments in the absence of plaque formation, suggesting that the use of A-beta 'per se' as a potential therapeutic agent is not without risk, especially in MS patients who have a compromised blood-brain barrier."

-- Mary Elizabeth Dallas

Viktor Luna to Live Stream Spring-Summer 2013 Collection Discussion via Watchitoo

In the fashion industry fans are outsiders, typically learning about favorite designers from Web news, Facebook sites, fashion magazines or following them on Twitter. The only way to get involved or attend a fashion show is to be an industry insider.

Rising Fashion Star and Season Nine Project Runway Finalist Viktor Luna is changing this paradigm and connecting with his fans on a more personal level by using Watchitoo, a SaaS based, interactive platform that combines streaming, professional HD videoconferencing, collaboration and social media integrated tools.

Luna will host a live event today at 4 p.m. EDT via Watchitoo to engage with fans and discuss his Spring-Summer 2013 collection, which he will present during New York's Fashion Week in September. Join the event on Viktor Luna's website (http://viktorluna.com/livestream.html) or his Facebook page (http://www.facebook.com/pages/Viktor-Luna/158093470887641).

During today's event, Luna will talk about his background, including the experience of being a Project Runway contestant and finalist; discuss what goes into his designs; preview his latest collection and take questions from fans looking to learn more. The event is also meant to encourage fans interested in getting involved to donate to Luna's Indiegogo Campaign. Funds from the campaign will help Luna complete his Spring-Summer 2013 collection. Contributors to the campaign will be given passes to the September runway event, along with other perks.

"I want to give my fans a new way to experience fashion," said Luna. "With Watchitoo I can live stream an interactive event that allows me to see my fans directly and take their questions. They've helped me build my brand so I want to be accessible and responsive to them. I hope this trend of engaging fans is something other designers will consider to make the fashion industry more open to the people wearing our designs."

Watchitoo is an increasingly popular way for event organizers, TV producers, businesses, educators and others to increase engagement with their audiences and extend the reach of their brands. Up to 25 individuals or groups can join a Watchitoo interactive online HD video conference and hundreds of thousands can follow the conversation, and use social tools to interact with their connections.

"Watchitoo is an exciting new platform for businesses and individuals to generate buzz, build their brands and connect with fans," said Rony Zarom, CEO of Watchitoo. "In an industry like fashion where the only connection between fan and designer has been at the retail counter, we give designers a way to truly engage with their consumers to make their designs more personal."

About Watchitoo
New York-based Watchitoo provides an embeddable video collaboration platform to deliver live content in a highly engaging way. The Watchitoo platform allows multiple participants to see and hear one another in real-time, collaborate around any form of rich media, and be viewed by an audience scalable into the thousands. With Watchitoo, any viewer can become a participant and any participant can be switched back to a general viewer. For more information, visit www.watchitoo.com.