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The “second generation” allergy drug desloratadine (brand name Clarinex) significantly reduces both the runny nose and congestion of seasonal and persistent allergic rhinitis, a study shows.

Allergic rhinitis, more commonly known as hay fever, is a collection of symptoms (runny nose, sneezing, red itchy and watery eyes, nasal congestion) caused by an allergic reaction to something in the environment such as pollen, dust mites, animal dander, or mold. It can be problem throughout the year (persistent) or only during certain months (seasonal), depending on the individual and the allergic trigger.

While second generation allergy drugs are non-sedating — a big problem with first generation antihistamines — they are generally thought to be less effective in reducing nasal congestion than nasal sprays and decongestants.

In the current study, French and Swedish researchers randomly assigned 584 people with allergic rhinitis to desloratadine (5 milligrams daily) or inactive placebo. Over the 28-day trial, the allergy sufferers kept symptom diaries and answered quality-of-life questions weekly. Unlike many previous studies, the researchers included nasal congestion as a measured symptom.

According to a report in the journal Allergy, desloratadine was significantly better than placebo in reducing both the runny nose and congestion of seasonal and persistent allergic rhinitis.

Desloratadine led to significant symptom relief by the end of day three in both seasonal and persistent allergy sufferers, the study team found. The full extent of symptom relief was reached after two weeks on the drug.

At various times during the trial and at its conclusion, the group taking desloratadine felt better and slept better compared to the placebo group, the researchers report.

Previous studies have demonstrated much slower onset of action of other second generation antihistamines in persistent allergic rhinitis, but “the present study emphasizes the rapid relief of nasal congestion” with desloratadine in these patients, the investigators note.

Clarinex (desloratadine) is the prescription version of the over-the-counter drug Claritin (loratadine), which is available in generic form. As with loratadine, desloratadine it is taken in pill form daily.

Cost may be the biggest difference between the two drugs with desloratadine costing about twice the generic loratadine. A generic version of desloratadine will not be available until 2012 at the earliest.

Study co-author Dr. Philippe Devillier of Foch Hospital in Suresnes, France, told Reuters Health that there’s no demonstrated difference in the clinical efficacy of desloratadine and loratadine but that desloratadine may pose less risk of interacting with other drugs.

The study was funded by Schering-Plough, maker of Clarinex. Four of the study’s seven authors were Schering-Plough employees.

The most common allergic illness in the United States, allergic rhinitis affects about 40 million people every year resulting in 5.5 million sick days away from school or work.

In 2000, Americans spent about $9 billion for symptom relief medications.

SOURCE: Allergy, November 2009.

Popularity: 24% [?]

Technorati Tags: Allergic rhinitis, allergic trigger, allergy drug, Clarinex, desloratadine

Eating a Westernized diet with lots of sugar and carbohydrates caused almost instantaneous changes in the gut flora of mice — changes that caused the mice to become obese, researchers have found.

These shifts in the microbial environment, reported in the Nov. 11 edition of Science Translational Medicine, might mean that experts should look more closely at the billions of microorganisms residing in human guts to better understand and perhaps even treat the epidemic of obesity plaguing the modern world.

“Although how much you eat and how much you exercise are dominant drivers of your energy balance, it’s possible that microbial communities and how they work also comprise a factor that determines your risk for obesity or risk for malnutrition,” said study senior author Dr. Jeffrey I. Gordon, director of the Center for Genome Sciences at Washington University School of Medicine in St. Louis.

The researchers plan to use the mouse model, or “humanized” mouse, to further study the diverse organisms that reside in people’s guts and how their presence might effect their hosts’ health.

“There are 10 times more microbial cells associated with adult human bodies than there are human cells, so we are 90 percent microbial and 10 percent human,” Gordon said. The bacteria can help people digest and absorb food that might otherwise be indigestible.

But the denizens of the digestive system are hard to study, given the complex environmental, genetic and cultural factors that affect digestion and obesity.

To devise a better way to study these microorganisms, Gordon and his fellow researchers transplanted microbes from human feces into mice that, courtesy of genetic manipulation, had no gut microorganisms of their own.

“When we switched these humanized animals [from a low-fat] to a junk-food diet, high in fat with lots of simple sugars, the structure of the microbial community changed dramatically and very rapidly, not only in terms of who’s there or which species but the proportional representation of species changed very abruptly within 24 hours,” Gordon explained. “These mice also became obese on Western diets.”

“The microbes can adjust with astonishing speed to different types of diets,” he said.

And transplanting the microbes to another set of microbe-free mice also caused the new mice to gain weight, even though they were on a low-fat feeding plan.

“They also showed that the microbiota passes from generation to generation,” said Jun Sun, an assistant professor of microbiology and immunology at the University of Rochester School of Medicine and Dentistry in New York. “This raises the question of whether we can pass microbiota from mothers to children, and the answer seems to be yes.”

The “21st century medicine cabinet,” then, might be composed of microbes themselves or drugs targeting particular sets of microbes to modify how they work in a person’s gut, Gordon said. “We can identify the human genes that are manipulated by microbes and those themselves could become therapeutic targets.”

The findings also helped advance science, Sun said.

“In the past, scientists published very descriptive studies of the flora, but the big question was how to apply the research,” she said. “I think we have jumped a big step forward. Now scientists have an established, well-controlled model of the gut flora.”

Popularity: 23% [?]

Technorati Tags: Gut Bacteria, microbiota, obesity, Western diets

The recession has made it more difficult than ever before for many Americans to afford prescription medications, but several options are available, according to an expert from Butler University in Indianapolis.

First, talk to your pharmacist, advised Carriann Richey, director of outreach and assistant professor of pharmacy practice at Butler’s College of Pharmacy and Health Sciences. Pharmacists may be able to recommend a lower-cost generic drug or an alternative, less expensive drug. Many pharmacies have low-cost options such as $4 generics or free antibiotics and prenatal vitamins. If your pharmacy doesn’t have this program, ask if they will match other pharmacies’ lower pricing, Richey suggested.

Here are some other strategies:

• Go to a reduced-cost or free clinic, where health care providers are trained to consider lower-cost alternatives and may be able to provide prescriptions at reduced cost or no cost.
• Look into drug manufacturer or government programs. Some drug makers offer discount cards or programs for brand-name medications free or at reduced-cost. There are a number of Web sites that provide information about these programs, including www.benefitscheckup.org. In addition, some government agencies offer drug discount programs, and most states offer senior assistance plans. (for example, discount code b2eb735754 available for online pharmacy broker PharmacyTouch.com which gives up to 10% discount)
• Online and mail-order pharmacies that offer lower prices on prescription drugs may be helpful for people with chronic conditions. However, because of the time it takes to fill and ship orders, this approach isn’t ideal for people with acute conditions. Look for online pharmacies with the VIPPS seal, which indicates the site is approved by the National Association of Boards of Pharmacy.
• In some cases, tablet-splitting can help reduce costs. But not all medications can be split, and not all tablet-splitting will save money. Patients should check with their pharmacist or physician before using this approach.
• Getting food or heating assistance could free up money that could be used to pay for prescription drugs. Check into this type of help by contacting social service organizations such as the United Way.
• Lifestyle changes, such as getting more exercise and eating healthier foods, may reduce the need for medications.

Popularity: 18% [?]

Technorati Tags: generic drug, prescription drugs, prescription medications, save on drugs

Most adults transition to their post-cancer treatment lives needing minimal or no healthcare support, but a significant proportion of cancer survivors continue to have multiple unmet physical and mental health needs, hint study findings from the United Kingdom.

In post-treatment surveys of 1,425 cancer survivors, 34 percent indicated having five or more unmet physical or mental health needs, researchers report in the Journal of Clinical Oncology.

A similar survey completed 6 months later found 60 percent of these survivors with similarly unmet needs, Dr. Jo Armes, of King’s College in London, and colleagues report.

The survey participants were 61 years old on average and most (69 percent) were women. Most of those surveyed had breast (56 percent) and prostate (23 percent) cancers. Forty percent also had other health problems such as heart or bone and muscle disease.

Both surveys generally revealed patients’ fears and concerns about their disease and its impact on their future and their loved ones.

As many as 20 percent initially felt ill informed about the control of their cancer and the actions they could take to improve recovery, and 6 months later 16 percent felt the same, the researchers found.

Cancer survivors on hormone therapy and those who had post-treatment or other medical complications between the first and second surveys, were much more likely than others to report continuing moderate to severe unmet needs.

Therefore, Armes and colleagues suggest targeting support to these individuals who appear most in need of continued mental and physical care.

SOURCE: Journal of Clinical Oncology, published online November 2, 2009

Popularity: 15% [?]

Technorati Tags: cancer, cancer treatment, muscle disease, Post-cancer treatment

Reports about possible kidney problems, including renal failure, in people taking the diabetes drug exenatide (Byetta) have prompted changes to the drug’s prescribing information, the U.S. Food and Drug Administration said Monday.

From April 2005 to October 2008, the FDA received 78 reports of kidney function problems in patients taking Byetta. Most of the problems occurred in patients with pre-existing kidney disease or one or more risk factors for developing kidney problems. Byetta is prescribed for type 2 diabetes; 7 million prescriptions were filled between April 2005 and September 2008, according to the agency

“Health-care professionals and patients taking Byetta should pay close attention to any signs or symptoms of kidney problems,” Dr. Amy Egan, of the Division of Metabolism and Endocrinology Products at the FDA’s Center for Drug Evaluation and Research, said in an FDA news release.

“Patients also should be aware that problems with kidney function could lead to changes in urine color, frequency of urination or the amount of urine, unexplained swelling of the hands or feet, fatigue, changes in appetite or digestion, or dull ache in the mid- to lower back,” Egan said.

She advised patients with any of these symptoms to immediately consult with a health-care professional.

Byetta, made by San Diego-based Amylin Pharmaceuticals Inc., is used to control blood sugar levels.

Nausea, vomiting and diarrhea are the most common side effects associated with the drug. These side effects may contribute to the development of kidney malfunction, which can lead to a build-up of waste products in the blood, resulting in serious illness and potentially life-threatening conditions.

Popularity: 14% [?]

Technorati Tags: Amylin Pharmaceuticals, Byetta, diabetes drug, Food and Drug Administration, kidney problems