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Experimental Arthritis Treatment Does Well in Trial

November 06, 2000|THOMAS H. MAUGH II | TIMES MEDICAL WRITER

An experimental treatment for rheumatoid arthritis has shown significant benefit for patients in an early study, allowing some patients to resume normal activities and stop taking other arthritis drugs, British researchers said.

Other scientists said the results are promising but cautioned that the treatment has been tested in only 20 patients so far. A larger study is underway.

Dr. Jonathan Edwards of University College in London reported at the Oct. 30 meeting of the American College of Rheumatology in Philadelphia that 18 of the 20 patients treated so far have shown improvement. The first five patients had a 70% improvement after 18 months, he said, and all have resumed normal activities. Two patients required retreatment but showed the same benefit from the second treatment. The other 13 patients also showed benefit but have not been studied for as long a time.

They have stopped taking other arthritis drugs. Edwards said he has begun a larger trial of 160 patients in Europe, Australia and Canada. No U.S. trials are being conducted yet.

Much of the joint destruction produced in rheumatoid arthritis is mediated by antibodies produced by white blood cells called B lymphocytes or, simply, B cells. Researchers believe that the B cells somehow become inappropriately sensitized to cartilage tissue and begin producing antibodies against it.

Edwards and his colleagues at University College speculated that if these sensitized B cells could be removed from the body, new ones would be generated that would not produce antibodies against cartilage. They treated the patients with a combination of drugs that would destroy all the patients' B cells, then allowed the immune systems to regenerate.

Report Cites Benefits of Surgical Castration

Men may not like to hear it, but surgical castration is the most cost-effective way to treat advanced prostate cancer and provides the best quality of life, according to a new study.

Advanced prostate cancer is incurable. But because its progression is stimulated by male hormones, its growth and spread can be inhibited by blocking the production of those hormones with drugs or by surgically removing the testicles, which produce many of the hormones. An estimated 75% of U.S. men choose to use a family of drugs called luteinizing hormone-releasing hormone (LHRH) agonists (which performs chemical castration) because they prefer to keep their testicles. Medicare pays for the drug treatment.

Prostate cancer kills 31,000 U.S. men each year.

Dr. Ahmed Bayoumi of the University of Toronto and his colleagues studied six potential ways of treating advanced prostate cancer, including using diethylstilbestrol (which produces chemical castration), surgery, LHRH analogs, and various combinations of these options. They reported in the November issue of the Journal of the National Cancer Institute that diethylstilbestrol was the cheapest therapy, while castration provided the longest, highest quality of life and the longest survival at the lowest cost.

Equal Success Found in 2 Fertilization Methods

Two methods of artificial fertilization--implanting the embryo in the uterus or in the Fallopian tube--are equally successful, according to a new Yale University study.

Federal statistics collected since 1992 suggest that zygote intrafallopian transfer, commonly known as ZIFT, is more effective, even though it is more expensive and riskier. In particular, ZIFT leads to an increased risk of an ectopic pregancy, in which the fertilized egg implants outside the womb.

Yale researchers Dr. Steven Palter and graduate student Antonia Habana analyzed 24 small studies that included a total of 388 transfers into the uterus or the Fallopian tube. They reported Oct. 30 at a meeting of the Society for Reproductive Medicine in San Diego that the implantation and pregnancy rates were virtually identical for the two techniques. Because of the higher cost and risk of ZIFT, they concluded "this technique cannot be recommended for routine use."

Zanamivir Gets Credit in Flu Prevention

If someone in your family gets influenza and you haven't had the vaccine, you can reduce your risk of contracting it by taking the antiviral drug zanamivir, according to researchers from the University of Virginia at Charlottesville. They report in the Nov. 2 New England Journal of Medicine that taking the drug reduces the risk of contracting the flu by about 72%. The cost of the drug is about $40 per person.

Study Looks at Pregnant Women Who Smoke, Drink

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