I’ve got a soft spot in my heart for GI disorders since I suffer from one myself. They suck. So when I read this the other day I was a bit surprised.

“For people with active ulcerative colitis who do not respond to corticosteroids or immunosuppressive agents, infliximab is effective in inducing clinical remission, inducing clinical response, promoting mucosal healing and reducing the need for colectomy, at least in the short term,” said review co-author Dr. Anthony Kwaku Akobeng.

[…]

“Infliximab is another option if steroids fail,” said Peter Higgins, M.D., an assistant professor in gastroenterology at the University of Michigan Medical Center in Ann Arbor.

And here I was, thinking this was common knowledge. In fact I during my hospitalization a few weeks ago whilst on vacation I had a discussion about UC with the tech doing my CT scan. She was telling me one of her friends had severe UC, and that he was on steroids. I distinctly remember suggesting Remicade or Humira instead of prednisone through my drug-induced stupor. She was telling me he hated the side effects. What a surprise. Then I think I started rambling about monoclonals and the lack of a generic approval pathway for biologics in general. She stopped talking to me after that.

She was cute, too. Really cute.

But hey, more studies are always good. Too bad Remicade is WAY more expensive than prednisone…

[tags]Medicine, pharmacy, Remicade, infliximab, ulcerative colitis[/tags]

Hat tip to MRSA Notes for this one. An study published in JAMA suggests that by telling parents to wait 48 hours to fill scripts for ear infection, physicians can help curb antibiotic overuse in children. It’s not a bad idea, and it’s something that I’ve often thought about myself. As a child I had chronic ear infections until the age of 10 when I stopped consuming dairy products. I had tubes six times. Throughout that time in my life I was averaging around one ear infection per month. In my case, waiting a day or two didn’t do anything except make things worse.

Ironically, I’m sitting here now and I’ve got an ear infection in my left ear that I’m currently taking antibiotics for. Even more messed up is that I got the infection while on a 7 day regiment of Levaquin and Flagyl. (That’s whack, eh?) Anyway, when I was a kid I wondered what people did before antibiotics. Did they go deaf? Did they walk around with chronic ear pain? Did their eardrums burst? None of my infections ever went away on their own, so I thought they stuck around until you made them go away with drugs.

Of course I know better now, and it warms the concerned medical professional and microbiology enthusiast in me to see experts pushing for moderation in antibiotic use.

Out of 238 patients aged 6 months to 12 years brought to a hospital emergency room complaining of ear infections, two-thirds of the parents who were told to wait ultimately did not fill their prescriptions.

The group that did not fill the prescriptions recovered at the same rate as children who had prescriptions filled right away, an indication the condition often clears up on its own.

Those are some impressive findings. But it doesn’t get past the sense of entitlement that patients have when then visit a doctor’s office. People often want antibiotics now because germs are bad, mmkay? Why else would we have all these alcohol-based antibiotic cleansers on the market that we see so heavily advertised on TV? Surely it’s more than marketing…

[tags]Medicine, pharmacy, antibiotics, ear infections[/tags]

I’m a firm believer that one of the most important aspects of democracy is not a given outcome of a political debate, but is instead the constant push and pull of the ideas behind a decision. The decision to make Plan B available without a prescription was a long time in coming, and I support it fully.

I think it’s somewhat sad that it’s been overly politicized, but I guess that’s the price of doing something controversial in a country where the “religious right” has a lot more clout than is warranted. Politicians on both sides think the FDA has gone too far or hasn’t gone far enough. I’d say that the agency has done a good job with their Plan B policy so far, if for no other reason than the fact that no one’s completely happy with it.

Some of the nonsense on both sides is actually pretty funny, particularly when viewed with an eye towards history — especially the stuff from the right:

Coburn and other social conservatives said that the high doses of hormones in the pills carry risks, and that making them more easily available will encourage sexual activity and result in more unwanted pregnancies and sexually transmitted diseases.

That, my friends, is Grade A political BS. Opponents of oral contraception said the same stuff about “The Pill” when it first came out. It was then, and still is, a complete load of crap.

First of all, Plan B will prevent unwanted pregnancies. That’s why it exists, and it does its job quite well. That whole STD thing… is anyone else having 1960s flashbacks here? Hello, these arguments were made when the pill first came out. They were unsubstantiated then, how is today any different?

“This is a bad decision for women, for girls, for parents and for public health,” said Wendy Wright of Concerned Women for America, which led a campaign to block the decision. “The FDA’s decision today will only make things worse for American women.”

I’d love to hear the logic behind that one, backed up with some numbers. But wait, that’ll never happen because the numbers won’t be there, and the only thing the right will be able to come up with will be anecdotes here and there. And I’d put some serious money on that.

What does concern me is the current administration’s emphasis on teaching abstinence. I think a rigorous sexual education program would go a long way in preventing STD transmission — but that, of course, is a bad idea because it will encourage teenagers to have sex. (Insert a humongous roll-eyes emoticon here.) Nevermind that the US has the highest rates of teen pregnancy and STD transmission of any first world country. Clearly the abstinence emphasis isn’t working.

But the left isn’t entirely reasonable either.

Plan B’s backers, meanwhile, criticized the agency for not allowing the drug to be sold to everyone.

“We urge the FDA to revisit placing age restrictions on the sale of Plan B,” said Sens. Hillary Rodham Clinton (D-N.Y.) and Patty Murray (D-Wash.). But because the decision represents “real progress” and an “important step in restoring the American people’s faith in the FDA,” the senators said, they were lifting a hold they had imposed on von Eschenbach’s confirmation as FDA commissioner.

I don’t think it’s a good idea for it to be sold willy-nilly to anyone that wants it. Ideally it’d be only sold to the person who is going to use it so its use can be more closely monitored, and the procedure for using it — and how it works — can be made clear to the woman who needs it.

So we’ve got Plan B available OTC. Now it’d be nice if the lay public got on the “Plan B is not abortion” bandwagon. Because it’s not.

[tags]Medicine, pharmacy, Plan B, abortion, politics, healthcare policy[/tags]

Looks like Gardasil may be effective against more than just the four most-prevalent HPV strains (16, 18, 6, and 11): it’s showing promise against strains 31 and 45 as well.

HPV types 16 and 18, which are directly targeted by Gardasil, are responsible for 75 percent of all cervical cancer. But scientists found the vaccine also induces an antibody response capable of neutralising strains 31 and 45, which together account for another 8 to 9 percent of cases.

It makes me wonder how much mindshare (and possibly marketshare) Cervarix — the GSK competitor to Gardasil — will garner when it’s approved by the FDA. GSK is going to have to work hard to differentiate its vaccine against Gardasil. They’ll certainly have their work cut out for them, because you can bet Merck will be testing Gardasil against the remaining 34 strains of HPV (which makes up only a tiny percentage of cases) to see if it has any success there as well. If I were GSK, I’d be thinking about getting some more clinical trials going on strains that Merck isn’t playing with yet.

[tags]Medicine, pharmacy, Cervarix, Gardasil, HPV, cancer, oncology[/tags]