Day: 09/17/2010

Glucosamine and Chondroitin Are of No Help in Osteoarthritis, Researchers Find

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Glucosamine and chondroitin, either alone or in combination, have no clinically relevant effect on joint pain in osteoarthritis, according to a BMJ meta-analysis.

The authors analyzed results from 10 randomized trials encompassing some 3800 patients allocated to glucosamine, chondroitin, both, or placebo. Reductions in pain scores in some trials, although occasionally attaining statistical significance at certain time points, did not reach clinical relevance.

The authors conclude: “We are confident that neither of the preparations is dangerous. Therefore, we see no harm in having patients continue these preparations as long as they perceive a benefit and cover the costs of treatment themselves.”

souece:BMJ

The use of tumor necrosis factor-alpha antagonist therapy in Inflammatory Bowel Diseasestar, open

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Biological therapies are an important step in the management of Inflammatory Bowel Diseases. In consideration of high cost and safety issues there is the need to have clear recommendations for their use. Despite the American Gastroenterological Association and the European Crohn’s and Colitis Organisation have published exhaustive Inflammatory Bowel Disease guidelines, national guidelines may be necessary as cultural values, economical and legal issues may differ between countries. For these reasons the Italian Society of Gastroenterology and the Italian Group for the study of Inflammatory Bowel Disease have decided to elaborate the Italian guidelines on the use of biologics in Inflammatory Bowel Disease. The following items have been chosen: definitions of active, inactive, steroid dependent and resistant disease; measures of activity; anti-tumor necrosis factor alpha therapy use in active steroid dependent and refractory luminal Crohn’s Disease, in fistulising Crohn’s Disease, in steroid dependent and resistant active Ulcerative Colitis; risk of cancer; risk of infections during anti-tumor necrosis factor alpha therapy; special situations. These guidelines are based on evidence from relevant medical literature and clinical experience of a national working group.

Scientists Discover Major Genetic Risk Factor For The Most Common Form Of Glaucoma

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Scientists at deCODE genetics and academic colleagues from Iceland, China, Sweden, the UK and Australia today report the discovery of the most important single-letter variation (SNP) in the sequence of the human genome yet associated with risk of primary open-angle glaucoma. This is the most common form of glaucoma and a major cause of blindness worldwide.

The SNP on chromosome 7 is common among Europeans, with approximately 6% of people of European ancestry carrying two copies of the at-risk version, putting them at roughly 60% greater risk of developing the disease than those who carry none. But among Chinese, the impact of the SNP is markedly different. In study groups from Hong Kong and Shantou, the at-risk version of the SNP is shown to be carried by less than 1% the population, but each copy carried confers more than five-fold increase in risk. The SNP is near the genes encoding caveolin 1 and 2, membrane proteins that are expressed in the meshwork that drains fluid from the eye, a process that if disturbed can increase pressure on the optic nerve and lead to glaucoma.

The key to reducing the personal and public health impact of glaucoma is early diagnosis and treatment to slow the loss of sight. Discoveries such as today’s, which follows on our previous landmark findings in exfoliation glaucoma, are important because we can fold them directly into tests to target screening and to detect and treat more disease earlier. Moreover, among Chinese this latest SNP alone can define a small fraction of the population that should be very carefully screened. This underscores the value of being able to systematically analyze the impact of genetic risk factors across continental ancestries. Not only are these markers medically useful, they also tell us a bit about evolution and the spread of humanity across the globe,” said Kari Stefansson, deCODE’s Executive Chairman and President of Research and senior author of the study.

The authors would like to thank the more than 40,000 people who participated in this study, both glaucoma patients and control subjects. The paper, “Common variants near CAV1 and CAV2 are associated with primary open-angle glaucoma,” is published online in Nature Genetics and will appear in an upcoming print edition of the journal.

Primary open-angle glaucoma is a disease in which the optic nerve becomes damaged, leading to a progressive loss of sight. It affects tens of millions of people worldwide, mostly those over the age of 50. Incidence increases with age and varies between populations. Other known risk factors include high blood pressure and diabetes. Current treatments include eye drops that reduce pressure on the optic nerve, as well as surgery.