In The News 02/07
Zoledronic Therapy Reduces Fractures; Risedronate Tops Alendronate
Zoledronic acid (Zometa), administered once a year, delivers significant reductions in the frequency of fractures in postmenopausal women. According to a study of 7,736 osteoporotic women (average age 73) reported by the American Society for Bone and Mineral Research, an annual injection of 5 mg of zoledronic acid reduced vertebral fractures by 75 percent, hip fractures by 40 percent and nonvertebral fractures by 25 percent at the end of three years. Lumbar spine bone mineral density (BMD) also increased 7 percent and total hip BMD increased 6 percent in the treated women, compared with those on placebo. Based on these findings, zoledronic acid, a bisphosphonate currently used to prevent skeletal fractures in cancer patients, is now being evaluated by the U.S. Food and Drug Administration for the treatment of osteoporosis.
In another study, conducted in France, risedronate (Actonel) was found to provide greater fracture protection in the first year of therapy than alendronate (Fosamax). Participants included 33,830 women age 65 and older who took once-weekly risedronate and alendronate for the first time. After 12 months of therapy, the risedronate group experienced 43 percent fewer hip fractures and had an 18 percent lower incidence of nonvertebral fracture compared to the alendronate group.
Gout Increases Heart Attack Risk
That painful throbbing in your foot may signal more than gout. It may also put you at risk of developing a heart attack. In a study of 12,866 men (average age 46), University of Pittsburgh researchers found, after following the group for six and a half years (none of the participants had a prior history of heart disease), that hyperuricemia a buildup of uric acid in the blood, which is known to cause gout was a contributing factor in instances of acute myocardial infarction (MI). During the trial period, there were 1,108 MI events in the group with gout and, of those, 246 were fatal.
Researchers concluded that since hyperuricemia is both the root cause of gout and is well known to be a risk factor for heart attacks, gout is a risk factor for heart attack in men with no previous history of heart disease.
Orthoses Offer Only Short-Term Benefit For Plantar Fasciitis
It has long been believed that a customized orthosis is an effective remedy if you suffer from plantar fasciitis pain emanating from the connective tissue that spans the plantar surface of the foot and experienced by people who are overweight or suffer from inflammatory arthritis. However, a study of 135 patients, as reported in the
Archives of Internal Medicine, casts doubt on the long-term effectiveness of such a device.
Patients were randomized to receive a sham orthosis (soft, thin foam), a prefabricated orthosis (firm foam), or a custom orthosis (semi-rigid plastic). After three months, patients’ pain scores were 8.7 points better for the prefabricated orthoses and 7.4 points better for the custom orthoses than for the sham devices. After 12 months, there were no significant differences in either pain or function scores.
The study’s conclusion: Foot orthoses produce small, short-term benefits in function and may also produce small reductions in pain, but they do not have long-term benefits.
Pregabalin Earns High Marks For Spinal Cord Pain
The drug pregabalin (Lyrica) significantly eases discomfort in patients experiencing nerve pain resulting from a spinal cord injury. An Australian study reports that spinal cord-injury patients with moderate to severe nerve pain had less pain and, in some cases, no pain while taking the drug. The study involved 137 adults over a 12-week period. Half the group received pregabalin; the other half was given a placebo. After 12 weeks, fewer than 16 patients on pregabalin experienced severe pain compared with 43 percent in the placebo group. And more than one-third of the patients in the pregablin group had no or mild pain.
Pain relief was rapid (the pregabalin group had significant pain relief after the first week), and 57 percent of those on the drug reported feeling better overall, compared to 21 percent in the placebo group.