NACDS emphasizes pharmacy’s role in preventing meth abuse, production
ALEXANDRIA, Va. In a statement to Congress Tuesday, the National Association of Chain Drug Stores emphasized pharmacy’s voluntary and proactive measures to help fight methamphetamine production and abuse, and urged against requiring patients to obtain prescriptions for pseudoephedrine products.
“Our membership remains committed to working with law enforcement to address this ongoing problem in a manner that stops criminal activity while ensuring that legitimate consumers continue to have access to medications for treatment of colds, flu, and allergies,” NACDS stated.
The statement was made in response to the Senate Caucus on International Narcotics Control, which held a hearing Tuesday morning on “The Status of Meth: Oregon’s Experience Making Pseudoephedrine Prescription Only.”
NACDS suggested that a nationwide electronic system to track sales of these products would be more effective at crime-fighting and more patient-friendly than a move to prescription-only status for these products.
Earlier Tuesday morning, the Consumer Healthcare Products Association suggested Congress ought to amend and strengthen the federal Combat Methamphetamine Epidemic Act by requiring nationwide electronic tracking for all over-the-counter sales of cold-and-allergy medicines containing pseudoephedrine.
CHPA president Linda Suydam committed on behalf of industry to fund a national e-tracking system, the system that NACDS is endorsing, and work with the retail community to expand the National Precursor Log Exchange system currently being implemented in eight states that have passed e-tracking legislation.
“We are asking Congress to significantly improve the Combat Methamphetamine Epidemic Act by leveraging cutting-edge technology to block illegal pseudoephedrine sales nationwide,” Suydam stated. “Electronic tracking offers the best solution to reducing methamphetamine labs without imposing a costly and unnecessary prescription mandate. Our goal is to stop illegal pseudoephedrine sales while maintaining important over-the-counter access to the 15 million consumers who rely on these medicines each year.”
New study unveils roles of vitamins in skin care
SCHAUMBURG, Ill. A study supporting use of certain vitamins (vitamins A, C, E and B3) in either oral or topical formulations to improve the health of skin was published online Monday in the Journal of American Academy of Dermatology.
“It is well documented that ultraviolet radiation contributes to premature skin aging through the process of photoaging, and there is increasing evidence that the antioxidant properties of vitamins may contribute to the prevention and treatment of photoaging,” stated Jenny Kim, associate professor in the division of dermatology, department of medicine, at the University of California, Los Angeles, and lead author of the study. “In fact, numerous companies developing cosmeceuticals base their effectiveness claims on the fact that their formulations contain vitamins proven in laboratories to modify cellular processes thought to contribute to the appearance of photoaged skin. As dermatologists, we can help our patients navigate this maze of marketing claims by sharing scientific data on the known efficacy of vitamins in skin care products.”
Based on a comprehensive review of the available published data on the role of vitamins in skin care products, Kim and her colleagues found there is evidence to support the potential role of vitamins A, C, E and B3 in modifying the photoaging process. “While it’s evident that these vitamins can play a role in fighting sun damage, the question still remains whether these properties are effective when delivered in skin care products,” Kim said.
The two most common forms of vitamin A studied for their role in protecting the skin from UV-induced damage are retinols and carotenoids. Retinol is found in such foods as liver, milk and eggs, and is the most biologically active form of the vitamin. Carotenoids are found in many fruits and vegetables, and have strong antioxidant capabilities.
While carotenoids are not shown to be beneficial in the treatment of photoaging, research suggested that they may play a role in photoprotection by preventing UV-induced collagen breakdown.
“Although the evidence available at this time is not strong enough to offer definitive support for the use of dietary carotenoids for photoprotection, a role for carotenoids as a supplement to photoprotective agents should not be discounted yet,” Kim said. “We hope to see larger-scale clinical trials conducted to further explore the photoprotective effects of carotenoids.”
Unlike carotenoids, there is vast evidence supporting the role of topical retinoids (the class of substances formed by retinol and its natural and synthetic derivatives) in treating photoaged skin, Kim noted. Prescription retinoid formulations have the most scientific data to support their use in this area.
Kim noted that both tretinoin cream (0.025% and 0.05%) and tazarotene cream (0.1%) are already FDA-approved for the treatment of fine wrinkles, skin roughness and mottled hyperpigmentation caused by aging and sun exposure. In addition, she added that studies of other retinoids have shown that a once-daily application of 0.1% isotretinoin cream for 36 weeks was effective in reducing fine wrinkles.
Retinoids also are found in over-the-counter cosmeceuticals, but there is less clinical evidence supporting their effectiveness in improving photoaged skin. “An important point to remember with retinoids is that we cannot assume that all retinoids are equal in their ability to fight photoaging,” Kim said. “In over-the-counter products, retinol appears to be the most effective retinoid based on clinical studies completed to date.”
Vitamin C, a water-soluble vitamin also known as ascorbic acid that is found in citrus fruits and dark green leafy vegetables, plays an essential role in the production of collagen and elastin. Because of its antioxidant properties, vitamin C may reverse the negative effects of UV radiation in the skin, but there are few clinically controlled studies to confirm this theory.
“An animal study examining the role of vitamin C in reversing sun damage found that when 5% ascorbate was applied two hours before UVB and UVA exposure, UVB-induced skin wrinkling was reduced,” Kim said. “Some of the human clinical trials have shown similar favorable results when applying a daily dose of L-ascorbic acid treatment, but all of these studies involved small sample sizes.”
In addition, Kim pointed out that one concern of adding vitamin C to cosmeceuticals is that vitamin C is unstable when used in formulations, and it is not known how much, if any, intact molecule remains when applied to the skin. “This problem has been partially overcome by chemically modifying ascorbic acid,” Kim said. “However, for the body to use the supplied ascorbic acid, it must convert it to L-ascorbic acid, and many of the stabilized, commercially available forms have not been examined to determine whether this conversion is possible. For that reason, the average consumer will not be able to determine if a cosmeceutical containing vitamin C will be effective.”
Vitamin E, or tocopherol, is a fat-soluble vitamin, and its synthetic form is found in many OTC products. Working as an antioxidant, vitamin E protects cell membranes and is thought to play an important role in skin aging because of its antioxidant properties. While topical vitamin E is available in a variety of products, there is no data which support claims that it improves skin wrinkling, discoloration and texture, Kim said.
“Topical vitamin E has been studied in humans, as in mice, more as a protectant to be used before sun exposure than as an agent to be included in cosmeceuticals to reduce the signs of skin aging,” Kim added. “Through research we have learned that UV exposure significantly decreases levels of cutaneous vitamin E, and vitamin C should be included in any formulation containing vitamin E because of the important role it plays in maintaining active vitamin E levels.”
The B vitamins consist of eight different water-soluble vitamins that are found in a variety of foods. Vitamin B3 has been shown to reduce blood cholesterol and atherosclerosis (a condition in which fatty materials collect along artery walls), but now new insights are examining its role as an effective treatment for several skin conditions — from acne to photoaging.
Specifically, Kim noted that vitamin B3 has been found to increase collagen production in vitro studies and to reduce skin hyperpigmentation (dark spots) in clinical studies. “There has been one clinical trial conducted in Caucasian women in which 50 women applied 5% niacinamide (topical vitamin B3) to one side of their faces twice per day for 12 weeks, and these women experienced significant reductions in the appearance of hyperpigmented spots, redness, wrinkles and yellowing, as well as improved skin elasticity,” Kim said. “While initial studies show promise that topical vitamin B3 may prevent UV-induced skin aging, larger clinical trials are needed to confirm its role as a definitive treatment of photoaging.”
Vaccines with two strains of influenza may be more effective in children, research team says
ST. LOUIS Vaccines likely would work better in protecting children from flu if they included both strains of influenza B instead of just one, a St. Louis University press report stated last week, citing research conducted through its Center for Vaccine Development.
"Adding a second influenza B virus strain to the seasonal influenza vaccine would take some of the guesswork out of strain selection and help improve the vaccine’s ability to prevent influenza," stated Robert Belshe, lead investigator and director of the center. "Since in five of the last 10 years, the influenza B component in the vaccine has been the incorrect one, this seems like an obvious advance to me."
Every spring, scientists predict which strain of influenza will be circulating in the community the following fall. Historically, they choose two different subtypes of influenza A and one of influenza B.
Research findings in the March issue of Vaccine highlight the importance of adding both lines of influenza B into the vaccine to better protect against the flu, Belshe noted.
The research team examined how well current vaccines protect against influenza B by looking at the immune response of ferrets that were given FluMist, a live attenuated influenza vaccine manufactured by MedImmune.
When ferrets were vaccinated against influenza, the ferrets that were exposed to a strain of influenza B virus that did not match what was in the vaccine didn’t have a strong antibody response. However they had a vigorous antibody response when given a vaccine that contained both strains of influenza B.
This showed that immunizing against one strain of influenza B does not appear to protect against the other strain and that a vaccine containing both influenza B strains is likely to offer greater protection from flu.
"These data highlight the need for vaccination strategies that provide enhanced protection against both lineages of influenza B," Belshe said.
The study was sponsored by MedImmune. Belshe has served as a consultant and as part of the speakers bureau for MedImmune and other study authors are MedImmune employees.