HEALTH

Pepcid better than Prilosec when taken with low-dose aspirin, trial finds

BY Michael Johnsen

NEW YORK The FAMOUS trial, reported in an article in Online First and in an upcoming edition of The Lancet, has found that Pepcid (famotidine) is effective in the prevention of stomach and upper intestinal ulcers, and damage to the gullet, The Lancet noted in a press statement earlier this week.

Low-dose aspirin (75mg to 325mg) is one of the most widely used drugs in the world. Increasingly, it is being bought over the counter or prescribed for its anti-clotting activity in the heart and brain, and in patients with diabetes. Despite the benefits of aspirin use, its rise has been accompanied by a rise in gastrointestinal complications, such as peptic ulcer bleeding, perforation and sometimes death. Such proton-pump inhibitors as Prilosec OTC (omeprazole) can prevent such ulcers but there have been concerns about cost, safety and risk of interaction with clopidogrel, another anti-clotting drug that is prescribed often with aspirin.

In the FAMOUS trial, researchers studied the effect of famotidine, which has a different mechanism of action to PPIs and belongs to a group of drugs called H2-receptor antagonists. The researchers found that stomach ulcers had developed in 3% of patients given famotidine compared with 15% given placebo. Upper-intestinal or duodenal ulcers were found in just one patient (0.5%) in the famotidine group compared with 17% of those given placebo. Gullet ulcers occurred in 4% of famotidine patients compared with 19% of placebo patients. And there were fewer adverse events in the famotidine group (9 vs. 15 placebo).

“Famotidine is effective in the prevention of gastric and duodenal ulcers, and erosive oesophagitis in patients taking low-dose aspirin,” concluded lead author Ali Taha, Crosshouse Hospital, Kilmarnock, England. “There is little doubt that aspirin and other anti-clotting drugs are very useful in the prevention of heart, brain and other vascular diseases, hence their increasing use world-wide. Patients on such drugs should continue using them as advised by their family doctors or hospital specialists. However, everybody should be aware that aspirin use can also be associated with a variety of gastrointestinal or digestive system problems, which sometimes can be serious. The results of this research widen the options for the prevention of such problems particularly when more than one clotting drug is required.”

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CDC reports increase of obesity rate

BY Michael Johnsen

ATLANTA The proportion of U.S. adults who are obese increased to 26.1% in 2008, compared with 25.6% in 2007, the Centers for Disease Control and Prevention revealed.

“Obesity is a major risk factor for many chronic diseases, such as heart disease and diabetes,” stated William Dietz, director of the CDC’s Division of Nutrition, Physical Activity and Obesity. “As obesity increases among all age groups, we are seeing chronic diseases in much younger adults compared to a few decades ago. … For example, we now see young adults who suffer from heart disease risk factors and other conditions such as Type 2 diabetes that were unheard of in the past.”

In six states – Alabama, Mississippi, Oklahoma, South Carolina, Tennessee and West Virginia – adult obesity prevalence was 30% or more. Thirty-two states, including those six, had obesity prevalence of 25% or more. Only one state, Colorado, had a prevalence of obesity less than 20%. But no state showed a significant decrease in obesity prevalence from 2007 to 2008.

The data comes from the CDC’s Behavioral Risk Factor Surveillance System, a state-based phone survey that collects health information from adults ages 18 years and over.

The 2008 BRFSS obesity data indicated that none of the 50 states or the District of Columbia achieved the Healthy People 2010 goal of reducing obesity prevalence to 15% or less. “The latest BRFSS survey data show that the obesity problem in this country is getting worse,” commented Liping Pan, CDC epidemiologist and lead author of the 2008 BRFSS obesity map analysis. “If this trend continues, we will likely see increases in healthcare costs for obesity-related diseases.”

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Obama administration: It is time to plan, prepare for upcoming flu season

BY Michael Johnsen

BETHESDA, Md. The Obama administration sent a message to the nation Thursday that it is time to start planning and preparing for the fall flu season and the ongoing H1N1 flu outbreak.

White House Homeland Security adviser John Brennan, secretary of Health and Human Services Kathleen Sebelius, secretary of Homeland Security Janet Napolitano and secretary of Education Arne Duncan joined with delegations from 54 states, tribes and territories Thursday at the H1N1 Influenza Preparedness Summit at the National Institutes of Health here to kick-off the government’s nation-wide fall flu preparedness efforts.

“The President and the administration are actively engaged in mitigating the effects of the H1N1 flu virus and developing a national response framework and action plan that builds on the efforts and lessons learned from this spring’s initial onset to prepare for the possibility of a more serious fall outbreak of the virus,” stated Brennan in his address to summit participants.

“Over the course of coming weeks and months, we will move aggressively to prepare the nation for the possibility of a more severe outbreak of the H1N1 virus,” added Sebelius. “We ask the American people to become actively engaged with their own preparation and prevention. It’s a responsibility we all share.”    

Maryland Gov. Martin O’Malley moderated a Governors panel with participation via videolink from Govs. Jim Douglas of Vermont, Jim Doyle of Wisconsin, Mark Parkinson of Kansas, John Baldacci of Maine and Jodi Rell of Connecticut.

“The experience in the spring taught us that while earlier pandemic flu planning efforts were effective,” O’Malley said. “We share the commitment of the Obama Administration to constantly monitor, evaluate and improve these processes.”

As part of the preparedness plan, HHS will make available preparedness grants worth a total of $350 million. These grants were funded by Congress in the latest supplemental appropriations bill and they will give state and local public health offices and health care systems resources to step up their preparedness efforts.

In addition, the federal government will centralize communications about H1N1 and seasonal flu on the federal government’s new Web site www.flu.gov. This one-stop comprehensive site brings together flu-related information from across HHS and other federal agencies. The expanded site builds on the pandemic planning information long presented on www.pandemicflu.gov, and incorporates information about the novel H1N1 flu as well as the seasonal flu.

Finally, HHS is launching a new PSA campaign contest to encourage more Americans to get involved in the nation’s flu preparedness efforts by making a 15-second or 30-second PSA. Officials at the summit stressed the idea of “shared responsibility” when it comes to combating the flu and the goal of the new HHS PSA campaign contest is to tap into the nation’s creativity to help educate Americans about how to plan for and prevent the spread of H1NI influenza. HHS will evaluate submissions and will present the best PSAs back to the public so everyone can vote on their favorite submission. The winning PSA will receive $2,500 in cash and will appear on national television.

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