Sweet Protection Against Parkinson’s Disease

New research shows men and women who regularly eat berries may have a lower risk of developing Parkinson’s disease.  Men may further lower their risk by regularly eating apples, oranges and other sources rich in dietary flavonoids.

The study which was supported by the National Institutes of Health involved 49,281 men and 80,336 women. Researchers gave participants questionnaires and used a database to calculate intake amount of flavonoids. They then analyzed the association between flavonoid intakes and risk of developing Parkinson’s disease. They also analyzed consumption of five major sources of foods rich in flavonoids: tea, berries, apples, red wine and oranges or orange juice. The participants were followed for 20 to 22 years.

During that time, 805 people developed Parkinson’s disease. In men, the top 20% who consumed the most flavonoids were about 40% less likely to develop Parkinson’s disease than the bottom 20% of male participants who consumed the least amount of flavonoids.

In women, there was no relationship between overall flavonoid consumption and developing Parkinson’s disease. However, when sub-classes of flavonoids were examined, regular consumption of anthocyanins, which are mainly obtained from berries, were found to be associated with a lower risk of Parkinson’s disease in both men and women.

This is the first study in humans to examine the association between flavonoids and risk of developing Parkinson’s disease,” said study author Xiang Gao, MD, PhD, with the Harvard School of Public Health in Boston.

Fruit consumption has also been related to health benefits in a whole range of conditions including cancer, stroke, heart disease, diverticulosis, hypertension, cataracts, diabetes, asthma, and bronchitis.

Do you have any fruity stories to share?  SRxA’s Word on Health would love to hear from you.

Improving Asthma Adherence

A new study, published in the Journal of Allergy and Clinical Immunology, shows that patients who are more confident about the benefits of their asthma controller therapies tend to report higher levels of adherence.

The Trial of Asthma Patient Education (TAPE) study examined the effect of an educational program aimed at increasing expectations of treatment benefit on medication adherence.

Patients with sub-optimally controlled asthma were randomized to either placebo or the active drug – montelukast (Singulair) in conjunction with an interactive computer-based multimedia educational presentation that was either neutral or designed to increase outcome expectancy.

The enhanced presentation was specifically designed to increase the expectation that the drug would adequately control asthma symptoms, while the neutral presentation included information on asthma care and management but without active promotion of the benefits of medication. The presentations were shown before the study drugs were dispensed, and again 2 weeks into the study.

Adherence was monitored electronically over 4 weeks and was defined as ≥80% use of prescribed doses. Medication adherence was measured electronically using devices fitted onto the medication bottles to record the date and time of each bottle opening.

Outcome expectancy, peak expiratory flow, prebronchodilator FEV1, asthma control (Juniper asthma control questionnaire), and asthma-related quality of life were assessed at baseline and at the 4-week follow-up.

Results showed that the enhanced presentation mode was associated with improved adherence to active drug. Additionally, when a patient expected a higher benefit from treatment, their breathing test scores improved and self-reported asthma control scores tended to be higher. There was also an accompanying trend for improvement in asthma-specific quality of life.

These results suggest that the manner in which medications are introduced to patients may not only affect their expectations about the potential benefits of the therapy, but may also impact their level of adherence and sense of improved health. The authors dubbed this The Madison Avenue effect.

This study further supports the results of work undertaken by SRxA’s Health Outcomes Advisors:  Dr. Allan Luskin and Dr. Don Bukstein.  Together with SRxA, Drs Luskin and Bukstein, both world authorities on Health Outcomes, have developed fully integrated Practice Management programs to improve medication adherence and patient outcomes. These programs can be customized for almost any drug or treatment modality.  Pharmaceutical companies wanting to know more about these guaranteed result programs should contact us today.

Twin Peaks

Peak flow readings help symptoms during the peak asthma season.

A new study from University of California San Francisco, has shown that a simple once-a-month peak flow test during the winter cold and flu season can improve symptom control in patients with asthma.

Researchers evaluated the impact of patients discussing their monthly peak flow readings with their doctors versus a control group who received standard care.

Significantly fewer patients in the intervention group:

  • required oral steroids (9% v. 23%)
  • had worsening symptoms  (65% v. 89%)
  • needed urgent care visits (10% v. 23%)

Patients in the intervention group also had greater adherence to their inhaled steroids than those in the control group.

Study leader Professor Susan Janson concluded: “Interpreted peak flow monitoring may be beneficial to people with asthma during the seasons of greatest vulnerability.

SRxA’s Clinical Advisors have pioneered a number of other unique programs to improve compliance with asthma therapy and improve health outcomes. Contact us today for more information.

Asthma Through the Ages

SRxA’s Word on Health prides itself on bringing you the latest, cutting edge health and medical new stories. Today, however we’re going back in time and looking at an issue close to our heart (and lungs) – asthma.

The earliest recorded reference to wheezing and respiratory distress was recorded in China around 2,600 B.C.  Huang Ti, legendary leader of China wrote: “Man is afflicted he cannot rest and when his breathing has a sound.”  At the time, it was believed that asthma was caused by an imbalance of the yin and yang.

A thousand or so years later, the Babylonian “Code of Hammurabi” (1792-1750 B.C.) recorded symptoms of breathlessness: “If a man’s lungs pant with his work … When the breath of a man’s mouth is difficult.”

Around 300 B.C. Hippocrates first used the word “Asthma” (Greek for “wind” or “to blow”) for panting and respiratory distress. He is believed to be the first physician to understand the relationship between the environment and respiratory ailments, correlating illness with climate and location.

When Alexander the Great invaded India in 321 B.C. , he found locals smoking the herb stramonium, which they claimed relaxed the lungs. Today, a number of similar atropine-based compounds are still  used in asthma treatment.

The Greco-Roman doctor Galen ( 201-130 B.C.), identified asthma symptoms and established that asthma was caused by bronchial obstruction.  His treatment for the condition was owl’s wine.

Around the same time, other Roman physicians described asthma as “gasping” and the “inability to breathe without making noise.”  They also claimed: “If from running, gymnastic exercises or any other work, the breath becomes difficult, it is called asthma.” Today the American Lung Association calls this “silent asthma”.

A little later, another Roman, Gaius Plinius Secundus (23 A.D.) better known as Pliny the Elder noted that pollen was a source of respiratory distress and recommended use of ephedra (better known today as an FDA banned diet drug) and red wine as asthma remedies.   He also suggested that drinking the blood of wild horses and eating 21 millipedes soaked in honey could help!

Approximately  400 years later, the Jewish Talmud describes “drinking three weights of hiltith,” a resin of the carrot family, as a remedy for asthma.   While seven hundred or so years later, the philosopher and physician Maimonides published his “Treatise on Asthma.” In this he recommended comprehensive treatment including rest, good personal hygiene and environment, avoidance of opium, a small quantity of wine and special diet. Nuts, fowl, milk, cool vegetables and legumes were forbidden, while the soup of fat hens was considered beneficial.

Chicken noodle soup anyone?

Bad Breath? – Doctors speak doctor while Patients speak patient

While attending the ACAAI congress in Phoenix, SRxA’s Word on Health learned that despite the increasing availability of effective treatments, overall asthma care in the U.S. is suboptimal.

In a survey of almost 4,000 asthma patients, doctors and members of the general population, 71% of the asthma patients had disease that was either not well or very poorly controlled according to definitions established by current guidelines.

On the other hand, the majority of asthma patients said they thought their disease was well controlled, suggesting that many patients don’t understand the meaning of the term “adequate asthma control”.

The so-called Asthma Insight and Management study was a national survey of three populations, with responses from 2,500 asthma patients age 12 and older, 1,090 adults in the general population, and 309 health care providers.  It was conducted by SRxA Advisors, Michael Blaiss,  Eli Meltzer and colleagues, Drs Kevin Murphy, Robert Nathan and Stuart Stoloff

Among some of the more surprising results, researchers found:

  • 64% of asthma patients thought their disease was well controlled because they had two or more months between exacerbations.
  • 61% thought their asthma was well controlled because they had only been forced to go to the emergency room for asthma once in the previous year.
  • Only 6% agreed their disease was either not well or very poorly controlled.
  • Only 48% of patients reported that they followed the advice of their doctor.

Despite this, the disease burden is high.  63% of the patients said their asthma persisted throughout the year and 41% reported that the illness interfered with their life “some” or “a lot.”  Compared with the general population, Blaiss and colleagues found, asthma patients reported poorer general health, greater limitations on activity, and taking more than twice as many sick and disability days off work.

According to another SRxA Advisor, Dr. John Oppenheimer,  the study confirms what many clinicians have long suspected. He told us, “While there are many possible causes for suboptimal management, one of the problems is doctors speak doctor and patients speak patient.”

Both physicians and the manufacturers of asthma drugs need to make more of an effort to understand why asthma patients don’t use medications as directed  in order to help them improve both their health and quality of life.

What are your thoughts on this?  Word in Health is waiting to hear from you.

Word on Health Goes West

SRxA’s Word on Health in-house team of healthcare experts and many of our renowned Clinical Advisors are about to head out for the annual American College of Asthma Allergy and Immunology (ACAAI) congress, which, this year, is taking place in Phoenix, AZ; from November 11-16.

In addition to educating ourselves on all that’s new in this exciting specialty, we are available to meet with our existing and potential new clients.

Our multitalented, multinational team has, between us, decades of experience in clinical practice, clinical research, regulatory strategy, compliance, professional education, publications, pharmaceutical sales and marketing, advocacy, thought leader development, health outcomes and consulting.

If you are looking for help with:

  • Strategic planning
  • Product support
  • Professional marketing
  • Clinical development
  • Regulatory strategy
  • Social media outreach
  • Peer-to-peer education
  • …and so much more

we’d love to meet you and explain how SRxA can transform your challenges into opportunities.

Contact us today to set up an appointment.

Interfering Interferon

Word on Health heard some news this week that might just help asthma patients breathe easier.

Researchers at UT Southwestern Medical Center have found that interferon, a drug used to treat a variety of cancers such as leukemia and melanoma as well as multiple sclerosis and hepatitis; can block the development of certain immune cells known to cause asthma.

Known as T-helper 2 cells, under normal circumstances, they help protect against infections by releasing chemicals that induce inflammation. However in some people, these cells can promote allergic responses to normally harmless substances, including animal dander, pollens, and pollutants. Once Th2 cells become reactive to these substances, they promote all of the inflammatory processes common to allergic diseases like asthma and eczema.

The results which have just been published in the Journal of Immunology, suggest that interferon might be a viable, therapy for the treatment of asthma.

Dr. J. David Farrar (right) and research assistant Jonathan Huber

This finding is incredibly important, because humans are being treated with interferon for a variety of diseases, yet no one has tried treating asthma patients with interferon,” said J. David Farrar, PhD, Assistant Professor of Immunology and Molecular Biology at UT Southwestern and lead author of the study. “The current therapies for asthma are inhalers and steroids, both of which offer only temporary relief.”

In the current study, the researchers showed that interferon blocks the development of developing Th2 cells by targeting the very transcription factor that regulates their development and stability in the first place.

According to Farrar, “If you can stop a Th2 cell from ever developing, and if you can take a Th2 cell that has already become one and stop it from secreting these asthma-causing chemicals, then that’s really the ‘Holy Grail’ of treating asthma.”

Could this be an end to inhalers?  Only time and clinical trials will tell.

Asthma Warning for Pregnant Women

It may surprise some of our readers to learn that asthma is the most common serious complication of pregnancy.  In fact, up to 55% of women will have at least one acute asthma attack during pregnancy.

Pregnancy may affect asthmatic patients in several ways. Hormonal changes may affect the nose, sinuses and lungs. An increase in estrogen contributes to congestion of the tiny blood vessels in the lining of the nose. A rise in progesterone causes increased respiratory drive, and a consequent feeling of shortness of breath.

Yet, despite this, many pregnant women are just not identified as asthmatic. All too often asthma is not reported by moms-to-be during antenatal visits and is therefore under-treated. Then there are those who know they have asthma but fail to take their controller medications for fear they harm the baby.

Such concerns appear to be unjustified.  According to the American College of Asthma, Allergy and Immunology (ACAAI), well-controlled asthma is not associated with significant risk to mother or fetus.

Uncontrolled asthma, on the other hand, can cause serious complications to the mother, including:

  • high blood pressure
  • toxemia
  • premature delivery
  • death

For the baby, complications of uncontrolled asthma include:

  • increased risk of stillbirth
  • fetal growth retardation
  • premature delivery
  • low birth weight
  • a low APGAR score at birth

The Pregnancy Committee of ACAAI advises that the risks of asthma medications are lower than the risks of uncontrolled asthma. They suggest that women discuss the use of asthma or allergy medication needs with their doctor, ideally before pregnancy.

SRxA’s Word on Health would like to hear your asthma and pregnancy stories.

Stress at work increases the risk of asthma

A couple of weeks ago Word on Health reported that working too hard may be bad for your heart.  Now, there’s evidence that it’s also bad for your lungs!

According to a new study, employees who find it difficult to leave their problems at the office are much more likely to develop asthma. The research showed that having a stressful job can increase the risk of developing asthma by 40%.

Although most sufferers develop asthma in childhood, significant numbers are now diagnosed as adults. The research, from Heidelberg University in Germany, suggests stress at work could be one reason why. Researchers tracked 5,000 men and women, aged between 40 and 65, over eight years.

They found that among those free of asthma at the start of the project, there was up to a 40% higher incidence of asthma eight years later, if they suffered stress at work.

The signs were long working hours, demanding schedules and uncomfortable working conditions.

The report, detailed in Allergy, said: ‘Our study suggests work stress and the inability to relax after work are associated with an increased risk of asthma.’

Earlier studies have shown stress can lead to the release of chemicals that promote allergies and disrupt the way the body halts inflammation of the airways.

The team stressed that the absolute risk of someone developing asthma because they are overloaded at work is still very small.

Nevertheless, next time you’re asked to work late, you may want to stop and think of your health.

New Way to Eliminate Source of Asthma?

U.S. researchers say they’ve found a way to eliminate the source of immune system molecules that cause asthma and other allergic diseases.

These soluble IgE moleclues are produced by immune cells called B cells. While targeting IgE in the blood is an effective treatment for moderate-to-severe allergic asthma, this approach doesn’t stop IgE production and patients require repeated treatments.

According to the May 10 edition of the Journal of Clinical Investigation, scientists from Genentech say they’ve developed a way to eliminate IgE-producing B cells.  This finding could potentially lead to new long-lasting treatments for asthma and other allergic diseases.  So far the method has only been tested in mice, where it proved highly effective.

Word on Health awaits the results of future studies in humans.