Health & Medicine
Health Watch: Mood and Arthritis Pain
Painful knees. Stiff ankles. These are some of the daily struggles for kids with arthritis pain. And more drugs, a new study implies, are not the answer. Therapies that help kids deal with bad moods may be a better choice. In the current issue of Arthritis and Rheumatism, researchers report on 51 kids with inflammatory arthritis, about age 12, who kept pain and mood diaries for two months. Poor moods and stress were linked with more pain and fewer social activities. "We're talking about missing soccer practice or just playing with other kids, and I can't imagine that makes them happy," says Laura Schanberg, a pediatric rheumatologist at Duke University Medical Center and one of the study authors. "When people are less happy, they have more pain. It's a vicious cycle." These children were already on lots of arthritis drugs, so doctors are reluctant to prescribe more. Schanberg suggests relaxation techniques or other therapies that teach kids how to control their symptoms.
Health Watch: Pressure From Patients
The more than $3 billion the pharmaceutical industry spends on consumer advertising each year seems to be paying off. When consumers request medication that they've seen in commercials, doctors respond by writing more prescriptions, according to a study in last week's Journal of the American Medical Association. That's good if the treatment is appropriate but bad if there are lower-cost or nondrug alternatives. Researchers sent actors into doctors' offices with symptoms of either depression, which could improve with antidepressants, or adjustment disorder, a milder condition for which drugs are not usually prescribed. In both cases, the actors who asked for antidepressants were much more likely to get a prescription than those who said nothing, even when the drug's benefit was questionable. Previous studies have shown that marketing spurs patients to ask for drugs. Says Richard Kravitz, the lead author of the study: "Patients should be careful what they ask for because they might get it." Whether they need it or not.
Health Watch: Better Drugs for Breast Cancer
JoAnne Zujewski is not naive. "I've been doing breast cancer research for 12 years," says the National Cancer Institute oncologist. "And I've seen many treatments fail our patients." But not last week. The institute announced that a combination of drugs, used in two trials on women with aggressive tumors, cut their relapse rate in half. "That means disease free. These are stunning results." The combo uses standard chemotherapy plus the drug Herceptin, which blocks a molecule that's key to growth in one type of tumor. In more than 3,000 women who had early-stage tumors removed, this proved much more effective than chemo alone. "If I had 100 patients on chemo, 33 would get cancer again in four years. With this combo, only 15 would get it," says Edith Perez, an oncologist from the Mayo Clinic in Jacksonville, Fla., who led one of the studies. Herceptin is usually used after cancer has spread, but this indicates the drug has much wider potential in patients with early disease. Not for everyone, though: Only about one third of patients with breast tumors have its target molecule, called HER2. It also carries a small risk of heart trouble. "But clearly a lot more patients should be tested for HER2," Perez says, "because now we can treat them."
This story appears in the May 9, 2005 print edition of U.S. News & World Report.
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