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Month: June 2018

New drug goes after major cause of asthma — eosinophils

New drug goes after major cause of asthma — eosinophils

Maybe you’ve seen the ads on TV lately for Fasenra, also known as Benralizumab, a new monoclonal antibody to help treat asthma. Fasenra blocks the proliferation of asthma-causing bad guys called eosinophils. The decreasing of these white blood cells helps prevent asthmatic inflammation.

The new Fasenra antibody is “selective for interleukin-5 (IL-5),” counteracting this chemical mediator that causes the proliferation of eosinophils — the major cause of asthma.

It is indicated for severe asthmatics 12 years old or older. Clinical trials have resulted in marked improvement in asthma control and in reduction of asthma exacerbations. It is administered as an injection in the arm, thigh or abdomen, and is given every four weeks for the first three doses; then every eight weeks.

Two other monoclonal drugs that also target IL-5 are Nucala and Cinqair. Nucala is also given by injection but every four weeks. Cinqair is given intravenously every four weeks. No head-to-head trials have been conducted comparing these three medicines. Nucala and Cinqair are given more often than Fasenra, but Fasenra is twice as expensive, so all three cost about the same.

Causes clearer for this eczema than relief

Causes clearer for this eczema than relief

Dyshidrotic eczema is a common condition that is still poorly understood. In fact, there is as much confusion with its name(s) as with its etiology.

The condition is a type of eczema that is characterized by pruritic vesicles (itchy, tiny blisters) that erupt in the fingers, palms and sometimes feet. It affects both children and adults, and can range from a rare, self-limiting problem to a chronic, severe and sometimes debilitating one.

Unfortunately, it also tends to be resistant to many forms of treatment.

The term dyshidrotic refers to the hypothesis that sweat glands dysfunction and cause the tiny blisters. But when a research group did biopsies of the palms of affected patients they did not find a problem with the sweat glands. Yet, it is known that people with hyperhidrosis (super-sweaters) are very prone to the condition. Also, Botox injections which help people with hyperhidrosis in their arm pits also help hand/foot eczema if the Botox is administered there.

Two other names for the condition: pompholyx (which means “bubble”), or pedpompholyx (if the rash appears only on the feet); and also, acute and recurrent vesicular hand and foot dermatitis.

The tiny blisters itch intensely, then pop and cause the skin to peel. Over time the skin can become thickened and fissured. About 50% of persons with this condition also have allergic problems. Also shown is a strong familial tendency for the condition.

Certain metals if ingested can cause the problem; most common are nickel and cobalt. Websites can detail the metal content of various foods and beverages.

Emotional stress is a well-recognized aggravator of the misery, but episodes also can be precipitated by environmental factors such as changes in temperature and humidity.

Although resistant to therapies, most people benefit by intensive efforts to moisturize the hands. A simple therapy that often works is Vaseline petroleum jelly applied to the hands, and then covered with white cotton gloves at night.

A variety of OTC and prescription steroid creams, lotions and ointments are effective to speed healing.

Finally, soaking the hands in cool water for 10-15 minutes stops the itch and can re-hydrate the skin.

Diabetes med Metformin quite a multi-tasker

Diabetes med Metformin quite a multi-tasker

Dear Dr. Sasha K: I read that the Metformin I take for my Type II diabetes has an anti-cancer benefit. Is this true?

In a word: yes. Metformin is an old drug that keeps making itself new. Metformin’s origins go back to medieval Europe where the French lilac plant was used to treat diabetes. The lilac contains biguanide, the main component of Metformin.

This drug works for diabetes by reducing the amount of glucose the liver makes by decreasing the amount of glucose the intestines absorb, and by enhancing patients’ sensitivity to their own insulin.

In addition to its anti-diabetic effects, Metformin is good for the cardiovascular system – lowering blood pressure and lipids, and lessening atherosclerosis. Some research centers are using Metformin in nondiabetics for these cardiovascular benefits.

Another application is in polycystic ovarian syndrome (PCOS). This condition is a problem for many women because it causes infertility, a tendency to diabetes and hirsutism (excess hair growth) and acne. Metformin has helped many young women obtain a desired pregnancy, while also helping them lose weight and reduce unwanted hair growth and acne.

Metformin has been found to play a role in the coagulation system; lessening unwanted clotting and improving the endothelium (the inner lining) of blood vessels so plaque does not accumulate as fast. In the brain Metformin can help the insulin resistance of brain cells in patients with Alzheimer’s. It also decreases oxidative stresses on brain cells and therefore, may have value in ALS, Parkinson’s and some cancers.

Finally, to answer your question, it’s Metformin’s potential as an anti-cancer therapy that has researchers most excited. It seems that this is because of its anti-inflammatory and anti-oxidant roles. For instance, Metformin has been shown to cause cancer cells to self-destruct. Of course, much further research is needed.

Pharma companies give free meds for school adrenalin emergencies

Pharma companies give free meds for school adrenalin emergencies

The two pharmaceutical companies that produce the two available forms of auto-injector adrenalin to deal with anaphylactic (allergic) shock are offering a program of free epinephrine doses to schools. The companies are Mylan, which makes the EpiPen, and Kaléo, maker of Auvi-Q.

Epinephrine, as many know, must be on hand to treat food allergy and insect sting emergencies.

Even with insurance coverage, these drugs have become very expensive. For some families this expense limits the purchase of the adrenalin to a single unit at home, but not one at school. Through this program, the medication can be placed in a child’s school, but access would be allowed to any student in peril.

Each company will provide both doses of epinephrine – the .15mg and the .30mg.  Mylan offers the medicine to all schools — public or private — and to all grade levels. Kaléo offers it to public grade schools. To request the medications be placed at your child’s school, visit EpiPen’s site at info@bioridgepharma.com and you’ll find info on the EpiPen4Schools program. For Auvi-Q: https://www.allergicliving.com.

You’ll need to give the name and address of the school and send a physician’s prescription with the request.

Q – Tips: itchy skin

Q – Tips: itchy skin

Dry skin leads to itchy skin. For people experiencing this combination it might be time to switch to a non-drying soap such as one based on shea-butter. And maybe to stop applying soap to the entire skin surface. A safer but still hygienic approach is to use soap in the key areas: armpits, groin, feet, and let water clean the rest.

Q – Tips: Pets in childhood

Q – Tips: Pets in childhood

A recently published German study about pet exposure in childhood has not only confirmed that there is less allergy in children in pet households, but a new finding shows when these children become adults they are less buffeted by life’s stresses, and less likely to develop anxiety or depression.

Q – Tips: Chlortrimeton

Q – Tips: Chlortrimeton

A new application for an old drug has been found. Chlortrimeton (chlorpheniramine maleate), one of the oldest OTC antihistamines still in use, has been found to be very effective in suppressing a chronic “tickle” cough known as hyperactive cough syndrome.