Study Finds Bortezomib To Be Promising Treatment For Rheumatoid Arthritis

Proteasome Inhibitor Reduces Inflammation and Promotes Bone Healing in Arthritis Models.

A new study by Greek researchers suggests that the biologic drug bortezomib (Velcade), a proteasome inhibitor used to treat multiple myeloma (bone marrow cancer), may represent a promising treatment for rheumatoid arthritis (RA). In this study, bortezomib displayed favorable effects in an animal model of inflammatory arthritis that mimics RA, in reducing disease severity and inflammation, and promoting bone healing. Full findings of this study are published in the November issue of Arthritis & Rheumatism, a journal of the American College of Rheumatology (ACR).

RA is a chronic, systemic, autoimmune disease characterized by inflammation and joint destruction. The newer biologics, such as the tumor necrosis factor (TNF) inhibitors and monoclonal antibodies, have increased the therapeutic options for patients with RA. However, studies have shown that more than 50% of patients treated with a TNF inhibitor do not meet the ACR 50 improvement criteria a standard set of measures developed by the college to determine efficacy of drugs in clinical trials.

“The definitive role of biologic agents in treating this difficult-to-cure population has yet to be defined in prospective trials comparing the available therapeutic options,” explained study leader Evangelia Yannaki, M.D, of George Papanicolaou Hospital in Thessaloniki, Greece. “Given the lack of options for poor responders and the increased risk of infections and malignancies with available biologic agents for RA, there is a great need for novel therapies that are safe and effective.”

The research team explored bortezomib as an optimal treatment for RA because the drug targets multiple pathways. In RA, the most important proinflammatory mediators are regulated by the transcription factor NF-???B proteins that control genes involved in inflammation and the immune response to infection. Where bortezomib inhibits NF-???B, researchers speculate that the drug may improve autoimmune conditions, such as RA, which are characterized by chronic inflammation.

The analysis demonstrated that in vitro, bortezomib significantly reduced proliferation and increased death of the inflammatory cells in rats with adjuvant induced arthritis (AIA), thereby reducing invasiveness of fibroblast-like cells that are responsible for the damage to the lining of the joints; it also modified the pattern of protein cell signaling (cytokine secretion) in T-lymphocytes that are involved in the immune system response. In vivo, bortezomib significantly improved clinical manifestations of arthritis in these animals, even when administered during the advanced disease phase. Researchers noted that joints in animals treated with the drug displayed limited damage and inflammation, and an obvious bone healing effect was observed.

“Our research showed that bortezomib is a useful treatment in targeting critical cell populations involved in the development of inflammation and autoimmunity in RA,” concluded Dr. Yannaki. “We believe that bortezomib should be further explored in a clinical setting, as it represents an attractive intervention for inflammatory conditions and a highly promising agent in the treatment of RA.”

Sources: Wiley – Blackwell, AlphaGalileo Foundation.

View drug information on Velcade.

New Medicare Reimbursement Code For Orthovisc For Patients With Osteoarthritis, USA

DePuy Mitek, Inc., a Johnson & Johnson company, today announced that the Centers for Medicare & Medicaid Services (CMS) has assigned a new reimbursement HCPCS (“J”) Code to ORTHOVISC®, an ultra pure hyaluronan injectable used to improve mobility and treat knee pain caused by osteoarthritis.

The HCPCS J Code, J7319, will take effect in January 2007 and will cover all hyaluronic acids.  Previously, ORTHOVISC was assigned a miscellaneous code that required manual billing and caused challenges and delays in processing claims. 
The new code should improve claim processing, reduce denials of coverage and reduce administrative costs for physicians’ offices.  Doctors should continue to use the current miscellaneous code until the new code is published in January.  Existing codes for hylaruonic acids are scheduled for deletion on December 31, 2006.

“This is good news for doctors and their patients who suffer from osteoarthritis of the knee,” said Michel Paul, President, DePuy Mitek.  “By assigning ORTHOVISC a permanent J Code, CMS has simplified the reimbursement process for doctors and improved patient access to this important treatment.  However, while ORTHOVISC will have the same code as other hyaluronic acids, important differences remain.”

ORTHOVISC is the only viscosupplementation product in this classification with a 30-mg per dose, 3-injection treatment regime that offers 26 weeks of pain relief.  ORTHOVISC contains no buffers or preservatives and no pseudoseptic reactions have been reported in more than 1 million injections.

More than 10 million people suffer from osteoarthritis of the knee, an often painful condition caused by the deterioration or loss of cartilage around the knee.  Treatment options include physical therapy and exercise, medications, corticosteroid or hyaluronic acid injections, and surgery.

Hyaluronan is a natural chemical found in the body that acts like a lubricant and shock absorber for the knee.  ORTHOVISC contains the highest concentration of ultra-pure hyaluronic acid per injection on the market today.  A doctor injects ORTHOVISC directly into the knee once a week, for a total of three injections, usually in the doctor’s office.  ORTHOVISC provides lubrication for the knee, helps to cushion the knee joint and can relieve knee pain for up to six months and improve mobility. 

DePuy Mitek markets ORTHOVISC to arthroscopists, orthopedic surgeons and rheumatologists.  Anika Therapeutics, Inc. (Nasdaq: ANIK) developed and manufactures ORTHOVISC.

ORTHOVISC is contraindicated in patients with known hypersensitivity to hyaluronate formulations or known avian or avian-derived allergies including eggs, feathers, or poultry.  ORTHOVISC should not be injected in patients with infections or skin diseases in the area of the injection site or joint.  Strict aseptic technique should be used.  The effectiveness of more than one course has not been established. 

For more information contact DePuy Mitek Customer Service at 800-382-4682 or visit orthovisc.  For reimbursement information visit orthoviscline or call 866-633-VISC (8472).

About DePuy Mitek, Inc.

DePuy Mitek, Inc., a Johnson & Johnson company, is a leading developer and manufacturer of a wide range of products and solutions that simplify procedures and “Restore the Anatomy”™.  Well known for its innovative surgical sports medicine and arthroscopic medical devices, DePuy Mitek currently operates in 58 countries.  Through an on-going process of improving upon and creating technologically advanced materials, instruments, implants and techniques for shoulder, knee and small joint pathologies, DePuy Mitek continues to advance arthroscopic procedural solutions in the field of sports medicine while expanding into viscosupplementation and biologics.  DePuy Mitek’s patient education efforts include websites such as managingosteoarthritis and shoulderpainsolutions/.  For more information, visit depuymitek.

About Anika Therapeutics, Inc.

Headquartered in Woburn, Mass., Anika Therapeutics, Inc. (anikatherapeutics) develops, manufactures and commercializes therapeutic products for tissue protection, healing and repair. These products are based on hyaluronic acid (HA), a naturally occurring, biocompatible polymer found throughout the body. ORTHOVISC is a registered trademark of Anika Therapeutics, Inc.

2nd International ‘Come To Your Senses’ Conference – For Those Who Work With Children & Adults With Various Disabilities

The 2nd International Come To Your Senses Conference will take place on May 23 – 27, 2007 at The Sheraton Centre Toronto. The focus of this conference is Opening the Sensory World to Children and Adults with Complex Disabilities.

We invite professionals, parents, caregivers, persons with disabilities, researchers, and students to attend the conference and participate in discussions covering a wide array of topics within the realm of Sensory Field and people with disabilities. The goal is to share and disseminate knowledge and experience from around the world so that we can better understand the Sensory Reality of people with disabilities and the many forms of treatment that exist.

Take advantage of this opportunity and REGISTER NOW by visiting sensoryconference

To become an exhibitor and be given a chance to demonstrate your services and products to conference participants, please visit the Exhibitors section of the conference webpage. To help make this unique event a huge success visit the Sponsors section and review the Sponsorship Package for a number of exciting opportunities!

To find out more information about MukiBaum Treatment Centres, visit mukibaum.

MukiBaum Treatment Centres
209 – 265 Rimrock Road
Toronto, ON, M3J 3C6
P: 416-630-2222 ext 230
F: 416-630-2236

House Appropriations Committee Passes Bill Allowing Contraceptive Donations To International Groups Barred From Funding

The House Appropriations Committee on Tuesday by voice vote approved a foreign aid spending bill that would allow the federal government to give contraceptives but not money to international groups barred from receiving U.S. aid because of their abortion policies, the AP/Forbes reports (Taylor, AP/Forbes, 6/13).

The so-called “Mexico City” policy bars U.S. funding from going to international groups that support abortion, even with their own money, through direct services, counseling or lobbying activities. The policy was originally implemented by former President Reagan at a population conference in Mexico City in 1984, removed by former President Clinton and reinstated by President Bush during the first days of his presidency. Bush in September 2003 issued an executive order that prevents the State Department from giving family planning grants to international groups that provide abortion-related counseling.

Rep. Nita Lowey (D-N.Y.), chair of the House Appropriations Subcommittee on State, Foreign Operations and Related Programs, recently said the legislation leaves the Mexico City policy intact, but Republicans disagreed and cited a threat by Bush to veto legislation that would change current abortion-related policies and laws. Bush last month in a letter to House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Harry Reid (D-Nev.) said he will veto any legislation that would weaken federal policies or laws on abortion, including measures that would “allow taxpayer dollars to be used for the destruction of human life” (Kaiser Daily Women’s Health Policy Report, 6/6).

Rep. Frank Wolf (R-Va.) said the amended Mexico City policy “is a guaranteed veto if it stays in.” Lowey said the policy retains all the current prohibitions on abortion and “simply allows for the provision of lifesaving contraceptives” (Kivlan, CongressDaily, 6/13).

The provisions included in the $34.2 billion spending bill for fiscal year 2008 must still be debated by the full House and Senate, Reuters reports (Cowan, Reuters, 6/12).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Bacteria’s Glue Valve Surprises Scientists

St Louis, USA – To stick to cells in the respiratory tract and start an infection, the bacterium Haemophilus influenza has to secrete a glue-like protein. Researchers at Washington University School of Medicine in St. Louis report this week that a study of the valve that lets out the glue has produced some surprising information.

Scientists are studying the valve to better understand how bacteria interact with host cells. Insights into these interactions could lead to new targets for drugs to treat H. influenzae infection, which is a common cause of respiratory tract disease and in some parts of the world is responsible for most cases of childhood bacterial meningitis.

The study is available online in the Proceedings of the National Academy of Sciences and will appear October 5 in the print edition of the journal. The first author is Neil K. Surana, an M.D./Ph.D. student at Washington University.

Washington University researchers determined that the protein that makes up the valve, HMW1B, is structurally similar to other proteins found in a wide variety of life forms ranging from humans to plants to single-celled organisms and bacteria. Those proteins, which create openings that move substances from one side of a cell membrane to another, are collectively known as Omp85-like proteins.

In addition to the similarities, though, researchers also found that HMW1B has some unexpected quirks.

“Previous studies of Omp85-like proteins on other bacterial surfaces had suggested that they are monomers, proteins active when only a single copy of the protein is present,” says senior investigator Joseph W. St. Geme, M.D., a Washington University pediatrician at St. Louis Children’s Hospital and a professor of molecular microbiology and pediatrics. “But we found that four copies of HMW1B come together in a structure known as a tetramer to form an active pore.”

Discovery of the tetramer led researchers to expect that the four copies of HMW1B would form a ring-like structure with a single central opening. But based on data still under review, they now suspect that each copy of HMW1B may have an opening in its center that lets the glue-like proteins, called adhesins, cross the cell membrane.

“We were already curious about why the tetramer exists instead of a monomer,” says St. Geme. “Now we need to see if we can confirm whether each copy creates its own opening.”

St. Geme speculates that the tetramer may be more stably positioned in the bacteria’s outer membrane than a monomer. Alternatively, the tetramer may facilitate interaction among multiple copies of the glue, perhaps allowing the glue to become activated as it emerges onto the surface of the bacteria.

Scientists previously have found other proteins similar to HMW1B and the glues it secretes in infectious agents like Bordetella pertussis, the bacteria that causes whooping cough. According to St. Geme, it’s too early to tell if these similarities make this group of proteins good targets for drug development.

“The similarities to other Omp85-like proteins could make it difficult to develop drugs that block HMW1B without adversely affecting Omp85-like proteins normally active in humans,” he explains. “But another major part of this paper is the discovery that there are some unique aspects to the interaction between HMW1B and the adhesin it exports. We may be able to focus our efforts on this interaction. ”

Surana NK, Grass S, Hardy GG, Li H, Thanassi DG, St. Geme JW III. Evidence for conservation of architecture and physical properties of Omp85-like proteins throughout evolution. Proceedings of the National Academy of Sciences, early online edition.

Funding from the National Institutes of Health and the Medical Scientist Training Program at Washington University School of Medicine.

Washington University School of Medicine’s full-time and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked second in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

Contact: Michael C. Purdy
Washington University School of Medicine

NHLBI Asthma Clinical Research Networks And ALA ACRC Network Presenedt At ATS 2007

Researchers studying inhaled steroids and children with asthma, as well as asthma and obesity, presented new findings from the National Heart, Lung, and Blood Institute (NHLBI) Asthma Clinical Research Networks at the American Thoracic Society 2007 International Conference in San Francisco.

Researchers from the American Lung Association Asthma Clinical Research Centers (ACRC) presented substudies and subgroup analyses for three ACRC studies, plus an overview of ongoing and future ACRC studies.

NHLBI Asthma Clinical Research Networks

Two of the presentations included new research findings from the Prevention of Early Asthma in Kids (PEAK) study, which is investigating the effect of inhaled-corticosteroid therapy on children with asthma. In May 2006, PEAK researchers published findings in The New England Journal of Medicine that showed that preschool children at high risk for asthma had decreased asthma-like symptoms while on two years of inhaled-corticosteroid therapy; however, this therapy did not change the development of asthma symptoms or lung function during a third, treatment-free year.

Since then, the researchers have continued to observe the 285 children in the study, to get a more in-depth look at the changes in the lungs, including inflammation, in these children. The new PEAK results will look at the follow-up of the study, with more in-depth information about the predictors of response to inhaled steroids and long-term changes in the physiology of the lung.

Wayne Morgan, M.D., of the University of Arizona Health Sciences Center in Tucson, who presented new data at the ATS meeting, comments, “The question was, can you protect the airways by using inhaled steroids early in life in high-risk kids to modify the development of wheezing and protect lung function” The bottom line is no. You can control asthma, but you can’t make it go away.” In this study, children considered to be at high risk of asthma include those with recurrent wheezing in the first three years of life, as well as those with eczema or a parent with asthma.

A second presentation on the PEAK studylooked at whether there are ways to predict which high-risk children will do poorly with their asthma. “Some children outgrow their asthma and some maintain their asthma, and PEAK found that inhaled steroids didn’t change that course. However, these high-risk children do respond to inhaled steroids, but if you take them off, they tend to do worse,” says researcher Theresa Guilbert, M.D., Assistant Professor of Pediatrics at the University of Wisconsin-Madison and lead author of The New England Journal of Medicine article. “We know that if children have certain characteristics such if they’re male, have allergy, or have eczema that they tend to do poorly over time.”

A third study from NHLBI’s Asthma Clinical Research Network looks at the impact of overweight and obesity on asthma severity and response to asthma therapy. The study is using data from the NHLBI on approximately 1,200 people with asthma.

“This type of study provides extremely rich data in terms of the participants’ height, weight and asthma severity, allowing us to more precisely evaluate the relationship between body mass and asthma severity,” says researcher E. Rand Sutherland, M.D., M.P.H., Assistant Professor of Medicine at the National Jewish Medical and Research Center in Denver. “We can also look at how obesity modifies the response to therapy.”

Dr. Sutherland’s findings suggest that in patients with mild-to-moderate asthma, increased weight does not substantially worsen physiologic and inflammatory markers of asthma. “However, overweight and obese patients with asthma do appear to respond less well to traditional asthma therapies than do their lean counterparts,” he says.

ACRC Trials

The American Lung Association Clinical Research Centers’ (ACRC) purpose is to conduct clinical trials with practical importance to both adults and children with asthma. Researchers will present new data from substudies and subgroup analysis of the following three studies:

Leukotriene Modifier or Corticosteroids or Corticosteroid-Salmeterol Trial (The LOCCS Trial) aimed to determine the optimal “step down” therapy for mild-moderate persistent asthma that was controlled on inhaled corticosteroids

The Sinusitis and Rhinitis in Asthma Study (SIRNA) trial developed a clinical tool to reliably diagnose rhinosinusitis in people with poorly controlled asthma

Contact: Suzy Martin

American Thoracic Society

Asthma in Northern Ireland – the true picture revealed

Admissions to hospital for asthma in Northern Ireland remain significantly higher than the rest of the UK, says a report
launched today by Asthma UK Northern Ireland.

‘A Moving Picture – Asthma in Northern Ireland Today’ reveals the true extent of how asthma affects people in Northern
Ireland and describes the standards of care that they receive.

The report also details that people’s confidence in how Health and Social Services handles asthma emergencies is low.

Marjory Burns, Executive Director of Asthma UK Northern Ireland said: ‘Asthma is a condition that should be controllable with
modern treatments and specialist training yet we still see an unacceptable level of hospital admissions for asthma
emergencies. 75% of hospital admissions and 90% of asthma deaths are preventable. We would like to see every person with
asthma have a personal action plan to help them take control of their asthma.’

One shocking statistic from the report shows that asthma has a real and all-pervading effect on people’s lives with only 1 in
4 people with asthma in Northern Ireland expecting their medicines to control their asthma. The survey also revealed that
people with asthma in Northern Ireland have low expectations – four out of five are still experiencing daily asthma symptoms
and yet their confidence in local health care practitioners and routine care is higher than anywhere else in the UK.

Dr Vincent McGovern, GP and part-time Medical Officer in Respiratory Medicine, Belfast City Hospital added: ‘It is important
to ensure that people with asthma understand that for the majority of people, their condition can be effectively controlled
and that there is no reason why they should be experiencing symptoms every day. Their GP or practice nurse should be giving
advice about how their asthma might change over time and what they can do to control their symptoms. Using a reliever inhaler
three times a week or more or even waking up once a week, indicates that they should discuss their symptoms with their GP or
nurse. Healthcare professionals have a responsibility to monitor who is due for an asthma review and to check that their
symptoms are not taking over their lives.’

Ms Burns further commented: ‘Healthcare professionals in Northern Ireland need to review the way people with asthma are cared
for. Asthma UK Northern Ireland is calling for healthcare professionals to put Asthma UK’s ten-point Asthma Charter into
practice. The Charter outlines the standards of care that a person with asthma should expect. GPs and practice nurses should
also be following the BTS/SIGN Guideline on the management of asthma to improve care, save lives and keep people out of

As part of Asthma UK’s commitment to working with healthcare professionals, the charity is providing all GPs and practice
nurses in Northern Ireland with new tools for controlling asthma – the Be in Control pack, which includes an asthma action
plan and a guide to carrying out an asthma review as well as basic information for people with asthma.

For media queries about this story, call Will Chambr? on 028 9066 1006 or 07736 230585.

Download ‘A Moving Picture’ (PDF 380KB)

Notes to Editors:

1. Asthma UK is the charity dedicated to improving the health and well-being of the 5.2 million people with asthma in the UK.
Asthma UK works with people with asthma, healthcare professionals and researchers to develop and share expertise to help
people increase their understanding and reduce the effect of asthma on their lives.

2. For independent and confidential advice on asthma, call the Asthma UK Adviceline, which is staffed by asthma nurse
specialists. It is open weekdays from 9am to 5pm on 08457 01 02 03. Or email an asthma nurse at asthma/adviceline.

3. For up-to-date news on asthma, information and publications, visit the Asthma UK website asthma

Media Office
T: 020 7704 5841
F: 020 7704 5933
E: mediaofficeasthma

New Autism Association Centre Expands Services For WA, Australia

The Premier of Western Australia officially marked the commencement of construction of
the Autism Association of Western Australia’s new Service Headquarters and state of the art
Early Intervention Centre in Shenton Park.

The new facilities will expand the Association’s delivery of services in all areas and enable
clinical and training staff to connect with organisations, professionals and families throughout
Western Australia.

Autism Association of WA Chief Executive Officer, Joan McKenna Kerr, said the new Service
Headquarters was the result of a true partnership between the Autism Association, the
community and the public sector.

The Government and Lotterywest have supported the development of the centre with a
$4million grant with the balance of the funding coming largely from community fundraising and
other activities.

“Our new Service Centre will provide the infrastructure to expand services for both children and
adults, and will include a state of the art early intervention centre for newly diagnosed children
under the age of six years,” Ms McKenna Kerr said.

“It will provide the Association’s multi-disciplinary teams with the capacity to work with over 400
pre-school children with Autism each year. In addition to the Early Intervention Centre, the new
complex will also provide facilities for all of the Autism Association’s community based Children
and Adult Services as well as Family Support Programs.

“It will also have a medical consultancy suite for adolescents and adults with complex needs.”
Ms McKenna Kerr said importantly the new facilities would assist clinical and training staff to
connect with organisations, professionals and families in regional Western Australia.

“This will be a place where any member of the public can come to find out more about Autism; a
place where the achievements of people with Autism will be on show; and facilities where
families can come to meet with staff and with each other”.

Lisa Cocks, mother of two children with Autism, said early intervention was critical in helping
develop life-long skills for her children and strategies to cope in different situations.

“This is about teaching them many of things we all take for granted, such as how to play with
other children, to share, to understand emotions and facial expressions and to interact with
children their own age” Ms Cocks said.

“My eldest son Aaron was diagnosed with Asperger’s Syndrome at six years of age, while Bryce
received his diagnosis of Autism Spectrum Disorder (ASD) at three. While they both have very
different autistic tendencies they both need special support. Aaron would have benefited greatly
from early intervention if we’d had an earlier diagnosis,” she said.

“The work the Autism Association does is amazing. At three years old Bryce had no language
and communicated through ‘melt downs’. He still has trouble with eye contact but he is a
different child.

“I can’t wait to see the new centre operating. Having all the facilities located in one place rather
than being spread across different locations will certainly make it logistically better for both staff
and for families.”

Designed by Architects Cameron Chisholm Nicol and being constructed by Diploma Group, the
building is expected to be completed in early 2012.

Autism Association of WA Background

Autism is a complex, life-long developmental disability which is neurobiological in origin.
Approximately one in every 160 children in Australia is diagnosed with an Autism Spectrum
Disorder (ASD).

The Autism Association of Western Australia is a large not-for-profit organisation providing
services from diagnosis in infancy and throughout the life of person with Autism.
Our mission is to advance the personal development, equality of opportunity and community
participation of people with Autism.

The Association is the only specialist Autism organisation in Australia providing the full range of
services to meet the needs of people with Autism from early childhood into adulthood; and is the
second largest specialist organisation providing services to people with Autism and their families
in Australia.

The Association also works with a range of service providers in Western Australia and is one of
only five agencies worldwide providing specialist programs to assist job-seekers with Autism to
find and maintain employment.


Autism Association

Most Women Unaware Of Risk For Debilitating Fractures

Underscoring what researchers call a serious global public health concern, results from a new study led by Columbia University Medical Center reveal that many women at an elevated level of risk for osteoporosis-associated fractures fail to perceive the implications of the risk factors.

“We found that many women aren’t making the connection between their risk factors and the serious consequences of fractures,” said the lead author Ethel Siris, M.D., director of the Toni Stabile Osteoporosis Center at NewYork-Presbyterian Hospital/Columbia University Medical Center, and the Madeline C. Stabile Professor of Clinical Medicine at Columbia University College of Physicians and Surgeons. “Without a clear understanding of their risks, women cannot begin to protect themselves from fracture.”

This study, part of the Global Longitudinal Study of Osteoporosis in Women (GLOW), which is based at the Center for Outcomes Research at the University of Massachusetts Medical School, was published online by the journal Osteoporosis International on April 2, 2010. The study, conducted at 17 GLOW study sites worldwide, included more than 60,000 postmenopausal women in 10 countries in Europe, North America and Australia.

Results showed that among postmenopausal women diagnosed with osteoporosis a condition associated with a high risk for fractures, as it causes bones to become fragile and more likely to break only 43 percent thought their risk of a fracture was higher than other women their age. Additionally, only one in three (33 percent) women who reported two or more major risk factors for fracture, perceived themselves as being at higher risk for fracture than their age-matched peers.

Because many fractures can be prevented by appropriate treatment, it is important that elevated risk be recognized.

One in two women will suffer an osteoporosis-related fracture after age 50; these fractures often carry with them chronic pain, reduced mobility, loss of independence and in the case of hip fracture, an increased risk of death. Because the likelihood of fractures increases substantially with age, fracture numbers are projected to rise as the population ages. Osteoporosis-related fractures are an international public health problem; in addition to the human suffering associated with these fractures, they also are the source of enormous health-care costs.

Improved education of physicians and postmenopausal women about osteoporosis risk factors is urgently needed, according to the study authors. If left untreated, osteoporosis can progress painlessly until a fracture occurs. Several risk factors for fractures have been identified and should be considered by physicians treating women age 55 and older:

– older age

– low weight

– parental hip fracture

– personal history of fracture (clavicle, arm, wrist, spine, rib, hip, pelvis, upper leg, lower leg, ankle) since age 45

– two or more falls in the past year

– current use of cortisone or prednisone (steroids often prescribed for a number of medical conditions)

– rheumatoid arthritis

– cigarette smoking

– consumption of three or more alcoholic beverages daily

Other risk factors for fractures include a variety of medical conditions and medications. Tools for diagnosis and risk assessment, including bone-density testing and the World Health Organization FRAX fracture risk-assessment tool, are widely available; still, the connection between identified risk factors and serious fracture outcomes is not being made by a majority of women at highest risk.

“We hope the insight we obtain from GLOW will help physicians and patients work together to identify those at risk for fracture and to enhance understanding of the meaning of that risk,” said Siris. “Education is critical if we are to reduce the burden of fractures worldwide.”

GLOW is a prospective, international cohort study of women 55 years of age and older who visited their primary-care physician during the two years prior to enrollment in the study. More than 60,000 women were recruited by more than 700 primary-care physicians in 17 cities in 10 countries (Australia, Belgium, Canada, France, Germany, Italy, Netherlands, Spain, United Kingdom and the United States). GLOW is gathering information on osteoporosis risk factors, treatments, patient behaviors and fracture outcomes during a five-year period. Self-perceived risk of fracture was assessed using a five-point scale ranging from “much lower” to “much higher” risk than other women of the same age.

Of the 28,000 U.S. women participating in GLOW, 3,500 were from New York, enrolled at the Helen Hayes Hospital in West Haverstraw, an affiliate hospital of NewYork-Presbyterian Healthcare System. A quarter (25 percent) of these women reported an osteoporosis diagnosis, 23 percent had a previous fracture, 17 percent were low weight, 37 percent reported recent falls, and 20 percent a parental hip fracture. Despite the high prevalence of risk factors, only 36 percent of women with two or more major risk factors perceived themselves to be at higher risk of a fracture than their peers. This failure by women to appreciate their personal risk of fracture presents a barrier to them receiving appropriate management and safe and effective treatments.

GLOW is supported by a grant from The Alliance for Better Bone Health (formerly Sanofi-aventis and P&G Pharmaceuticals, now Sanofi-aventis and Warner Chilcott) and is being directed by the Center for Outcomes Research, University of Massachusetts Medical School.

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians and Surgeons was the first institution in the country to grant the M.D. degree and is now among the most selective medical schools in the country. Columbia University Medical Center is home to the most comprehensive medical research enterprise in New York City and State and one of the largest in the United States. Columbia University Medical Center is affiliated with NewYork-Presbyterian Hospital, the nation’s largest not-for-profit hospital provider.

NewYork-Presbyterian Hospital, based in New York City, is the nation’s largest not-for-profit, non-sectarian hospital, with 2,242 beds. The Hospital has nearly 2 million inpatient and outpatient visits in a year, including more than 230,000 visits to its emergency departments more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian Morgan Stanley Children’s Hospital, NewYork-Presbyterian Hospital/The Allen Hospital and NewYork-Presbyterian Hospital/Westchester Division. One of the largest and most comprehensive health care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. The Hospital has academic affiliations with two of the nation’s leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.

About the Center for Outcomes Research (COR)

COR is based at the University of Massachusetts, Worcester, Mass. The mission of COR is to collect and evaluate data that reflect real-world practices and outcomes and to provide physicians with confidential reports that allow comparison of their practices to evidence-based performance standards

Source: Columbia University Medical Center

Cohort Study Funded By Helmholtz

The Helmholtz Association will invest around 20 million euros over the next five years to put together a large-scale, long-term cohort study. The goal of the study will be to illuminate the causes of common health problems like cardiovascular disease, cancer, diabetes and dementia, as well as to identify risk factors and effective methods of prevention. The Helmholtz Association’s Senate reached the decision yesterday, 22nd October.

The cohort study will observe a group of 200,000 people over a period of ten to twenty years. The subjects will be healthy at the time they are recruited and will have given their permission to take part in the study. They will undergo regular medical checkups and answer questions about their lifestyle habits and socioeconomic status. Over time some of them will develop medical conditions, and doctors will then be able to relate to the medical data the patients provided earlier in the study. This makes the study a unique tool to gain a better understanding of a variety of epidemiological questions.

The Helmholtz Association will plan and conduct the cohort study with help from universities and other national research institutions. The planning and coordination phase will begin in 2009 and last for approximately three years. “Chronic conditions are placing an increasing burden on health care systems and presenting new challenges for health care researchers, as well. Cohort studies such as this one are helpful for developing new strategies for early recognition and prevention, especially for conditions that have a variety of causes such as lifestyle habits, environmental factors and genetic risk factors”, says Helmholtz Association President, Prof. J??rgen Mlynek.

All of the Helmholtz Association’s health centres will be involved in the initiative, with the German Cancer Research Center in Heidelberg and the Helmholtz Zentrum M??nchen – German Research Center for Environmental Health acting as coordinators. Other participants will include the Max Delbr??ck Center in Berlin-Buch, the Helmholtz Centre for Infec-tion Research, the Helmholtz Centre for Neurodegenerative Diseases (which is currently in the process of being established), and the health research division of Forschungszentrum J??lich. The total cost of the ten-year initiative is estimated to be between €150-200 million.

The Helmholtz Association contributes to solving major challenges facing society, science and the economy with top scientific achievements in six research fields: Energy, Earth and Environment, Health, Key Technologies, Structure of Matter, Transport and Space. With 28,000 employees in 15 research centres and an annual budget of approximately 2.4 billion euros, the Helmholtz Association is Germany’s largest scientific organisation. Its work follows in the tradition of the great natural scientist Hermann von Helmholtz (1821-1894).

Source: Thomas Gazlig

Helmholtz Association of German Research Centres