Anaesthesia Associates Expert

Sibutramine, brand name Meridia is an appetite suppressant, a weight loss pill. Editors at the NEJM (New England Journal of Medicine) write it is difficult for them to discern a “credible rationale for keeping this medication on the market”, even though it is restricted for people without heart disease.

According to a new study, individuals with heart problems have a significantly higher risk of stroke and heart attack if they take Meridia. This confirms concerns about Meridia’s safety for patients with heart disease and other heart problems (they are already warned against taking this prescription medication).

The NEJM article appears a couple of weeks before an FDA (Food and Drug Administration) advisory committee meets to discuss regulatory issues concerning Meridia. The meeting was scheduled after the publication of preliminary results from SCOUT, a study on Meridia released by the FDA in November 2009. In January 2010 the FDA asked Meridia makers, Abbot Laboratories to strengthen the warning on its label.

In January 2010 the European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP) concluded that the risks of these medicines (containing sibutramine) are greater than their benefits and recommended the suspension of marketing authorizations for these medicines across the European Union (Link to article).

Put simply, the SCOUT study prompted to Europeans to pull the drug off the shelves, while the FDA asked for stronger warnings only.

In this latest NEJM study, investigators monitored 10,744 obese/overweight individuals who had diabetes type 2 or heart disease and a risk factor, such as hypertension for approximately three-and-a-half years.

Michael Douglas told a US television audience on Tuesday night that he has been diagnosed with and is receiving treatment for stage four throat cancer.

Speaking on David Letterman’s “Late Show” to promote the release of his new film “Wall Street: Money Never Sleeps”, the 65- year old American actor and producer said his doctors had told him he has an 80 per cent chance of survival.

Stage four means the cancer has spread from the primary site, for example to another organ.

His press spokesman Allen Burry said that Douglas is being treated at Manhattan’s Memorial Sloan-Kettering Cancer Center:

“The tumor is at the base of his tongue and his doctor’s prognosis is for a full recovery,” he told ABCNews.com.

In the TV interview Douglas said he was diagnosed earlier in the summer: he had been experiencing a sore throat that would not go away and he consulted several doctors.

When asked about the severity of the tumor, Douglas said “I am above the neck, so nothing’s gone down”, and that “the expectations are good”.

He told Letterman he was a drinker and a smoker and that “this particular type of cancer is caused by alcohol and drinking”, reported the New York Times.

Earlier this year, Douglas pleaded with a judge who sentenced his son Cameron Dougals to five years in prison for drug dealing, to exercise leniency because there was a history of drug and alcohol abuse in the family and he himself had received treatment in the 1990s for alcohol abuse.

The actor said he has now completed the first week of an eight-week chemotherapy and radiotherapy treatment, which he described as “very intense”.

Apart from revealing the tumor is at stage four, Douglas did not, however, say what type of throat cancer he has, leaving others to speculate on what it might be.

Throat cancer, also called pharyngeal cancer, is a broad term that refers to a range of cancers that form in the tissues of the pharynx, the tube that starts behind the nose and finishes at the top of the windpipe (trachea) and foodpipe (esophagus). Air and food travel through the pharynx to the trachea or the esophagus.

If the cancer started at the tumor at the base of his tongue (that his press representative described), then Douglas probably has oropharyngeal cancer, suggest two head and neck medical experts consulted by WebMD.

In a year when news about Alzheimer’s disease seems to whipsaw between encouraging and disheartening, a new discovery by an 84-year-old scientist has illuminated a new direction.

The scientist, Paul Greengard, who was awarded a Nobel Prize in 2000 for his work on signaling in brain cells, still works in his Rockefeller University laboratory in New York City seven days a week, walking there from his apartment two blocks away, taking his aging Bernese mountain dog, Alpha.

He got interested in Alzheimer’s about 25 years ago when his wife’s father developed it, and his research is now supported by a philanthropic foundation that was started solely to allow him to study the disease.

It was mostly these funds and federal government grants that allowed him to find a new protein that is needed to make beta amyloid, which makes up the telltale plaque that builds up in the brains of people with Alzheimer’s.

The finding, to be published Thursday in the journal Nature, reveals a new potential drug target that, according to the prevailing hypothesis of the genesis of Alzheimer’s, could slow or halt the devastating effects of this now untreatable disease.

A clinical trial of Meridia, a controversial diet pill, in nearly 10,000 overweight or obese older patients over many years found that the drug increased the risks of heart attacks and strokes while doing little to slim their waists.

The study was paid for by Abbott Laboratories, Meridia’s maker, and published in The New England Journal of Medicine. And the authors of the study, three of whom are Abbott employees, concluded that the trial results did little more than show that patients with heart problems should not be prescribed Meridia — a restriction already included in Meridia’s label.

But in an unusual rebuke, The Journal’s top editors wrote an editorial concluding that the study actually showed that Meridia, also known as sibutramine, should be removed from the market.

“It wasn’t that we disagreed with the interpretation of the authors,” said Dr. Gregory D. Curfman, The Journal’s executive editor. “It’s just that we thought they didn’t quite go far enough.” Many patients, Dr. Curfman added, “have cardiovascular disease and don’t know it. How are you supposed to identify those patients who might be put at risk by putting them on drugs like sibutramine?”

After seeing preliminary results of the trial in January, the European Medicines Agency ordered Abbott to remove Meridia from the European market. The Food and Drug Administration took a less forceful step and instead requested that Abbott state on the drug’s label that Meridia should not be used in patients with a history of cardiovascular disease.