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11/22/19

Charcot-Marie-Tooth disease (CMT) is an inherited neurodegenerative condition that affects 1 in 2500 individuals. Currently, however, it is still lacking effective treatment options. New research has demonstrated that a class of cytoplasmic enzymes called tRNA synthetases can cause CMT by interfering with the gene transcription in the nucleus.

from Top Health News -- ScienceDaily https://ift.tt/2DaLb7G

A new cancer-detecting tool uses tiny circuits made of DNA to identify cancer cells by the molecular signature on their surface. The circuits work by attaching to the outside of a cell and analyzing it for proteins that are more abundant on some cell types than others. The devices distinguish cell types with higher specificity than previous methods, giving researchers hope their work could improve diagnosis, or give cancer therapies better aim.

from Top Health News -- ScienceDaily https://ift.tt/2L0ARUr

Wound healing in mucous tissues during early infection by Simian Immunodeficiency Virus guards some primate species against developing AIDS. Both HIV and SIV provoke an immune response that injures tissues surrounding the intestine; African green monkeys with SIV quickly repair their mucous tissues. This interrupts the disease course and avoids AIDS onset. Stimulating this response might be a way of treating HIV in people.

from Top Health News -- ScienceDaily https://ift.tt/2QE9HWZ

Both obesity and smoking can have negative effects on bone health. A recent study examined whether they also impact healing in patients who have undergone surgery for fractures of the wrist, or the distal radius, which are among the most common bone fractures.

from Diet and Weight Loss News -- ScienceDaily https://ift.tt/2XDfKfP

Higher exposure to commonly used oral antibiotics is linked to an increased risk of Parkinson's disease according to a recently published study. The strongest associations were found for broad spectrum antibiotics and those that act against against anaerobic bacteria and fungi. The timing of antibiotic exposure also seemed to matter.

from Top Health News -- ScienceDaily https://ift.tt/2XJcnnB

It’s something I’ve heard countless times from patients with fibromyalgia. They’re telling a friend or family member about their condition and the response is, “But you don’t look sick” or “But you look so well.” Sometimes, the reaction is more of an eye roll or some other response that reflects skepticism that the problem is even “real.”

Those are issues addressed head-on in a TV ad for Lyrica (pregabalin), a treatment for fibromyalgia. “To most people, I look like most people,” a woman says. “But on the inside I feel chronic, widespread pain.” After clarifying that the pain is real, this direct-to-consumer drug advertisement moves on to say one of the current theories about the origin of pain in fibromyalgia is that it’s “thought to be caused by overactive nerves.”

The mood of the ad is somber at first. Sad music serves as backdrop to a woman who is clearly suffering as a man — perhaps her husband? — plays in the park with two adorable kids. That all changes when she talks about taking Lyrica. Then the music soars and the voiceover tells us that “Lyrica is believed to calm these nerves.” The now-smiling woman looks into the camera and pronounces, “I’m glad my doctor prescribed Lyrica.” The scene brightens and she’s smiling as she goes about setting up for a neighborhood block party. The voiceover informs us that, “For some, Lyrica delivers effective relief for fibromyalgia pain and improves function.”

Then comes the litany of side effects that might accompany treatment. More on those shortly.

The good

The ad gets a number of things right, including:

  • the fact that the condition may be “invisible” to others
  • the notion that the cause of fibromyalgia is unknown, but experts believe it may be due to “overactive nerves”
  • the character in the ad who has fibromyalgia is a woman — in fact, the condition is up to six times more common in women than men
  • mentioning the risks (and not just benefits) of a medication is important. The most common, and many rare, potential side effects are described. Keep in mind, though, that including a description of side effects or referring consumers to more information is required by the FDA, as I noted in my initial blog on direct-to-consumer ads describing pros, cons, and words to consider very carefully).

What’s missing

Some important information is missing from this ad, including:

  • The limited effectiveness of the drug. Note the language in the ad: Lyrica works well “for some.” You might wonder just how many “some” is! A recent analysis of past studies found that only about 10% of treated study subjects reported excellent results, and only about 40% reported very good or excellent results. Lyrica was only modestly better than a placebo pill. Another analysis found that among prior studies, only 20% to 25% of study subjects experienced “at least 50% pain intensity reduction” within two to three months of treatment.
  • The ad only mentions one treatment option: medication. But that’s not the only option. In fact, nondrug options, such as regular exercise and improved sleep, are considered vital for the successful treatment of fibromyalgia.
  • No comparison to other medications. A number of other medications are approved and prescribed for fibromyalgia, yet there’s no mention of how Lyrica measures up to these other medications prescribed. According to a recent review, Lyrica seems to be no better (or worse) than other approved medications, including milnacipran (Savella) and duloxetine (Cymbalta).
  • As with nearly all drug ads, the price of the drug is not mentioned. In November, the price of Lyrica was about $12 per 75-mg capsule, according to Drugs.com. The recommended starting dose is 75 mg twice daily, which adds up to around $24/day or more than $760/month. Often, higher doses are needed, which pushes the price even higher. Of course, medication costs are a moving target, because health insurance coverage, copayments, deductibles, drug company coupons, and other factors may affect the price you pay.

The risks of treatment

The list of side effects in this commercial is so long that many (or perhaps most) viewers will tune out. While common side effects include dizziness, sleepiness, weight gain, or swelling of the extremities, “severe allergic reactions” and “suicidal thoughts or actions” are the first ones mentioned. These risks are listed against a visually interesting and wonderfully distracting backdrop — in this ad, it’s giant bubbles and puppies. Yes, bubbles and puppies! Maybe providing a distraction from the list of things that could go wrong if you take Lyrica is not a coincidence. In fact, most drug ads do this.

The bottom line

Ads for drugs are not meant to be thorough or balanced. Their intent is to increase sales of their drug. Drug makers often talk about the importance of these ads to educate the public about treatment options. But the obvious (and understandable) bias toward the drug being advertised — Lyrica, in this case — makes the quality of the education suspect. That’s why I’m opposed to direct advertising to consumers for medications and medical procedures, and that’s probably a reason most countries don’t allow it.

Yes, fibromyalgia is a real and troublesome condition that’s invisible to others. But medication treatment, such as Lyrica, is only one part of standard treatment. And it’s not always effective. Want more complete and balanced information about fibromyalgia? Talk to your doctor or consult unbiased sources that aren’t trying to sell you anything. A pharmaceutical advertisement may not be your best bet.

The post Harvard Health Ad Watch: A fibromyalgia treatment (“But you look so good!”) appeared first on Harvard Health Blog.



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