QUICK STUDY : A weekly digest of new research on major health topics

Tuesday, March 7, 2006

hay fever

An over-the-counter drug may do as well as prescription drug.

· THE QUESTION With spring comes a stuffy nose for many people as seasonal allergies kick in. Certain drugs target nasal congestion, a symptom generally not helped by antihistamines. How does an over-the-counter anti-congestion drug compare with one that requires a prescription?

· THIS STUDY randomly assigned 58 adults with ragweed allergies to take Sudafed (pseudoephedrine hydrochloride) or the prescription drug Singulair (montelukast sodium) every morning. After two weeks, symptoms -- including sneezing, itchy eyes and stuffed nose -- had declined in both groups. Those taking Sudafed reported somewhat more improvement in nasal congestion; a device that measures nasal air flow indicated little or no difference between the groups. Both groups indicated the treatment improved their quality of life and was easily tolerated.

· WHO MAY BE AFFECTED BY THESE FINDINGS? Anyone with seasonal allergies caused by such substances as ragweed pollen. More than half of all Americans are believed to be sensitive to such allergens.

· CAVEATS Drugs were taken only in the morning. This may explain why participants did not report problems with sleep, a common side effect of Sudafed, which has stimulant properties. Findings were based on recording and analysis of symptoms by the participants. Merck, which makes Singulair, contributed funds and content suggestions for the study, and two of its authors received fees from Merck.

· FIND THIS STUDY February issue of the Archives of Otolaryngology -- Head & Neck Surgery; abstract available online at http://www.archoto.com .

· LEARN MORE ABOUT hay fever at http://www.mayoclinic.com and http://www.aaaai.org (search for "rhinitis").

osteoarthritis

Supplements for knee pain may be more popular than effective.

· THE QUESTION The pain of bone rubbing against bone in the knee sends sufferers in search of lasting relief. Many people with osteoarthritis take glucosamine and chondroitin sulfate, believing that these nutritional supplements make movement easier and more comfortable. Put to the test, do these beliefs hold up?

· THIS STUDY randomly assigned 1,583 adults diagnosed with osteoarthritis of the knee to one of five groups: to take daily doses of either glucosamine, chondroitin sulfate, both supplements, the arthritis drug Celebrex (celecoxib) or a placebo. People also could take up to 4,000 milligrams of acetaminophen a day if needed. At the start of the study, about 78 percent of the participants had mild knee pain and 22 percent had moderate to severe pain. After six months, 64 percent of the people taking glucosamine, 65 percent of those taking chondroitin sulfate and 66 percent of the combination group had at least 20 percent less pain than at the start of the study, compared with 70 percent of the Celebrex group and 60 percent of those taking the placebo -- a difference described as "relatively small." Among people with pain that was more acute, those taking both supplements fared best, with 79 percent registering improvement, vs. 54 percent of the placebo group.

· WHO MAY BE AFFECTED BY THESE FINDINGS? People with osteoarthritis, usually caused by the wearing away of protective cartilage between bones in the joints. An estimated 21 million Americans have this joint disorder, most of them middle-aged or older.

· CAVEATS Because the makeup of nutritional supplements is not regulated and may vary, people taking them may have results different from those in the study. Nonsteroidal anti-inflammatory drugs such as Celebrex have been linked to heart problems; this study, however, was not designed to evaluate such risks. Eight of the 25 authors had received fees from Pfizer, which makes Celebrex.

· FIND THIS STUDY Feb. 23 issue of the New England Journal of Medicine; abstract available online at http://www.nejm.org .

· LEARN MORE ABOUT nutritional supplements for treating osteoarthritis at http://www.arthritis.org (search for "alternative treatments") and http://www.mayoclinic.com (search for "glucosamine").

rheumatoid arthritis

A common drug may be more helpful the second time around.

· THE QUESTION Shuffling from one medication to another has become common for people with rheumatoid arthritis. Not only do they seek a drug that relieves the pain and slows the joint damage caused by the disorder, but they want one without intolerable side effects. Might it be effective to return to a drug they tried earlier without success?

· THIS STUDY analyzed medical data on 79 people who had stopped taking the common rheumatoid arthritis drug methotrexate, either because it was not working for them or they encountered side effects. About two years later, and after trying at least one other drug, everyone resumed treatment with methotrexate and continued taking it for at least a year, generally at a higher dose. Overall, the drug was deemed effective in 53 percent of those trying it a second time; this included 45 percent of those who had had no success the first time and 67 percent of people who had quit taking it initially because of side effects. People who had taken lower doses of the drug initially were more likely to register success with a repeat regimen.

· WHO MAY BE AFFECTED BY THESE FINDINGS? People with rheumatoid arthritis, which affects an estimated 1 percent of the U.S. population.

· CAVEATS The authors suggest that higher doses of the drug proved tolerable because more people probably were taking folate supplements, which have been shown to reduce gastrointestinal and other side effects of methotrexate. About 90 percent of those analyzed took the drug orally, and the others took it via injection; the study did not determine whether the way the drug was administered affected the outcome.

· FIND THIS STUDY Feb. 24 issue of Arthritis Research & Therapy; article available online at http://www.arthritis-research.com .

· LEARN MORE ABOUT rheumatoid arthritis at http://www.arthritis.org and http://www.niams.nih.gov/hi .

--Linda Searing

The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.