multiple sclerosis

Intravenous therapy may stall the onset of full-fledged MS.

* THE QUESTION When the symptoms of multiple sclerosis periodically flare up and then fade, immunoglobulin therapy sometimes helps. Might this treatment -- an infusion of a drug, made from blood plasma, that can boost the immune system -- also help slow the early development of MS?

* THIS STUDY randomly assigned 91 people newly confirmed as having symptoms suggestive of MS to receive either intravenous immunoglobulin therapy once every six weeks or a placebo treatment. After a year, 26 percent of those who had received immunoglobulin therapy had experienced further symptoms, resulting in a definitive MS diagnosis, compared with 50 percent of the placebo group.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Anyone who has shown early signs of MS, a chronic inflammatory disease that affects the brain and spinal cord. Women are twice as likely as men to develop MS.

* CAVEATS Whether longer-term treatment would affect the results was not determined. The study was funded by Omrix Biopharmaceuticals, which also supplied the drugs used in the study. The study was done in Israel, and the particular drug used may not be available in the United States; however, other immunoglobulin formulas are available.

* BOTTOM LINE People with symptoms that hint of MS may want to ask their doctor about immunoglobulin drugs.

* FIND THIS STUDY October issue of Archives of Neurology; abstract available online at www.archneurol.com.

* LEARN MORE ABOUT multiple sclerosis at www.nationalmssociety.org and www.mayoclinic.com.

attention-deficit hyperactivity disoRder

Children may perform better with Focalin than with Ritalin.

* THE QUESTION Stimulants, which have a calming effect on children with attention-deficit hyperactivity disorder (ADHD), are the medication most often prescribed for this condition. How do two of these drugs -- Ritalin and Focalin, a refined version of Ritalin -- compare?

* THIS STUDY randomly assigned 132 children diagnosed with ADHD to take either Focalin, Ritalin or a placebo twice daily for four weeks. Their behavior and performance were evaluated by teachers, parents and physicians. Overall, 67 percent of the children who took Focalin were rated "much improved" or higher at the end of the treatment period, compared with 49 percent of those who took Ritalin and 22 percent of the placebo group.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Children diagnosed with ADHD. An estimated 5 percent of children may have this disorder.

* CAVEATS The study did not evaluate whether differences in the drugs' effects exist for longer than six hours after the final daily dose was given. Side effects were mild to moderate and similar between the drugs; however, side effects that could develop with longer use could not be determined. Celgene Corp., which developed Focalin, funded the study. Three of the eight authors had financial ties to Celgene or Novartis Pharmaceuticals, which markets Focalin and Ritalin in the United States.

* BOTTOM LINE Parents of children with ADHD may want to ask a doctor about Focalin.

* FIND THIS STUDY November issue of the Journal of the American Academy of Child and Adolescent Psychiatry; abstract available online at www.jaacap.com.

* LEARN MORE ABOUT diagnosing and treating ADHD at www.nimh.nih.gov and at www.familydoctor.org.

breast cancer

Chemotherapy, not tamoxifen, seems to increase stroke risk.

* THE QUESTION Whether to take tamoxifen and whether to undergo chemotherapy are among the decisions made by women with breast cancer. Do the benefits of these treatments outweigh the risks -- specifically the possibility of a stroke?

* THIS STUDY compared the use of tamoxifen and exposure to chemotherapy by 179 women who had a stroke after they were diagnosed with breast cancer to that of 353 breast cancer survivors of similar age who did not have a stroke. The researchers found no relationship between use of tamoxifen and stroke. They did find that undergoing chemotherapy more than doubled the chances of a stroke.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Women with breast cancer.

* CAVEATS The results do not necessarily apply to women who take tamoxifen as a preventive. Another recent study [Quick Study, Oct. 16] found that tamoxifen use correlated with a slight increase in the risk of stroke

* BOTTOM LINE Women diagnosed with breast cancer may want to discuss with their doctors the benefits and risks of tamoxifen and chemotherapy based on their individual situations.

* FIND THIS STUDY Oct. 20 issue of the Journal of the National Cancer Institute; abstract available online at www.jncicancerspectrum.oupjournals.org..

* LEARN MORE ABOUT breast cancer treatments at www.cancer.org and www.cancer.gov.

-- Linda Searing