Nitric Oxide Harmful
To Some Babies
Although nitric oxide can halve the risk of developmental problems in premature babies with undeveloped lungs, the gas could be harmful to newborns who are too small and too ill, according to two studies published today in the New England Journal of Medicine.
The findings mean doctors should avoid using the treatment during the first week of life in premature babies who are seriously ill and weigh less than about 2.2 pounds, Richard Martin and Michele Walsh of Rainbow Babies and Children's Hospital in Cleveland wrote in an editorial in the journal.
"Babies born at two pounds have only a 50 percent chance at 2 years of age of being considered totally normal," said pediatrician Michael Schreiber of the University of Chicago, whose team tracked 138 children.
They found that by the second birthday, 24 percent of the children given nitric oxide had problems such as blindness, hearing loss and cerebral palsy, compared with 46 percent for those 2-year-olds who did not receive the gas.
In a second study, a research team led by Krisa Van Meurs of the Stanford University School of Medicine found that the 210 premature babies with severe respiratory failure who got nitric oxide were just as likely to die or suffer lung damage as the 210 who were given a placebo.
The study, however, focused on babies who tended to be smaller and sicker than the ones in the Schreiber research.
The Schreiber study was paid for in part by Ino Therapeutics, which makes the nitric oxide treatment. The Van Meurs study was financed largely by the National Institute of Child Health and Human Development.
Old Beats New
In Drug Study
The older generic drug hydroxyurea, if combined with a small dose of aspirin and given to people with thrombocythemia, is more effective in preventing serious bleeding and other complications than the newer and more expensive Agrylin, according to a study published in today's New England Journal of Medicine.
Agrylin, also known as anagrelide, is made by Roberts Pharmaceuticals, which merged with Shire Pharmaceuticals Group in 1999.
Thrombocythemia occurs when too many of the blood-clotting structures known as platelets are produced in the bone marrow. It can affect other types of blood cells and can cause problems including chest pain, bleeding, and leg and lung clots. It usually strikes in middle age, affecting 1 in 30,000 people.
Although hydroxyurea has been a mainstay treatment for years, there have been concerns that it may cause leukemia.
At 138 centers in the United Kingdom, Ireland and Australia, a group led by Claire Harrison of the University of Cambridge followed more than 800 volunteers for an average of 39 months. It found that Agrylin recipients were 57 percent more likely to suffer serious problems connected with thrombocythemia.
Agrylin recipients were nearly six times as likely to suffer a small stroke and had 31/2 times the risk of developing serious stomach bleeding than those who were administered hydroxyurea.
-- From News Services