Spending on drugs for kids under 19 grew 10.8 percent last year, according to a new report from Medco Health Solutions. That’s bigger growth than in any other age group–almost four times the growth in any other group, in fact. Higher prices helped, but there was also a 5 percent increase in prescription drug use among kids. By comparison, drug use for over-65s grew by only two-tenths of one percent.

What gives? Well, kids are being medicated for illnesses that once were reserved for much older people. Twenty-nine percent of kids aged 10 to 19 are taking meds for a chronic health condition. Some of those meds are asthma drugs, but the others are a bit scary: diabetes drugs, blood-pressure meds and cholesterol drugs. The number of adolescents taking heartburn meds grew by an amazing 174 percent.

“All of these adult drugs are popping up in children, which is really disturbing,” Medco CMO Robert Epstein said on a media conference call (as quoted by the Wall Street Journal Health Blog). Epstein called the numbers on pediatric drug use “the real shocker” of the study and warned that unless some big lifestyle changes are in the offing, these children could end up with lower life expectancy.

Source: FiercePharma

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The combined use of proton pump inhibitors (PPIs) with sanofi-aventis and Bristol-Myers Squibb’s Plavix (clopidogrel), or with Eli Lilly and Daiichi Sankyo’s Effient (prasugrel), did not interfere with the clinical benefits of the antiplatelet agents in patients after an acute coronary syndrome (ACS), according to an analysis of study data to be published in The Lancet. Researchers noted that the results contrast with prior findings from other studies, and remarked that these latest data “do not support the need to avoid concomitant use of PPIs…in patients receiving clopidogrel or prasugrel.”

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The analysis was based on data from the randomised TRITON-TIMI 38 trial that enrolled over 13 600 patients who suffered a heart attack or unstable angina, and who were given either Plavix or Effient. The study authors evaluated the effects of PPIs in the trial, and they found that for patients who took these medications in combination with Plavix or Effient there was no increased risk of cardiovascular events, compared with patients who took Plavix or Effient alone.

A previous analysis of medical and pharmacy claims data by Medco indicated that among patients who had undergone a percutaneous coronary intervention, those who were being treated with Plavix plus a PPI had a 50-percent increase in the risk of having a major cardiovascular event, compared with those who took Plavix alone.

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The author of the Medco study, Robert Epstein, explained that the overall health of the patients involved in the studies may have played a role in producing contrasting results. He suggested that the new analysis involved healthier patients who were not in a “real-world setting.” The lead investigator of the latest study, Michelle O’Donoghue, noted that PPIs are often given to more seriously ill patients, which might explain why they experience more adverse events. However, she said such differences were adjusted for in the research. The authors stated that a thorough clinical trial is needed to clearly understand how PPI use affects treatment with antiplatelet drugs.

Source: FirstWord

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Results from a study presented at ASCO demonstrated that women who took certain antidepressant drugs while taking tamoxifen to treat their breast cancer had more than double the risk of cancer recurrence, compared with those who took tamoxifen alone. Researchers stated that this is “the first time that a comparative analysis has been done looking at various selective serotonin reuptake inhibitors [SSRIs] and what’s clear is that several of these drugs are extremely risky for women to take with tamoxifen, while others don’t present a problem.”

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The retrospective analysis examined the pharmacy and medical records for nearly 1300 women with breast cancer who were newly prescribed tamoxifen between 2003 and 2005 and who were followed up for an average of 2.7 years. The initial analysis involved one group of 353 women who were taking tamoxifen plus a moderate-to-potent CYP2D6 inhibitor, which included several types of SSRIs but was not limited to antidepressants, and a second group of 945 women who were taking tamoxifen and no CYP2D6 inhibitor.

Overall, results showed that the breast cancer recurrence rate for women using a CYP2D6 inhibitor plus tamoxifen was 13.9 percent, compared with a rate of 7.5 percent for those using only tamoxifen. Further analyses showed that the rate of recurrence for women whose treatment included use of moderate-to-potent CYP2D6 inhibitor SSRIs, such as Eli Lilly’s Prozac (fluoxetine), GlaxoSmithKline’s Paxil (paroxetine) and Pfizer’s Zoloft (sertraline), was 16 percent. In addition, data showed that those whose treatment included “weak” CYP2D6 inhibitor SSRIs, such as Forest’s Celexa (citalopram) and Lexapro (escitalopram) and Solvay’s Luvox (fluvoxamine), had a recurrence rate of 8.8 percent, which was considered to demonstrate no increase in risk for the disease.

Robert Epstein, one of the study’s authors, remarked that scientists were aware that CYP2D6 inhibitor drugs blocked the activation of tamoxifen chemically “but this is the first time there’s evidence that these drugs are putting women at a much higher risk for recurrent breast cancer.”

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