1. Superpill for strokes Rivaroxaban approved

    May 23, 2012 by Neuschwanstein

    A DAILY £2 superpill is set to revolutionise the lives of millions of people at risk of a stroke.

    Rivaroxaban is the first one-a-day clot-busting drug to be given the go-ahead for use on the NHS in 60 years. And it has fewer side-effects than the current treatment, meaning patients will be more inclined to take it.

    Unlike other stroke drugs which are taken twice daily, rivaroxaban, which is also called Xarelto, can be taken just once a day.

    It is just as effective at preventing strokes among people with atrial fibrillation as the current drug warfarin, originally developed six decades ago as a rat poison.

    Atrial fibrillation, which can be caused by high blood pressure, heart valve disease, an overactive thyroid and alcohol, leads to 12,500 stroke deaths a year.

    Sufferers have a faster than normal heartbeat, which may cause tiny blood clots. These can break up and travel towards the brain, triggering a stroke. Now the drug watchdog, Nice, is recommending rivaroxaban to stop the clots from forming.

    Trudie Lobban, founder of the Atrial Fibrillation Association, said: “For almost 60 years there has only been one anti- coagulant, which sadly is not suitable for all sufferers.

    Stroke

    Stroke

    “This latest approval by Nice will provide greater choice for the almost one million AF patients in England alone.”

    It is difficult to regulate an effective dose of warfarin, which means patients must be monitored to ensure they do not take too much or too little. As well as being notoriously difficult to control, warfarin interacts with many other drugs as well as food and drink. Nice estimates that 46 per cent of patients who should be taking war-farin are not having it.


    Rivaroxaban is given once daily at a fixed dose and does not need blood test monitoring. It can be used in patients with non-valvular AF who have one or more risk factors such as congestive heart failure, high blood pressure or a prior stroke.

    Professor Carole Longson from Nice said: “We know some people taking warfarin find it difficult to maintain their blood clotting at a proper level.

    “We are therefore pleased to recommend rivaroxaban as another cost-effective option for the prevention of stroke in people with atrial fibrillation.”

    Dr Peter Coleman, deputy director of research at the Stroke Association, said: “Warfarin is a highly effective treatment for stroke prevention but is not suitable for everyone.

    “It’s important to note that every AF patient needs to be treated on a case-by-case basis to ensure they receive the best possible treatment for them.”

    Dee Maddock, senior cardiac nurse at the British Heart Foundation, said: “This will be welcome news to many as rivaroxaban doesn’t require close monitoring like warfarin does.”

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  2. Snoring may raise cancer risk

    May 22, 2012 by Neuschwanstein

    Snoring and other types of ‘sleep disordered breathing’, as it is known, can deprive the body of enough oxygen for hours at a time.

    Scientists now believe having low blood oxygen levels can trigger the development of cancerous tumours, by promoting the growth of the vessels that feed them.

    They say in future doctors could help people fight the disease by stopping them snoring.

    Researchers in the US looked at cancer rates in more than 1,500 people, in a study of sleep problems that has been going for 22 years.

    They found those with severe sleep disordered breathing (SDB) were 4.8 times more likely to develop cancer than those who had no such problems.

    Those with moderate SDB were at double the risk, while those with only a slight problem had a 10 per cent increased chance, according to the group, from the University of Wisconsin-Madison.

    By far the most common type of sleep disordered breathing problem is obstructive sleep apnoea.

    In this, the airway frequently collapses during the breathing cycle, leaving the sleeper struggling for breath. Typically this produces snoring and repeated forced waking.

    Sleep apnoea is already known to be associated with other health problems including obesity, diabetes, high blood pressure, heart attacks and strokes.

    Sleep

    Sleep

    As being overweight can cause cancer, it could simply have been the case that snoring had no active role in promoting cancer, and was simply a proxy for obesity.

    However, the researchers took into account whether participants were a healthy weight or not, as well as a range of other confounding factors, such as age, sex, and smoking status.


    The link between SDB and cancer held true even after these were adjusted for. In fact, the association was stronger for those of a healthy weight than the obese.

    The researchers concluded this meant that sleep disordered breathing could itself raise the risk of cancer, rather than just being a general sign of poor health.

    Laboratory studies have also shown that intermittent hypoxia – or low oxygen levels – promotes tumour growth in mice with skin cancer. Lack of oxygen stimulates the generation of blood vessels that nourish tumours, a process known as angiogenesis.

    Dr Javier Nieto, who led the study, said: “The consistency of the evidence from the animal experiments and this new epidemiologic evidence in humans is highly compelling.”

    Laboratory and animal studies “suggest that intermittent hypoxia promotes angiogenesis and tumour growth”.

    He continued: “Ours is the first study to show an association between SDB and an elevated risk of cancer mortality in a population-based sample.”

    He said further research was needed to prove the link beyond doubt, but said if the relationship was firmy established, “the diagnosis and treatment of SDB in patients with cancer might be indicated to prolong survival”.

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