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NSAIDs and Statins Have No Impact on Renal Cell Carcinoma Risk - OncLive
Dr. Lisly Chery

Lisly Chéry, MD

Neither nonsteroidal anti-inflammatory drugs (NSAIDs) nor statins influence the development of renal cell carcinoma (RCC), investigators announced at the American Urological Association 2012 Annual Scientific Meeting held May 19-23 in Atlanta, Georgia.

The data, from an ongoing cohort study conducted in western Washington state, appear to undercut prior research suggesting that NSAIDs may increase RCC risk and that statins may reduce RCC risk.

Lisly Chéry, MD, a urology resident at the University of Washington School of Medicine in Seattle, and colleagues determined the effect of NSAIDs and statins on the risk of RCC by prospectively following 77,048 individuals aged 50 to 76 years who were enrolled in the VITamins And Lifestyle (VITAL) Study. The VITAL Study is a cohort study of the associations of supplement use with cancer risk.

Renal cell carcinoma, the most common type of kidney cancer, is the sixth most common cancer in men and the eighth most common cancer in women, Chéry pointed out. Over 64,000 new cases will be diagnosed in 2012, with over 13,000 expected deaths. The incidence of RCC, as with other forms of kidney cancer, is increasing, largely because of an increase in established risk factors such as obesity, hypertension, and smoking.

While numerous risk factors for RCC have been identified, there are limited data on preventive pharmacologic agents, he added. NSAIDs have been shown to protect against colon, breast, and lung cancer, and this protective effect has been largely attributed to their ability to reduce inflammation and cell proliferation. However, data, mostly from retrospective studies, suggest that this class of agents may actually boost the risk of RCC.

The cholesterol-lowering statin drugs have also demonstrated an association with RCC, Chéry noted. However, while statins have been shown to suppress metastasis in animal models of RCC, their effect on RCC in humans is as yet unknown.

At the time of enrollment, participants in the VITAL study completed a gender-specific questionnaire that focused on their dietary habits, medical and family history, and cancer risk factors.

Incident cases of RCC were identified via linkage to the local Surveillance, Epidemiology, and End Results (SEER) Program cancer registry. Overall, 249 cases of RCC were detected.

The investigators found that the observed associations between NSAIDs and statins and RCC risk did not persist after adjusting for known risk factors for RCC, including age, gender, race, lifestyle, and hypertension, diabetes, viral hepatitis, and renal disease.

Compared to nonusers of aspirin and nonaspirin NSAIDs, low (hazard ratio [HR] = 1.2; 95% CI, 0.8-1.6) and high (HR = 1.4; 95% CI, 1.0-2.0) users of NSAIDs had an increased risk of RCC in the base model (P-trend 0.03). Ten-year use of aspirin and other NSAIDs was categorized as none, low use (1-3 days/week or <4 years), or high-use (?4 days/week and ?4 years).

However, this relationship was attenuated and nonsignificant (P-trend 0.35) in the multivariate model for both low (HR = 1.01; 95% CI, 0.7-1.4) and high (HR = 1.2; 95% CI, 0.8-1.7) users compared to nonusers.

In the base model, statin use over the prior 2 weeks was associated with an increased risk of RCC (HR = 1.4; 95% CI, 1.0-1.8) but did not maintain significance in the multivariate model (HR = 1.1; 95% CI, 0.8-1.4).

“This will not be the final study on NSAIDs, statins, and kidney cancer,” Chéry said. “The best study would be a randomized controlled study, but those are often difficult to organize.”


Chéry L, Wright J, Hotaling J, et al. NSAID and statin use and risk of renal cell carcinoma. Presented at the American Urological Association Annual Meeting; May 19-23, 2012; Atlanta, GA. Abstract 575.

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CORRECTING and REPLACING Octapharma USA Expands Access ... - MarketWatch (press release)

HOBOKEN, N.J., Jun 26, 2012 (BUSINESS WIRE) -- Sixteenth graph of release dated June 25, 2012, should read: Please review the complete octagam(R) (Human) 5% liquid prescribing information at http://www.octapharma.com/en/about-octapharma/products-therapies/immunotherapy/octagam.html and then click on "Octagam_5__SPC_for_USA.pdf".

The corrected release reads:

OCTAPHARMA USA EXPANDS ACCESS TO OCTAGAM(R) 5% FOR PARTICIPATING 340B HEALTHCARE FACILITIES

Octapharma USA today announced that it has started an initiative to make octagam(R) (immune globulin intravenous [human] 5%), a therapy for Primary Immune Deficiency, widely available to covered entities in the 340B Drug Pricing Program, which is managed by the Health Resources and Services Administration (HRSA) Office of Pharmacy Affairs (OPA).

The 340B Drug Pricing Program is available to certain hospitals, clinics, and outpatient treatment facilities who qualify as "covered entities" under Public Law 102-585, the Veterans Health Care Act of 1992, which is codified as Section 340B of the Public Health Service Act.

"Octapharma is committed to providing therapies to treat life-threatening conditions to all patients, including those who are treated in facilities that have historically faced challenges accessing IGIV," said Octapharma USA President Flemming Nielsen. "We are pleased that the supply of octagam(R) 5% is now sufficient to adequately serve 340B covered entities, that have in recent years experienced difficulties in accessing specialty drugs such as IGIV at 340B discount prices. Octapharma is committed to serving patient needs, regardless of where they receive treatment, and ensuring a steady supply of octagam(R) 5% to all our hospital customers."

Octapharma USA intends to use ASD Healthcare of Frisco, Texas and FFF Enterprises of Temecula, Calif. as the contact point for distribution. More distributors will be added later in the year. Octapharma USA, a subsidiary of Octapharma AG, one of the world's largest human protein product manufacturers, has been marketing octagam(R) 5% since 2004.

Octapharma's commitment to making octagam(R) 5% available to 340B entities nationally will benefit those hospitals and medical facilities that face the constant challenge of obtaining adequate supplies of IGIV at the legally mandated discount rate. Over 17,000 covered entity sites participate in the 340B Program, including six categories of hospitals that are generally considered safety net providers, and 11 categories of non-hospital covered entities, such as federally qualified health centers and specialized clinics and treatment centers.

"Octapharma is extremely pleased to expand access to octagam 5% for 340B covered entities because the purpose of the national initiative is to maximize available healthcare resources and ensure that patient needs do not go unfulfilled," said Nielsen. "Octapharma's goal is to provide every patient the access to care they need. Providing patients with safe, high quality therapies is always our top priority."

WARNING: ACUTE RENAL DYSFUNCTION AND RENAL FAILURE

Immune Globulin Intravenous (Human) (IGIV) products have been reported to be associated with renal dysfunction, acute renal failure, osmotic nephrosis, and death. Patients predisposed to acute renal failure include patients with any degree of pre-existing renal insufficiency, diabetes mellitus, age >65, volume depletion, sepsis, paraproteinemia, or patients receiving known nephrotoxic drugs. Especially in such patients, IGIV products should be administered at the minimum concentration available and the minimum rate of infusion practicable. While these reports of renal dysfunction and acute renal failure have been associated with the use of many of the licensed IGIV products, those containing sucrose as a stabilizer accounted for a disproportionate share of the total number. octagam(R) (Human) 5% liquid does not contain sucrose.

IMPORTANT SAFETY INFORMATION

IgA deficient patients with antibodies against IgA are at greater risk of developing severe hypersensitivity and anaphylactic reactions. Epinephrine should be available immediately to treat any acute severe hypersensitivity reactions.

Monitor renal function, including blood urea nitrogen and serum creatinine, and urine output in patients at risk of developing acute renal failure.

Falsely elevated blood glucose readings may occur during and after the infusion of octagam(R) 5% liquid with some glucometer and test strip systems.

Hyperproteinemia, increased serum viscosity and hyponatremia occur in patients receiving IGIV therapy.

Thrombotic events have occurred in patients receiving IGIV therapy. Monitor patients with known risk factors for thrombotic events; consider baseline assessment of blood viscosity for those at risk of hyperviscosity.

Aseptic Meningitis Syndrome has been reported with octagam(R) 5% liquid and other IGIV treatments, especially with high doses or rapid infusion.

Hemolytic anemia can develop subsequent to IGIV therapy due to enhanced RBC sequestration. IGIV recipients should be monitored for pulmonary adverse reactions (TRALI).

The product is made from human plasma and may contain infectious agents, e.g. viruses and, theoretically, the Creutzfeldt-Jakob disease agent.

Please review the complete octagam(R) (Human) 5% liquid prescribing information at http://www.octapharma.com/en/about-octapharma/products-therapies/immunotherapy/octagam.html and then click on "Octagam_5__SPC_for_USA.pdf".

About the Octapharma Group

Headquartered in Lachen, Switzerland, Octapharma AG is one of the world's largest human protein products manufacturers and has been committed to patient care and medical innovation for nearly 30 years. Octapharma's core business is the development, production and sale of high quality human protein therapies from both human plasma and human cell-lines, including immune globulin intravenous. In the U.S., Octapharma markets octagam(R) (immune globulin intravenous [human] 5%) to treat primary immune deficiencies; Albumin (human)(R) for the restoration and maintenance of circulating blood volume; and wilate(R) (von Willebrand Factor/Coagulation Factor VIII Complex [human]), which has received orphan drug exclusivity from the U.S. Food and Drug Administration (FDA) for certain types of von Willebrand Disease. Octapharma employs over 4,000 people and has biopharmaceutical experience in 80 countries worldwide, including the United States, where Octapharma USA is located in Hoboken, N.J. Octapharma operates two state-of-the-art production sites licensed by the FDA, providing a high level of production flexibility. For more information, please visit www.octapharma.com or www.wilateusa.com .

SOURCE: Octapharma USA




        
        Yankee Public Relations 
        Fred Feiner, 800-977-1910, ext. 4 
        
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Copyright Business Wire 2012

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Steroid-free regimen post-pediatric renal transplant safe - Medical Xpress
Medical Xpress
(HealthDay) -- A steroid-free approach to immunosuppression following pediatric renal transplants is safe and effective, according to a study published online

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New procedure zaps blood pressure - WDAM-TV

(NBC) - A nationwide clinical trial is testing a minimally invasive procedure, called renal denervation. It zaps the nerves involved in this multi-organ system.

"You're interrupting the fight or flight nervous system from sending signals to the kidneys which help lower blood pressure," said Crystal Simpson M.D., a nephrology fellow.

Doctors thread a catheter to the kidney artery and apply radio frequency waves to certain nerves.

The idea is to calm the signals between the brain and kidneys, causing the blood vessels to relax.

Renal denervation is not approved in the US, but studies in Europe suggest it works.

"It showed a significant reduction in their blood pressure, 20 to 30 millimeters, now out 3 years or more," said Manesh Patel, M.D., of Duke University Medical Center.

Patients in the trial won't know if they're getting the real procedure or a fake.

So far, doctors have seen minimal side effects linked to the procedure, but admit they don't know much about the long-term effects.

Copyright 2012 NBC. All rights reserved.

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Steroid-Free Regimen Post-Pediatric Renal Transplant Safe - Doctors Lounge
A steroid-free approach to immunosuppression following pediatric renal transplants is safe and effective, according to a study published online June 13 in the American Journal of Transplantation.

TUESDAY, June 26 (HealthDay News) -- A steroid-free approach to immunosuppression following pediatric renal transplants is safe and effective, according to a study published online June 13 in the American Journal of Transplantation.

Minnie M. Sarwala, M.D., Ph.D., of the California Pacific Medical Center in San Francisco, and associates conducted a randomized multicenter study involving 130 children receiving primary kidney transplants between 2004 and 2006. Participants were randomly allocated to steroid-free (SF) or steroid-based (SB) immunosuppression, together with tacrolimus, mycophenolate, and standard or extended-dose daclizumab (SB and SF groups, respectively).

After three years of follow-up the researchers found that the standardized height Z-score change was ?0.99 for SF patients, compared with ?0.93 in SB patients (P = 0.825). At three years, recipients younger than 5 years showed improved linear growth with SF versus SB treatment (?0.43 versus ?1.07; P = 0.019). The rates of biopsy-proven acute rejection at three years post-transplant were similar in both groups (16.7 in SF versus 17.1 in SB; P = 0.94). Patient survival was 100 percent in both groups, with graft survival of 95 and 90 percent in the SF and SB groups, respectively. The SF group showed significantly lower systolic blood pressure and lower cholesterol levels than the SB group.

"In conclusion, complete steroid avoidance, combined with effective induction, tacrolimus and mycophenolate mofetil, provides a new therapeutic standard for safe and effective immunosuppression for renal transplantation of low-risk children with end-stage renal disease," the authors write.

The study was funded by Astellas and Roche Pharmaceuticals.

Abstract
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image Copyright © 2012 HealthDay. All rights reserved.




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