Studies outline dilemmas on new generic heart drugs, hormone replacement therapy

May 30 2012

One heart drug's move to generic status has complicated treatment options for some patients and doctors, the Wall Street Journal reports. Also, another study raises concerns about hormone replacement therapy in women.

The Wall Street Journal: Heart Patients May Face a New Drug Dilemma 
The newly low cost of Plavix, one of the biggest-selling drugs, is intensifying debate among cardiologists over how to make sure patients get optimal benefit from any blood-thinning medication. A generic version of Plavix became available this month so there is an incentive to switch patients to it. But, nearly a third of patients prescribed a blood thinner to prevent heart attack or stroke have a genetic variation that limits their response to Plavix. For these patients, some doctors prescribe Effient or Brilinta, two rival drugs used by far fewer patients (Winslow, 5/28).

The Washington Post: New Study Sounds Warning On Hormone Replacement Therapy
Women who are past menopause and healthy should not use hormone replacement therapy in hopes of warding off dementia, bone fractures or heart disease, says a new analysis by the government task force that weighs the risks and benefits of screening and other therapies aimed at preventing illness. The recommendation by the U.S. Preventive Services Task Force does not necessarily apply to women who use hormone replacement therapy to reduce menopausal symptoms such as hot flashes, night sweats and vaginal dryness. ... The recommendation ... comes a decade after the study first linked hormone replacement therapy with higher rates of invasive breast cancer. Those initial findings prompted droves of women to abandon or avoid hormone therapy (Healy, 5/29).

Other stories look at a medical marijuana movement in Florida, drugs for adults being used to treat children and a new method to treat hypertension --

The Wall Street Journal: Joint Effort: Reefer Roadshow Asks Seniors to Support Medical Pot
Selma Yeshion, an 83-year-old retiree here, says she long considered marijuana a menace. ... Then she attended a presentation at the local L'Dor Va-Dor synagogue in April put on by a group called the Silver Tour. The group aims to persuade seniors to support legislation to legalize marijuana for medicinal purposes in Florida. ... The group was founded in 2010 by an unlikely activist: Robert Platshorn, who served nearly 30 years in federal prison for his role in what drug-enforcement officials call one of the biggest marijuana-smuggling rings of the 1970s (Campo-Flores, 5/28).

The New York Times: Drug For Adults Is Popular As Children's Remedy 
Since it was first introduced 13 years ago, a drug called Miralax -- an odorless, tasteless laxative that can be easily diluted in orange juice or water -- has become a staple in many American households. But the way many families use Miralax and its many generic equivalents has strayed far from its original intent. The Food and Drug Administration approved the drug for use only by adults, and for only seven days at a time. Instead, Miralax has become a long-term solution for childhood constipation (Saint Louis, 5/25). 

The Associated Press/MSNBC: Drastic Method Targets Hard-To-Treat Hypertension 
Hypertension may be the nation's sneakiest epidemic, a time bomb that's a leading cause of heart attacks, strokes and kidney failure, and one that's growing worse as the population rapidly grows older. Despite an arsenal of drugs, millions of people in the United States can't get their blood pressure down to safe levels. Now, in a high-stakes experiment at dozens of hospitals, scientists are testing a dramatically different approach for the toughest to treat patients, by burning away some overactive nerves deep in the body that can fuel rising blood pressure (Neergaard and Perrone, 5/28).