(This is an excerpt of the Health Rounds newsletter, where we present latest medical studies on Tuesdays and Thursdays.)
By Nancy Lapid
(Reuters) -An inexpensive pill for treating HIV could become an alternative to injections for diabetic eye disease, a small study suggests.
“An oral drug that improves vision in diabetic macular edema (DME) would be a game changer because it would be more convenient for patients than frequent, often monthly, injections into the eye,” study leader Dr. Jayakrishna Ambati of the University of Virginia said in a statement.
At the start of the study, 24 patients in Brazil with DME were randomly assigned to receive Viiv Healthcare’s oral antiviral drug Epivir (lamivudine) or a placebo for four weeks, to be followed by a standard injection of Roche’s Avastin (bevacizumab) into the clear gel-like area that fills the eye between the lens and retina.
After that initial four weeks, the ability to read letters on an eye chart had improved by 9.8 letters, or about 2 lines on the eye chart, in the lamivudine group, while it had decreased by 1.8 letters in the placebo group.
Four weeks after the Avastin injection, the lamivudine recipients had improved by 16.9 letters, more than 3 lines on the chart, while the group that got just Avastin improved by only 5.3 letters.
The HIV drug inhibits an early step in the inflammatory process that leads to DME, the researchers explained in a report published on Tuesday in the Cell Press journal Med.
That mechanism of action is different from existing treatments, “so we could also develop combination therapies,” Ambati said.
While the results suggest that lamivudine may work both with and without Avastin injections, the Viiv drug alone could be life changing for patients in regions with limited access to specialty doctors or who are unable to afford or travel to monthly eye appointments, Ambati said.
“A $20-a-month or even cheaper oral pill that improves vision as much as or more than therapy with injections into the eye that cost up to $2,000 per month could be transformative both for patients and the healthcare system,” Ambati said.
WORKING TOWARD NAUSEA-FREE GLP-1 DRUGS
Researchers have come a step closer to designing GLP-1 drugs for weight loss that don’t cause nausea, according to a report in Cell Metabolism.
In experiments in mice with the GLP-1 drug semaglutide – the main ingredient in Novo Nordisk’s weight-loss drug Wegovy – the researchers identified the nerve cells in the brain stem that control the medicine’s effects on appetite and weight and distinguished those from brain cells that contribute to the nausea.
After determining which nerve cells were activated by the drug, they next found a way to stimulate these cells without administering the drug itself. The result was that the mice ate less and lost weight, just as they did when treated with semaglutide, but without nausea-related behavior.
“This suggests that these nerve cells control the beneficial effects of semaglutide,” study leader Júlia Teixidor-Deulofeu, a PhD student at Sahlgrenska Academy at the University of Gothenburg, said in a statement.
“If we can target the treatment there, we may be able to maintain the positive effects while reducing side effects.”
FOR SECOND LOOK AT DENSE BREASTS, MRI TOPS ULTRASOUND
When mammography is negative in women with dense breasts, MRI is superior to ultrasound for double-checking that no early-stage cancers have been missed, researchers reported in The Lancet.
Women with dense breasts face increased risks of breast cancer, but mammograms are less effective for detecting early-stage cancer in these individuals because the dense tissue can hide tumors, the researchers explain.
Doctors often advise them to follow a negative mammogram with an MRI or ultrasound exam, but it has not been clear whether one is better than the other for this purpose.
More than 9,000 UK women with dense breasts and a negative mammogram, ages 50 to 70, were randomly assigned to undergo various supplemental screening techniques. The cancer detection rate was 0.4% with ultrasound, 1.7% with MRI, and 1.9% with mammography using an intravenous dye.
The authors acknowledge that while the scans can detect additional small cancers, it’s not clear whether finding those early tumors will reduce the number of deaths due to breast cancer.
Further study is needed to establish the risk of over-diagnosis and to estimate the cost-benefit ratio of implementing a supplemental imaging strategy for breast cancer screening, they said.
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(Reporting by Nancy Lapid; editing by Bill Berkrot)
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