HCPLive Network

Pegaptanib Shows Promise in Ocular Complications of Diabetes
CANNES, France—Treatment with pegaptanib sodium (Macugen), currently indicated for age-related macular degeneration, has been shown to thwart the progression of diabetic retinopathy and diabetic macular edema, researchers announced at a joint meeting of the American Society of Retinal Specialists and the European VitreoRetinal Society.

Although retinopathy is the most common diabetic eye disease and can lead to blindness, existing treatments are fraught with shortcomings.

Victor H. Gonzalez, MD, of the Valley Retinal Institute, McAllen, Tex, reported results in 172 patients who had been randomized to treatment with intravitreal injections of pegaptanib or sham injections at enrollment and at weeks 6 and 12. Additional injections and/or laser photocoagulation were given as needed for another 18 weeks.

Compared with sham-treated patients, those assigned to pegaptanib had improved visual acuity and greater reductions in central retinal thickness and in diabetic retinopathy severity, as well as regression of neovascularization, and were less likely than the sham group to need laser therapy.

Diabetic retinopathy is often treated with the off-label use of agents; however, those treatments may lead to cataract formation and pressure elevations. Laser therapy is now the only treatment with documented efficacy, but it is associated with loss of visual function, because tissue must be sacrificed at the periphery to help preserve central vision.

Transcranial Magnetic Stimulation Viable Option for Depression in the Elderly?
PARIS, France—Preliminary findings from an ongoing study that were released at the meeting of the European College of Neuropsychopharmacology show that repetitive transcranial magnetic stimulation (rTMS) appears to be an effective treatment for depression in older adults who are resistant to antidepressant drug therapy, reported Roumen Milev, MD, PhD, of Queen’s University, Kingston, Ontario. 

Dr Milev and colleagues are studying 19 patients aged ≥60 years. All were diagnosed with major depressive disorder or bipolar disorder and had a score of >18 on the 21-item Hamilton Depression Rating Scale (HAM-D-21).

All patients underwent 10 sessions of rTMS, a noninvasive brain stimulation that uses electromagnetic impulses delivered to the brain through a coil pressed against the skull. HAM-D-21 scores were reduced from an average of 25.4 at the start of the trial to 16.4 at 4 weeks after the end of treatment. Hamilton Anxiety Rating Scale scores improved from 19.4 at baseline to 13.5 at 4 weeks after the end of treatment. Clinical Global Impression scores also improved. One patient discontinued treatment after 5 sessions, because she found it intolerable. 

“Although depressive disorders are common in older patients, and several psychopharmacologic treatments are available, older patients are frequently unable to tolerate these treatments because of side effects,” Dr Milev noted. He emphasized that the results are preliminary and that the trial is continuing.

Short-term therapy with rTMS has been shown to be beneficial in several studies, but questions remain about long-term benefits. Electroconvulsive therapy, the preferred treatment in especially difficult cases, is risky in older patients, because it can cause cognitive impairment.

Obesity Taking Europe by a Storm, Inversely Tied to Income in France
PARIS/LONDON—Obesity is on the rise in France, according to a recent government report. There are now 5.9 million obese persons in France, compared with only 2.5 million in 1995, an average 2.1-kg (4.2-lb) weight gain for an adult during this 9-year period. Not surprisingly, the incidence of obesity was found to be inversely proportional to income, with 19% of persons with a monthly income <€900 (about $1150) being obese versus 5% of those with a monthly income ≥€5301 (about $6800).

And the new report issued by the UK Department of Health, “Forecasting Obesity to 2010,” predicts that 1 in 3 men and more than 1 in 4 women in the United Kingdom, which translates to 12 million adults and 1 million children, will be obese in 4 years unless something is done soon.

“In the old days, the big health challenges were infectious diseases like typhoid and tuberculosis, but these days, our health depends much more on what we do for ourselves than on what the National Health Service does for us,” Secretary of State for Health Patricia Hewitt said. “That’s why each of us needs to think about how we can lead healthier lives. It might be as simple as cutting down on the number of take-aways we eat, saying no to that extra pint of beer, getting off the bus 1 stop earlier, or walking our children to school.”

Compiled by our Paris-based correspondent Jill Stein.

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