Inflammatory Bowel Disease News: Tysabri, Accutane and More
There have been a few items in the news lately related to Inflammatory Bowel Disease that I thought prudent to pass along to everyone.
A few weeks ago I wrote about the multiple sclerosis drug, Tysabri, being approved for use in severe Crohn's disease cases (Tysabri Approved for Crohn's). However, last week, a new warning was added to the drug's label, per the Food and Drug Administration. According to an article in MedPage Today, the FDA sent a letter to make medical clinicians aware of the new warning about possible liver toxicity seen as early as six days after the initial dose. The drug's label now states that Tysabri (natalizumab) should be discontinued in patients with jaundice or other laboratory evidence of significant liver injury.
See Neurologist and Multiple Sclerosis expert Dr. Gross' take on the latest Tysabri warning.
Accutane Acne Medicine May Cause IBD:
It seems the evidence of Accutane-induced IBD is growing. Intended for use as a last resort in the treatment of severe acne cases, is seems Accutane is being blamed for more and more cases of IBD, and the legal system is listening. In October 2007 a Florida man was awarded $7 million after suing Roche Pharmaceuticals in 2001 claiming "the company failed to adequately warn him about the risk of IBD associated with Accutane use." This February, Roche lost its appeal when the courts upheld the award. In May 2007 in New Jersey another settlement was awarded in the amount of $2.6 million. A number of other related lawsuits are currently being considered for similar action.
If you read the warning about Accutane - all of them, not the one's about IBD - this is a serious drug and to be used with great caution and knowing all the pros and cons before starting it. I've done a little looking around the internet about this issue with Accutane and IBD and find that is seems not only a plausible cause of IBD in some individuals but likely. It is also noted that if you already have IBD and are considering taking Accutane and may exacerbate your symptoms and cause a flare-up.
Health Records Online - Pro or Con?
This doesn't have to do with IBD, per se, but it does have to do with medical records so I thought is worth mentioning here.
Google Inc. and the Cleveland Clinic have teamed up this past week to test a new system of storing patient's medical records and information online. Between 1,500 and 10,000 Cleveland Clinic patients volunteered to have their patient information stored online and retrievable with a password. According to a CNN.com news report, Google sees its expansion into medical records management as logical because so many people already use the search engine to find information about illnesses, injuries, and medications.
But I think the question is, do you want your medical information accessible on the internet? We know from the past that the internet is not always secure and that web site security can be breached and user's information put at risk. Another company, Practice Fusion launched a service three months ago which gives doctors a free service to help automate their offices, from administrative duties to patient medical records. What's the catch? As the doctors and their staff enter information into the computer software targeted ads pop-up suggesting medications and treatments. For example, when your doctor looks at your colonoscopy results it may pop-up an ad for Asacol. This may not be too much different than having a pharmaceutical representative appear in your doctor's office with free coffee and samples of their drugs - which is why doctors can give away so many free drug samples to their patients - but it does show how our privacy is slowly but surely being compromised. Plus, do you really want a drug prescribed to you by a computer software program? I'm not sure I do. Nor do I want my medical records stored anywhere on the internet - I want to have a little control over who can and can't see my medical records and I fear a future where my medical records could possibly be seen by anyone.
IBD or Endometriosis?
A case report released in the January 7, 2008 issue of the World Journal of Gastroenterology suggests that in some women symptoms of endometriosis may in fact be Crohn's disease. The study follows the case of a woman in Turkey who presented to her Gynecologist with symptoms of endometriosis - perimenstrual lower and mid-abdominal pain that radiated to her back, as well as lower abdominal fullness. She was diagnosed with small bowel endometriosis and treated with oral contraceptives which did not help her symptoms and a exploratory laparotomy was performed where a biopsy was taken from the inflamed areas. The results of the biopsy indicated an unspecified inflammation. The patient was then referred to a gastroenterologist who ultimately performed a second surgery based on the view she suffered from Crohn's disease. Ultimately the Crohn's diagnosis was confirmed after 40 cm of small bowel were removed. The patient experienced a rapid resolution of symptoms after the surgical treatment.