MedicalResearch.com Interview with:
Mostafa Borahay, MD, FACOG
Assistant Professor, Director of Simulation Education
Department of Obstetrics and Gynecology
University of Texas Medical BranchCo-director of Minimally Invasive Gynecologic Surgery University of Texas Medical Branch
Medical Research: What is the background for this study? What are the main findings?
Dr. Borahay: Uterine fibroids are the most common type of tumor in the female reproductive system, accounting for half of the 600,000 hysterectomies done annually in the U.S. Their estimated annual cost is up to $34 billion in the U.S. alone. Despite this, the exact cause of these tumors is not well understood, as there are several genetic, familial and hormonal abnormalities linked with their development. Even more, we currently don’t have a satisfactory medical treatment for these tumors.
Our team investigated the impact of simvastatin on human uterine fibroid cell growth. Statins, such as simvastatin, are commonly prescribed to lower high cholesterol levels. Statins work by blocking an early step in cholesterol production. Beyond these well-known cholesterol-lowering abilities, statins also combat certain tumors. Statins have previously been shown to have anti-tumor effects on breast, ovarian, prostate, colon, leukemia and lung cancers. However, the effect of statins on uterine fibroids was unknown.
We found that simvastatin impedes the growth of uterine fibroid tumor cells. We also studied the way simvastatin works to suppress these tumors. Simvastatin was shown to inhibit ERK phosphorylation, which is a critical step in the molecular pathway that prompts the growth of new cells. In addition, simvastatin stops the progression of tumor cells that have already begun to grow and induces calcium-dependent cell death mechanisms in fibroid tumor cells. Therefore, we identified a novel pathway by which simvastatin induces the death of uterine fibroid tumor cells.
MedicalResearch.com Interview with
David S.H. Lee, Pharm.D., Ph.D.
Assistant Professor
Department of Pharmacy Practice
College of Pharmacy
Oregon State University/Oregon Health and Science University
Portland OR, 97239
MedicalResearch: What are the main findings of the study?
Dr. Lee: We found that older men taking a statin were less physically active and had more sedentary behavior. They had about 37 minutes of less moderate exercise per week. For comparison, the American heart Association recommends about 40 minutes of moderate activity 3-4 times per week. We also found that those that started using a statin during the study had the largest drop in physical activity.
MedicalResearch.com Interview with:
Jonathon D. Truwit, MD, MBA
Enterprise Chief Medical Officer
Sr. Administrative Dean
Froedtert-Medical College of Wisconsin
Milwaukee, WI 53226
MedicalResearch.com: What are the main findings of the study?
Dr. Truwit: Rosuvastatin did not reduce mortality, nor days free of the breathing machine, in patients with sepsis-associated acute respiratory distress syndrome (ARDS). One in four patients with ARDS die.
MedicalResearch Interview with:
Dr. Gerard J. Criner MD, FACP, FACCP
Professor, Medicine
Director, Medical Intensive Care Unit and Ventilator Rehabilitation Unit
Co-Director, Center for Inflammation, Translational and Clinical Lung Research, Temple University Hospital in Philadelphia, PA
MedicalResearch: What are the main findings of the study?
Dr. Criner: The STATCOPE Trial (Simvastatin in the Prevention of COPD Exacerbations) found that a statin drug commonly used to lower cholesterol is not effective in reducing the number and severity of flare ups from chronic obstructive pulmonary disease (COPD). The study rigorously tested the hypothesis that statin drugs may be beneficial to persons with COPD because of the drugs’ purported anti-inflammatory effect. However, researchers found that:
calResearch.com Interview with:
Jennifer G. Robinson, MD, MPH
Professor ,Departments of Epidemiology & Medicine
Director, Prevention Intervention Center
Department of Epidemiology
College of Public Health
University of Iowa
Iowa City, IA 52242-2007
MedicalResearch: What are the main findings of the study?
Dr. Robinson: The PCSK9 antibody, evolocumab, reduced LDL (or bad) cholesterol by about 65-70% regardless of the dose or type of statin used. This is a greater percentage reduction than ezetimibe, another drug used to lower LDL cholesterol in statin-treated patients, which lowered LDL cholesterol 15-20%. Side effects of evolocumab were similar to those for ezetimibe or placebo.
MedicalResearch.com Interview with:
Takehiro Sugiyama, MD, MSHS, PhD
Project Director, Diabetes Policy Planning Office
Management and Planning Bureau
Fellow, Department of Diabetes, Endocrinology and Metabolism
National Center for Global Health and Medicine
Shinjuku-ku, Tokyo Japan
MedicalResearch.com: What are the main findings of the study?
Dr. Sugiyama: In the US nationally representative sample from the National Health and Nutrition Examination Survey 1999-2010, we found that statin users in 2009-2010 eat 9.6% more calories and 14.4% more fat than statin users in 1999-2000. These increases were not observed in statin non-users; the trends of caloric and fat intake were statistically different between statin users and non-users. In 1999-2000, caloric and fat intake was significantly less for statin users compared with non-users, but the difference between the groups because smaller as time went by and there was no statistical difference in 2009-2010. Body mass index increased more rapidly for statin users compared to non-users.
MedicalResearch.com Interview with:
Evan A. Stein, M.D., Ph.D. FRCP(C), FCAP
Metabolic and Atherosclerosis Research Center
Cincinnati, OH 45225,
MedicalResearch.com: What are the main findings of the study?
Dr. Stein: The study which is the first 52 week randomized double blind trial of a PCSK9 to report results (all others have been 12 weeks) demonstrated that the excellent LDL-C reductions of 55-60% seen at 12 weeks are maintained through 52 weeks, with no fall off in patient compliance, tolerability of efficacy. It also demonstrated that with longer treatment no new or unexpected side effects.
The study also had a unique design in that prior to randomization to the PCSK9 inhibitor (evolocumab) or placebo patients had a run in period during which time they were assigned, based on NCEP-ATP III criteria, to appropriated background therapy which ranged from diet only, to atorvastatin 10 mg a day, to atorvatatin 80 mg a day or atorvastatin 80 mg a day plus ezetimibe - reflecting how these patients are treated in practice. Only then if their LDL-C was still above 75 mg/dL were they randomized into the treatment part of the study with the new drug. The study showed that irrespective of background therapy the reduction with evolocumab was consistent.
MedicalResearch.com Interview with:
Dr. John B. Kostis, MD
Chief of Medical Service, RWJUH
Professor of Medicine & Pharmacology
Chair - Department of Medicine
Rutgers Robert Wood Johnson
MedicalResearch.com: What are the main findings of the study?
Dr.Kostis: In this meta-analysis statins improved erectile function in men with decreased function on the average.
MedicalResearch.com Interview with:
Michael J. Pencina, PhD
Professor of Biostatistics and Bioinformatics
Director of Biostatistics
Duke Clinical Research Institute
Durham, NC 27710
MedicalResearch.com: What motivated your research?
Dr. Pencina: After the new guidelines were issued last November, we were intrigued by the change in treatment philosophy from that based on cholesterol levels (used by the “old guidelines” known as NCEP ATPIII) to one based on 10-year risk of cardiovascular disease (used by the new AHA-ACC guidelines). We were curious what the practical consequences of this shift would be.
Furthermore, the media quoted a lot of experts making educated guesses on the impact. We realized that this question can be answered much more precisely based on the NHANES data.
MedicalResearch.com Interview with:
Prof Ype Elgersma PhD
Professor, Neuroscience
Neuroscience Institute, Erasmus University Rotterdam
Rotterdam, Netherlands
MedicalResearch.com: What are the main findings of the study?
Answer: Research in genetic mouse models suggested that inhibition of HMG-CoA-reductase by statins might ameliorate the cognitive and behavioral phenotype of children with Neurofibromatosis type 1 (NF1), an autosomal dominant disorder. In a 12-month randomized placebo-controlled study including 84 children with NF1, we found that simvastatin, an inhibitor of the HMG-CoA-reductase pathway had no effect on full-scale intelligence, attention problems or internalizing behavioral problems, or on any of the secondary outcome measures.
MedicalResearch.com eInterview with Muhammad Mamdani Director, Applied Health Research Centre, St. Michael's Hospital Scientist in the Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital Associate Professor, Department of Health Policy, Management, and Evaluation University of Toronto MedicalResearch.com: What are the main findings of this study? Our study examined over 470,000...
MedicalResearch.com Interview Dr. Alexander Turchin M.D.,M.S.
Director of Informatics Research
Assistant Professor, Harvard Medical School
Endocrinology, Diabetes and Hypertension
Brigham and Women's Hospital Boston, MA
MedicalResearch.com: What are the main findings of the study?
Dr. Turchi: A large number of patients – 17% of individuals included in our study – report side effects to statins in routine care settings. Nearly 60% of these patients stopped the statin at least temporarily. However, overwhelming majority of patients who stopped taking a statin after experiencing a possible side effect, could tolerate a statin long-term if they tried taking one again. In other words, it appears that many statin-related events are tolerable, specific to individual statins or have other causes. These findings are consistent with the current guidelines that urge a conservative approach to statin discontinuation. They are particularly important because statins have been convincingly shown to save lives – they decrease all-cause mortality, and also cardiovascular mortality and incidence of cardiovascular events in patients with ischemic heart disease and / or elevated cholesterol levels.