Medical Forum / Diseases and Disorders / AIDS / December 2006
South Africa: Scientists Warn State-Supplied Aids Drug Poses Diabetes Threat
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Alex - 15 Dec 2006 20:23 GMT http://allafrica.com/stories/200612060603.html
South Africa: Scientists Warn State-Supplied Aids Drug Poses Diabetes Threat
December 6, 2006 Posted to the web December 6, 2006 Tamar Kahn Johannesburg
Widely used HIV drug stavudine increases the risk of diabetes, scientists warned yesterday at the 19th World Diabetes Congress, as they urged government to speed up registration of an alternative antiretroviral medicine called tenofovir. Their call has added weight to an AIDS activists' campaign to expand access to cheap generic copies of tenofovir, which is believed to have fewer side-effects than other treatments. "Antiretroviral medicines are HIV patients' best hope, but they are not without their problems," said Linda Gail Bekker, co-director at Desmond Tutu HIV/AIDS Centre at the University of Cape Town.
SA has one of the world's worst HIV epidemics, with about 5,5-million people living with the disease, according to government figures. About 310000 of them are receiving antiretroviral therapy, says the health department. Most of these patients are taking stavudine, also called d4T. The drug is one of three provided to patients in SA as "first-line therapy", along with lamivudine (3TC) and nevirapine or efavirenz. If patients develop severe side-effects or resistance, they switch to "second-line therapy", based on zidovudine (AZT), didanosine (ddI), and ritonavir-boosted lopinavir (Kaletra).
Yesterday, scientists highlighted a growing body of published studies showing an association between stavudine and the onset of diabetes, which in turn raises the risks of heart attack and stroke. For example, results from the DAD (data collection on adverse events of antiretroviral drugs) study presented at the eighth International Congress on Drug Therapy in HIV Infection in Glasgow last month showed three drugs in a class called nucleosides -- stavudine, didanosine and zidovudine -- were associated with increased risk of diabetes. The risk was highest with stavudine. The study showed patients had an increased risk of 19% of developing diabetes each year they were on stavudine.
The drugs were also associated with other metabolic changes, including increased cholesterol levels and the development of lipodistrophy, in which the body's fat distribution changes. Prof Peter Reis from Amsterdam's Academic Medicine Centre said the problems associated with stavudine were "not a reason to withhold these life- saving drugs" in SA. He said while stavudine was the best affordable choice for many developing countries, they should move away from it as quickly as possible.
Although manufacturer Gilead has licensed production of tenofovir to local drug manufacturer Aspen Pharmacare, it is waiting for Medicines Control Council approval, having submitted its dossier on tenofovir 10 months ago. "Our best-case scenario is to have the drug registered by the end of March 2007," said Aspen head of strategic trade Stavros Nicolau.
Life - 16 Dec 2006 21:56 GMT > http://allafrica.com/stories/200612060603.html > [quoted text clipped - 8 lines] > Widely used HIV drug stavudine increases the risk of diabetes, scientists > warned This drug came from a class of drugs that were used to INDUCE diabetes in experimental mice so that the mice could be used as test platforms for diabetes drugs.
> yesterday at the 19th World Diabetes Congress, as they urged government to > speed up registration of an alternative antiretroviral medicine called [quoted text clipped - 8 lines] > Tutu > HIV/AIDS Centre at the University of Cape Town. Isn't it ironic that a drug used to treat "AIDS" actually helps create many of the symptoms of "AIDS"???
Alex - 17 Dec 2006 00:09 GMT > Isn't it ironic that a drug used to treat "AIDS" actually helps create many > of the symptoms of "AIDS"??? Apparently diabetes is now an AIDS defining illness.
Alex
GMCarter - 17 Dec 2006 00:19 GMT >> Isn't it ironic that a drug used to treat "AIDS" actually helps create many >> of the symptoms of "AIDS"??? > >Apparently diabetes is now an AIDS defining illness. Apparently, the two of you are talking out your respective a.ses.
No surprise there!
Death - 17 Dec 2006 01:00 GMT "GMCarter" <fiar@verizon.net> wrote in message
> On Sun, 17 Dec 2006 01:00:50 -0000, "Alex" > [quoted text clipped - 10 lines] > > No surprise there! Contact: Marjorie Dwyer marjorie.dwyer@joslin.harvard.edu 617-732-2415 Joslin Diabetes Center
Mechanism discovered for muscle wasting seen in diabetes, AIDS and other diseases Discovery could one day lead to new drug therapies BOSTON -- Muscle wasting is associated with aging and a serious consequence of different diseases, including cancer and diabetes. Researchers at Joslin Diabetes Center, with the assistance of other collaborating researchers, have discovered an important biochemical pathway for muscle wasting--as well as a potential target for drug therapy. The study will be published in the Oct. 15 issue of the journal Cell. Muscle wasting is a hallmark of a number of diseases, including cancer, bacterial sepsis, AIDS, diabetes, and end-stage heart, kidney and obstructive pulmonary disease. Muscle wasting can cause generalized weakness and debilitation and in its extreme, when respiratory muscles are involved, asphyxia and even death.
Dongsheng Cai, M.D., Ph.D., a postdoctoral Fellow at Joslin Diabetes Center and Steven Shoelson, M.D., Ph.D., Helen and Morton Adler Chair and Associate Research Director at Joslin Diabetes Center, and Professor of Medicine at Harvard Medical School in Boston, along with their colleagues at Joslin, Beth Israel Deaconess Medical Center, The Children's Hospital Boston, Spaulding Rehabilitation Hospital, and Regeneron Pharmaceuticals in Tarrytown, NY, used transgenic (genetically altered) mice to study the biochemical pathways underlying muscle wasting. Their studies zeroed in on a transcription factor called NF-kB, which is well known for its importance in immune cells but was previously not known to be a critical mediator of muscle wasting.
The investigators created two different strains of transgenic mice--MIKK mice, in which NF-kB was activated selectively in muscle tissue, and MISR mice, in which NF-kB activation was inhibited in muscle. The MIKK mice were viable and appeared normal at birth, but as they matured, their body weight was reduced due to decreases in skeletal muscle mass. Their muscle fibers were also smaller than those of their non-genetically altered littermates. On the other hand, the MISR mice were normal in terms of appearance, body weight, and individual muscle weight and histology (the appearance of cells under the microscope) throughout life.
High doses of drugs called salicylates have been shown to inhibit NF-kB activity, so the researchers studied the impact of these drugs on MIKK mice. In one protocol, they initiated treatment with salicylates after weaning in 4-week-old MIKK mice already affected by muscle wasting. The mice's body weights increased with salicylate treatment and, after six months of therapy, their body weight, muscle mass and muscle fiber size were nearly normal. In a prevention protocol, salicylate treatment was begun during gestation. In these latter mice, body weights and muscle mass were essentially normal throughout life.
The researchers also studied the effects of blocking NF-kB activation in mouse models of muscle wasting, including immobilization/denervation and cancer. The former is a model for the muscle wasting that occurs during disuse, such as when a limb is casted, or in spinal cord injuries. Inhibition of NF-kB in MISR mice was accompanied by a partial remission of denervation-induced muscle atrophy, including increased muscle mass and fiber size. Muscle wasting is a significant problem for patients with certain forms of cancer, where it seriously diminishes their quality of life. They found that the MISR mice with cancer were protected from loosing muscle mass, and the MISR mice had much better survival rates than did normal mice with cancer. Thus, selective NF-kB blockade in muscle decreased muscle wasting and prolonged survival in this mouse model of cancer.
"The discovery that NF-kB activation is sufficient to cause skeletal muscle atrophy in vivo and that blockage of the NF-kB pathway can ameliorate atrophy suggests a new set of drug targets for chemical intervention during cachexia, cancer, AIDS and other settings of atrophy," the authors conclude. "This is critically important because unfortunately there are currently no drugs approved for the treatment of skeletal muscle atrophy."
### Other authors of the study included J. Daniel Frantz, Ph.D., Nicholas E. Tawa Jr., M.D., Ph.D., Peter A. Melendez, Ph.D., Byung-Chul Oh, Ph.D., Hart G.W. Lidov, M.D., Ph.D., Per-Olof Hasselgren, M.D., Ph.D., Walter R. Frontera, M.D., Ph.D., Jongsoon Lee, Ph.D., and David J. Glass, M.D. The study was funded by the National Institutes of Health and the American Diabetes Association.
For more information, contact: Marge Dwyer or Jenny Eriksen 617-732-2415
About Joslin Diabetes Center Joslin Diabetes Center, dedicated to conquering diabetes in all of its forms, is the global leader in diabetes research, care and education. Founded in 1898, Joslin is affiliated with Harvard Medical School. Joslin research is a team of over 300 people at the forefront of discovery aimed at preventing and curing diabetes. Joslin Clinic, affiliated with Beth Israel Deaconess Medical Center in Boston, the nationwide network of Joslin Affiliated Programs, and the hundreds of Joslin educational programs offered each year for clinicians, researchers and patients, enable Joslin to develop, implement and share innovations that immeasurably improve the lives of people with diabetes. As a nonprofit, Joslin benefits from the generosity of donors in advancing its mission. For more information on Joslin, call 1-800-JOSLIN-1 or visit www.joslin.org.
DavidT - 18 Dec 2006 13:48 GMT I am absolutely appalled that these toxic drugs are being prescribed. Who would have ever imagined that they might have, god forbid, a side effect? They should be, like all other drugs are, entirely harmless with no adverse effects at all. It is a totally inadequate industry response to develop a drug can save someone's life if at the same time it could sometimes make his ears feel cold. I for one would rather be dead from AIDS that have cold ears.
Moira de Swardt - 18 Dec 2006 15:28 GMT "DavidT" <david199@volcanomail.com> wrote in message
> I am absolutely appalled that these toxic drugs are being prescribed. > Who would have ever imagined that they might have, god forbid, a side [quoted text clipped - 3 lines] > it could sometimes make his ears feel cold. > I for one would rather be dead from AIDS that have cold ears. LOL!
The reality is that HIV drugs come in with all sorts of side effects. A friend of mine in Finland, a former ballet dancer, will one day be in a wheel chair as a result of the side effects of his particular drug combination, unless new drugs without the problems are developed but he's looking forward to it. The alternative would have been an early death.
A friend in South Africa is battling cholesterol problems as a result of his medication. He, too, would rather have a cholesterol problem than be dead.
-- Moira de Swardt posting from Johannesburg, South Africa Remove the dot in my address to find me at home.
Life - 20 Dec 2006 17:23 GMT > The reality is that HIV drugs come in with all sorts of side > effects. A friend of mine in Finland, a former ballet dancer, will > one day be in a wheel chair as a result of the side effects of his > particular drug combination, unless new drugs without the problems > are developed but he's looking forward to it. The alternative would > have been an early death. How do you know the alternative would be an early death when there are no studies to prove your theory that not taking toxic drugs is worse than taking them?
Moira de Swardt - 20 Dec 2006 20:37 GMT "Life" <Life@life.com> wrote in message
> "Moira de Swardt" <moira.ds@wol.co.za> wrote in message
> > The reality is that HIV drugs come in with all sorts of side > > effects. A friend of mine in Finland, a former ballet dancer, will > > one day be in a wheel chair as a result of the side effects of his > > particular drug combination, unless new drugs without the problems > > are developed but he's looking forward to it. The alternative would > > have been an early death.
> How do you know the alternative would be an early death > when there are no studies to prove your theory that not > taking toxic drugs is worse than taking them? His personal testimony about how sick he was before he started taking the drugs is the best indicator.
-- Moira de Swardt posting from Johannesburg, South Africa Remove the dot in my address to find me at home.
DavidT - 18 Dec 2006 13:49 GMT I am absolutely appalled that these toxic drugs are being prescribed. Who would have ever imagined that they might have, god forbid, a side effect? They should be, like all other drugs are, entirely harmless with no adverse effects at all. It is a totally inadequate industry response to develop a drug can save someone's life if at the same time it could sometimes make his ears feel cold. I for one would rather be dead from AIDS than have cold ears.
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