News & Notes

Abstract

AbstractCyproterone acetate may increase VTE riskA UK case‐control analysis suggests that treatment with cyproterone acetate (CPA) may increase the risk of venous thromboembolism (VTE) in men with prostate cancer (BJU Int 2007; 99: 1398‐403).Using the General Practice Research Database to identify 11 199 men with prostate cancer and 229 cases of VTE, the authors found that the risk of prostate cancer associated with CPA was more than five times greater than with orchiectomy or treatment with an LHRH analogue. VTE was also diagnosed sooner in men first treated with CPA compared with those treated with an LHRH analogue.The authors acknowledged that confounding by disease severity could not be excluded.Azithromycin vs doxycycline for PIDTwo weekly doses of azithromycin (1g) are as effective as daily doxycycline (200mg/day for 14 days) following intramuscular ceftriaxone 250mg for the treatment of pelvic inflammatory disease, according to a Brazilian study (Obstet Gynecol 2007; 110: 53‐60). Clinical cure rates were 90 and 72 per cent respectively.New NICE programmeThe National Institute for Health and Clinical Excellence (NICE) has announced the topics selected for its 14th work programme, including a technology appraisal of bevacizumab for metastatic or advanced breast cancer and a clinical guideline on bedwetting in children. The Department of Health has asked NICE to consult on the remit for a technology appraisal for satraplatin for hormone‐refractory prostate cancer.Government updates teenage pregnancy strategyThe latest guidance on the government's strategy to reduce teenage pregnancy and improve outcomes for young parents has been published at www.everychildmatters.gov.uk. The government aims to accelerate its programme, which, it says, has already reduced unwanted pregnancies.Shortage of mifepristone?Reports in the lay press suggest that NHS shortages of mifepristone are forcing women to seek terminations in the private sector.According to a spokesperson at Bath's Royal United Hospital, demand for mifepristone exceeds supply nationally. One clinic in Bristol reportedly told women on its waiting list that not all could be treated within the customary nine‐week period.Low‐dose HRTWyeth has introduced a low‐dose version of its Premarin brand of conjugated oestrogens for HRT. Premarin 0.3mg is an oestrogen‐only preparation for women who have undergone hysterectomy.HRT data misinterpreted?Epidemiological studies on the safety of HRT misrepresent the risk of breast cancer for many women, according to Women's Health Concern (www.womens‐health‐concern.org), a charity providing health information for women.Chair of WHC and consultant physician John Stevenson, and Richard Farmer, Emeritus Professor of Epidemiology at the University of Surrey, say early interpretations of the Women's Health Initiative (WHI) suggested that HRT increased myocardial infarction, strokes, thrombosis and breast cancer. This was followed by a 50 per cent reduction in the use of HRT.Subsequent data show that the apparently increased risk of MI and breast cancer was not statistically significant. Together with the Million Women Study, WHI shows that women who begin HRT below age 60 do not have increased cancer risk, though the risk of thrombosis is raised. Recently, the WISDOM study (BMJ 2007; 335: 239) confirmed that combined HRT was associated with an increased risk of major cardiovascular events and venous thromboembolism; the study had been stopped prematurely when the WHI results were published. Copyright © 2007 Wiley Interface Ltd