Pfizer Limited has launched Toviaz(R)(Black Triangle Drug) (fesoterodine fumarate), a new once daily treatment for the symptoms of overactive bladder (OAB). OAB is a condition which affects an estimated 4.9 million people in the UK(1) (more than twice the number of people with diabetes(2)) and has been shown to have a serious and detrimental effect on people’s emotional, psychological and sexual wellbeing(3).

Fesoterodine is an antimuscarinic drug which works by relaxing the muscles found in the wall of the bladder, decreasing sudden uncontrollable bladder contractions and increasing bladder capacity.(4) In two 12 week long, international clinical trials, fesoterodine significantly improved the symptoms of OAB compared to placebo(5),(6) (at least three quarters of patients said their condition improved or greatly improved on the medicine compared with 53% on placebo)(5) and patients taking fesoterodine also showed significant and consistent improvement in health related quality of life (HRQL) compared to placebo(7). This is important as OAB has a significant impact on quality of life, often causing sufferers to stop many of the social and physical activities they previously enjoyed and preventing them from leading a ‘normal’ life(3).

Fesoterodine is available as a 4 mg and 8 mg prolonged-release tablet(8). In trials, initial treatment effect was seen as early as two weeks after the start of therapy with fesoterodine. In addition, the medicine was generally well tolerated(9). Dry mouth was the most commonly reported adverse event(5),(6).

Overactive bladder occurs when the detrusor muscle that controls emptying of the bladder contracts involuntarily, creating a strong, sometimes uncontrollable urge to urinate. Key symptoms include frequency (needing to pass water more than eight times per day); urgency (the sudden desire to pass urine), and sometimes urge incontinence (leaking or wetting oneself due to complete or partial loss of bladder control)(10). People with an overactive bladder may pass urine as often as 12 times a day or more(5).

OAB can cause significant emotional, psychological and physical problems(3). Yet 40% of people with OAB never seek medical help, usually because they believe that it is an inevitable part of ageing and that no effective treatment is available(10). Lesley Woolnough, Executive Director of Incontact, the UK advocacy charity for people living with bladder and bowel control problems, said “We welcome any new treatment that comes to the market that may potentially improve the quality of life for people living with overactive bladder.”

Karen Logan, Nurse Consultant and head of Continence Services for Gwent NHS Healthcare Trust said “Incontinence still has a huge stigma attached to it and many patients feel isolated and suffer in silence with it for many years. As healthcare professionals we need to challenge the stigma and consider new ways of raising awareness and encouraging patients to seek help and take control of their condition.”

  • During phase III studies with Toviaz(R), the King’s Health Questionnaire (KHQ) and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) were used to determine health related quality of life. The KHQ comprises nine domains and assesses the impact of incontinence on physical and emotional wellbeing. Scores range from 0 (best) to 100 (worst). The ICIQ-SF assesses urinary frequency and urinary leakage and the effects on daily life and scores range from 0 (low bother) to 21 (maximum bother).
  • Incontact is the leading UK advocacy charity which campaigns for people living with bladder & bowel control problems. Dedicated to raising awareness and improving the understanding of continence issues, they provide user-friendly booklets and fact sheets, offer an on-line support forum, a specialist nurse and counsellor helpline and a magazine three times a year. Call confidentially on +44(0)1536-533255, email info@incontact.org or visit http://www.incontact.org. Registered charity number 1085095.

References

1. Milsom I, Irwin DE, Kelleher C, Reilly K, Bridge SM. Prevalence of urinary incontinence and overactive bladder: UK results from the EPIC study. (Abstract 337). Int Urogynecol J 2006; 17 (Suppl. 2): S57-S100

2. Diabetes: State of the Nations 2006. Progress made in delivering the national diabetes frameworks. A report from Diabetes UK.

3. Nitti V W. Clinical impact of overactive bladder. Rev Urol. 2002;4(suppl 4):S2-S6

4. BNF 55. March 2008

5. Chapple C, Van Kerrebroeck P, Tubaro A et al. Clinical efficacy, safety and tolerability of once-daily fesoterodine in subjects with overactive bladder. European Urol 2007;52:1204-1212

6. Nitti V, Dmochowski R, Sand PK et al. Efficacy, safety and tolerability of fesoterodine for overactive bladder syndrome. J Urol 2007;178:2488-2494

7. Tubaro A, Wang J, Kopp Z, Bavendam T. Improvements in health-related quality of life with fesoterodine in subjects with overactive bladder: pooled data from two randomised controlled studies. ICS 2007. Abstract 462.

8. Summary of Product Characteristics: Toviaz 4 mg & 8 mg prolonged-release tablets

9. Khullar V, Rovner ES, Dmochowski R et al. Fesoterodine dose response in subjects with overactive bladder syndrome. Urol 2008;71:839-843

10. Milsom I, Abrams P, Cardozo L, et al. How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int. 2001;87(9):760-766.

Source: Pfizer Ltd


Public Health Advocates Deliver Demand during the Democratic National Convention Calling on Senators Barack Obama and John McCain to Support a Comprehensive National AIDS Strategy

In a historically unprecedented move, over 30 national HIV/AIDS organizations and leaders representing African-American, Latino, Native American/Alaska Native, and Asian & Pacific Islander communities have joined forces in an urgent call for the development and implementation of a comprehensive national AIDS strategy. The demands to the Democratic and Republican presidential nominees come in response to long-standing concerns about unmet needs for targeted HIV research, treatment access, medical care and prevention in communities of color. A recently-released report from the U.S. Center for Disease Control and Prevention (CDC) on estimates of new HIV infections in the United States amplifies the crises faced in communities of color.

According to the CDC’s alarming new estimates, communities of color account for a combined total of 65% of the approximately 56,300 new HIV infections occurring in the United States. By the CDC’s own admission, this new estimate is 40% higher than the CDC’s earlier estimate of 40,000 infections per year. The startling new HIV rates are of special concern for people of color who are more likely to die from the disease than HIV-infected whites. AIDS advocates representing communities of color have long expressed dissatisfaction with the current lethargic, fragmented and unaccountable U.S. response to the epidemic, which they point out, is a direct result of the non- existent national plan.

Leading national HIV organizations and leaders representing communities of color convened at the Ford Foundation in New York City in August 2008 to formulate a national HIV response to the new administration that will take office in January 2009. Pledging to work together to strengthen the HIV/AIDS response nationally, and in their own communities, these organizations agreed on an urgent seven-point action plan.

The action points stipulate first and foremost the urgent need for the next administration to rapidly initiate a National AIDS Strategy that engages the entire federal government in the fight against HIV and holds each department accountable for improved results in communities of color. Ironically, the U.S. government requires foreign countries receiving American HIV/AIDS assistance to have a national strategy for addressing the epidemic, where there is none in place in our own country. The action plan also demands that the federal government improve its inadequate data gathering methods, currently accounting for only 33 out of the 50 states and 5 dependent territories, excluding other states and territories severely impacted by the epidemic. This flawed process results in the underestimation of HIV rates and impedes efforts to allocate adequate resources to address HIV/AIDS prevention, treatment, and care for all at-risk Americans.

Public health advocates also stress that the socio-economic drivers of the epidemic disproportionately impact communities of color. Such factors include poverty, limited educational opportunities, gender inequities, homophobia, HIV stigma and inadequate health access. The needs of communities of color are further compromised by the current administration’s response to the epidemic including a derisory allocation of only 4% of HIV-related domestic spending towards HIV prevention efforts and the flat-funding of the Minority HIV/AIDS Initiative for the past six years despite increasing rates of transmission in people of color communities during that time.

The partnering organizations and leaders stand together to demand concrete action from the new President and his administration. The organizations and leaders represent various individuals, including health service providers, policy makers, physicians, medical schools and people living with HIV/AIDS. The representatives come together from across the country including Hawaii. Together, they bring a voice to the needs of people in urban, rural and native reservation communities.

The time has come for all American leaders, regardless of political affiliation, to support the development and implementation of a comprehensive national plan focused on prevention, treatment, and care for communities of color.

Partnering organizations include: Asian & Pacific Islander Wellness Center, BIENESTAR, Black AIDS Institute, Black Leadership Commission on AIDS, Inc., National Minority AIDS Council, National Native American AIDS Prevention Center, The Balm In Gilead and National Association of People with AIDS.

Source: A&PI Wellness Center


The American Society of Nuclear Cardiology (www.asnc.org) will be pleased to host its Annual Scientific Session from September 10 – 14, 2008 in Boston, MA. Imaging specialists from around the globe will gather at ASNC2008 to discuss the meeting’s theme — “Imaging for Primary and Secondary Prevention: Improving the Detection Gap.”

With medical imaging gaining increasing validity and scrutiny as a diagnostic tool, the ASNC Annual Scientific Session is critical to advancing best practices and new research in the nuclear cardiology field. More than 1,500 physicians, scientists, technologists, and nurses will attend this year’s meeting, which will feature lectures from world-renowned faculty such as Dr. Jeffrey Leppo of the Berkshire Medical Center and Dr. Jagat Narula of the University of California — Irvine.

“It is an exciting time for cardiovascular imaging,” said ASNC Executive Director Steve Carter. “ASNC2008 showcases how far we’ve come as a profession and the new research and technology that are helping advance our field even further.”

For a full program agenda, scientific abstracts, and registration materials, please visit www.asnc.org/ASNC2008.

The American Society of Nuclear Cardiology (ASNC) is the leader in education, advocacy, and quality for the field of nuclear cardiology. Serving more than 5,000 individuals in over 50 countries, ASNC is the only professional association dedicated to the dynamic subspecialty of nuclear cardiology.

Source: American Society of Nuclear Cardiology


The following is a statement of William V. Corr Executive Director, Campaign for Tobacco-Free Kids

A new scientific study being published this week finds that California’s state tobacco control program saved $86 billion (in 2004 dollars) in personal health care costs in its first 15 years and provides important new evidence for states to increase spending on tobacco prevention and cessation programs. This study demonstrates powerfully that state tobacco prevention and cessation programs are smart, cost-effective investments that not only improve health and save lives, but also save money by dramatically reducing health care costs for government, businesses and families. It should spur states to significantly increase funding for tobacco prevention and cessation programs with the $25 billion in revenue they collect each year from the tobacco settlement and tobacco taxes.

The new study was conducted by researchers at the University of California, San Francisco, and published in the August 25, 2008, online issue of the peer-reviewed medical journal PLoS Medicine (published by the Public Library of Science, or PLoS). Between 1989, when the state-funded California Tobacco Control Program began, and 2004, when the study ended, the program saved $86 billion in personal health care costs, while the state spent $1.8 billion on the program, for a 50-to-1 return on investment, according to the study. The program prevented 3.6 billion packs of cigarettes from being smoked during this period, the researchers found.

These dramatic cost savings came even as funding for California’s tobacco control program was reduced substantially in the mid-1990s. If funding had remained consistent with the program’s early years, California’s total health care cost savings could have reached $156 billion, according to the researchers. The researchers attribute the savings to declines in tobacco-related diseases in California, especially heart disease, cancer and lung diseases, that have far exceeded national declines.

The California study adds to the already overwhelming evidence from scientific studies and states’ results that tobacco prevention and cessation programs work to reduce smoking among both youth and adults, save lives and save money. Just last week, the National Cancer Institute issued a comprehensive, 684-page report, titled The Role of the Media in Promoting and Reducing Tobacco Use, that concluded that mass media campaigns are effective at reducing tobacco use, especially when combined with school and community programs. The NCI report found that such programs can change youth attitudes about tobacco use, prevent youth from starting to smoke and encourage adult cessation.

This overwhelming evidence that state tobacco prevention and cessation programs work and deliver so many health and financial benefits leaves elected leaders with no excuse for failing to fund such programs in every state at levels recommended by the U.S. Centers for Disease Control and Prevention. Despite the success of these cost-effective programs, too often they have been among the first targets for budget cuts whenever states have faced budget deficits, as they do now. This new study shows why states should increase funding for tobacco prevention programs and why cutting funding for them is penny-wise and pound-foolish. The decision to properly fund these programs should be an easy one:

  • The problem is huge and warrants urgent action. Tobacco use is the leading preventable cause of death in the United States, resulting in 400,000 premature deaths and costing the nation nearly $100 billion in health care bills each year. These expenditures include $65 billion under state and federal health care programs such as Medicaid, amounting to hidden tax of $575 on every American household.
  • We know the solution works. Comprehensive, well-funded state tobacco prevention and cessation programs are highly effective, especially when combined with higher tobacco taxes and smoke-free workplace laws.
  • States have the revenue. The states will collect about $25 billion this year in revenue from the tobacco settlement and tobacco taxes. It would take just 15 percent of this revenue for each state to fund a tobacco prevention and cessation program at the CDC’s recommended levels. Right now, the states are spending less than 3 percent.
  • The public supports it. Poll after poll shows that Americans strongly believe tobacco settlement and tax dollars should be spent on tobacco prevention.

Despite the overwhelming evidence that state tobacco prevention and cessation programs are highly effective when they are funded appropriately, only three states currently fund these programs at even the minimum level recommended by the CDC (www.tobaccofreekids.org/reports/settlements/ ). This is part of the reason that declines in both youth and adult smoking in the United States have stalled in recent years. With the tobacco companies spending more $13.4 billion per year marketing their deadly products, it is imperative that state leaders act now to fund programs that we know work to prevent kids from smoking and help smokers quit.

Source: Campaign for Tobacco-Free Kids


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