Sugar pills work as well as leading prescribed drugs on juvenile migraine — and no side effects

❝ Sugar pills worked as well at preventing kids’ migraines as two commonly used headache medicines, but had fewer side effects, in a study that may lead doctors to rethink how they treat a common ailment in children and teens.

It’s the first rigorous head-to-head test in kids of two generic prescription drugs also used for adults’ migraines: topiramate, an anti-seizure medicine, and amitriptyline, an anti-depressant. The idea was to see if either drug could reduce by half the number of days kids had migraines over a month’s time. Both drugs worked that well — but so did placebo sugar pills.

❝ The study was released online Thursday in the New England Journal of Medicine. The National Institute of Neurological Disorders and Stroke and National Institute of Child Health and Human Development paid for the research.

“The fact that it shows that two of the most commonly used medications are no more effective than a placebo and have adverse effects makes a very clear statement,” said Dr. Leon Epstein…He said it should lead neurologists to rely on other prevention strategies; he advises lifestyle changes including getting more sleep and reducing stress, which he said can help prevent migraines in teen patients…

❝ Side effects from the drugs were common, including fatigue, dry mouth and forgetfulness. Almost one-third of kids on topiramate also had tingling sensations in their hands, arms, legs or feet. There was one suicide attempt in the topiramate group, another known side-effect of that drug.

The side effects were not unexpected, but given the risks, the results suggest the drugs shouldn’t be “first-line prevention treatments” for kids’ migraines, study author Scott Powers said.

Sad commentary on much of American medicine: inadequate testing to determine effectiveness – lax IMHO. Drug manufacturers are essentially focused on achieving at least a minimal positive effect – while not killing the patient – and providing the highest possible profit margin.

Genetically engineered bacteria treat symptoms of incurable disease

For the first time, scientists have used a genetically engineered “friendly” bacterium to deliver a therapy.

The treatment is for bowel disorders such as inflammatory bowel disease, which affects one in 400 people in the UK and for which there is no cure.

The bacterium Bacteroides ovatus activates a protein when exposed to a specific type of sugar, xylan. In research to be published in Gut, the therapy has been proven to work in animals with colitis, one of the major forms of inflammatory bowel disease.

The bacterium is able to deliver the protein, a human growth factor called KGF-2, directly to the damaged cells that line the gut, unlike other treatments which can cause unwanted side effects. Also unlike other treatments, it is envisaged that patients will be able to control the medication themselves by ingesting xylan, perhaps in the form of a drink.

“This is the first time that anyone has been able to control a therapeutic protein in a living system using something that can be eaten,” said Professor Simon Carding…lead author on the research. “The beneficial bugs could be activated when they are needed…”

“Initially I envisage this being an adjunct therapy to patients’ existing medicine, but eventually it could be the sole therapy,” said Professor Carding. “Once our bugs are in the colon they could be activated when needed so we aim to use our bugs to prevent disease or relapse in IBD.”

RTFA for the details.

Worth a “bravo” even if it scares the hell out of the Luddites.