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    <recommendedItem id="20100101_19_397"
                     title="AAPM: Nerve Growth Factor Antibody  May Reduce Pain (CME/CE)"
                     score="0.008"
                     href="http://www.medpagetoday.com/MeetingCoverage/AAPM/tb/18300?impressionId=1265796513398"
                     
      &lt;p&gt;SAN ANTONIO  --  A humanized monoclonal antibody against nerve growth factor provided relief in three chronic pain syndromes, according to a summary of small studies reported as an abstract here.&lt;/p&gt;
&lt;p&gt;Treatment with tanezumab led to statistically or clinically significant reductions in pain for patients with osteoarthritis, chronic lower back pain, and interstitial cystitis. The most common adverse events were transient abnormal peripheral sensations, which generally occurred only after the first infusion.&lt;/p&gt;
&lt;p&gt;&quot;Patients with these three different pain syndromes all had significant improvement when treated with tanezumab,&quot; Leslie Tive, PhD, of Pfizer, said in an interview at the American Academy of Pain Medicine meeting. &quot;The pain relief was sustained over time, and patient acceptance was good.&quot;&lt;/p&gt;
&lt;p&gt;&quot;Nerve growth factor is increased in many types of chronic pain and therefore represents an attractive target for therapy,&quot; she added. &quot;Tanezumab is being evaluated in some of these other conditions in ongoing studies.&quot;&lt;/p&gt;
&lt;p&gt;A small phase I study showed that the humanized monoclonal antibody resulted in significant pain improvement in patients with osteoarthritis (&lt;em&gt;Arthritis Rheum&lt;/em&gt; 2005; 52: S461). Tive presented data from a phase II trial involving 400 patients with osteoarthritis of the knee. They were randomized to placebo or to one of five tanezumab doses, administered on day one and day 56.&lt;/p&gt;
&lt;p&gt;All five doses of tanezumab resulted in significant reductions (&lt;em&gt;P&lt;/em&gt;&amp;lt;0.05) versus placebo after one week and were sustained through 16 weeks. As assessed by a visual analog scale, the mean change in pain on walking from baseline to week 16 ranged from 30 to 45 points (&lt;em&gt;P&lt;/em&gt;&amp;lt;0.0001), a two- to threefold difference compared with placebo.&lt;/p&gt;
&lt;p&gt;The trial in chronic low back pain involved 217 adults with Quebec Task Force on Spinal Disorders category 1 or 2 pain for at least three months. The primary location of the pain was between the 12th thoracic vertebra and the lower gluteal folds.&lt;/p&gt;
&lt;p&gt;Eligibility criteria included a score of at least 4 on an 11-point pain scale on at least four occasions in the five days before randomization, as indicated by entries in an electronic pain diary.&lt;/p&gt;
&lt;p&gt;Patients were randomized 2:2:1 to a single infusion of tanezumab, to oral naproxen, or to placebo. The primary endpoint was the change in mean Lower Back Pain Index score from baseline to six weeks, averaged over the last seven days.&lt;/p&gt;
&lt;p&gt;Beginning at week one and continuing through week six, patients who were randomized to either dose of tanezumab had significantly greater improvement in pain than those who took the placebo (&lt;em&gt;P&lt;/em&gt;&amp;lt;0.05 to &lt;em&gt;P&lt;/em&gt;&amp;lt;0.001), and compared with the naproxen group beginning at week two (&lt;em&gt;P&lt;/em&gt;&amp;lt;0.05 to &lt;em&gt;P&lt;/em&gt;&amp;lt;0.01).&lt;/p&gt;
&lt;p&gt;The interstitial cystitis study included 64 men and women who had a score &amp;#8805;13 on Pelvic Pain Symptom/Frequency questionnaire, &amp;#8805;7 score on the O&apos;Leary-Sant Interstitial Cystitis index, and micturition frequency &amp;#8805;8 times a day, as recorded in an electronic diary for at least five consecutive days prior to randomization.&lt;/p&gt;
&lt;p&gt;Patients were randomized to intravenous tanezumab or matching placebo. The primary efficacy endpoint was change from baseline to six weeks in the 11-point pain scale. A difference of at least one point from placebo was considered clinically significant. Statistical significance was not evaluated.&lt;/p&gt;
&lt;p&gt;The mean difference between tanezumab and placebo was -0.7 at week two, increasing to -1.1 at week four and -1.4 at week six. The advantage versus placebo was maintained at week 10 (-0.9) and week 16 (-0.5).&lt;/p&gt;
&lt;p&gt;Adverse events were evaluated for all patients combined in the three studies. Adverse events were reported by 66.3% of tanezumab patients, 61.4% of naproxen patients, and 59.3% of placebo patients. Serious and severe adverse events occurred in 1.6% to 3.4% of patients and 4.8% to 5.7%, respectively.&lt;/p&gt;
&lt;p&gt;Tive said 14.4% of tanezumab patients reported abnormal peripheral sensations, the most common being paresthesia (7.1%), hyperesthesia (4.1%), and hypoesthesia (3.9%).&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;The studies included in the summary were funded by Pfizer.&lt;/p&gt;&lt;p&gt;Investigators included several Pfizer employees.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20100101_19_338"
                     title="Surgical Database Collects Haiti Cases"
                     score="0.004"
                     href="http://www.medpagetoday.com/EmergencyMedicine/EmergencyMedicine/tb/18216?impressionId=1265796513398"
                     
      &lt;p&gt;An electronic data collection system, now available to track cases in Haiti, should provide valuable information for future disasters, according to the American College of Surgeons.&lt;/p&gt;
&lt;p&gt;&quot;We need to have a good understanding of how to react and respond to these sorts of things,&quot; said Kathleen Casey, MD, director of the college&apos;s humanitarian program, Operation Giving Back.&lt;/p&gt;
&lt;p&gt;But the reaction and response is often complicated by the &quot;predictable loss&quot; of coordination in the first few days, Casey told &lt;em&gt;MedPage Today&lt;/em&gt;.&lt;/p&gt;
&lt;p&gt;&quot;In the midst of chaos,&quot; she said, it&apos;s often difficult to get an overview of what is happening on the ground, let alone figure out whether aspects of the response are working well or poorly.&lt;/p&gt;
&lt;p&gt;The college decided one way to help was to repurpose an electronic tool already used by many of its members to track their cases.&lt;/p&gt;
&lt;p&gt;The system allows surgeons to enter all the details of a case using a computer or Palm and PocketPC phones. Blackberry and iPhone versions will be released soon, the college said.&lt;/p&gt;
&lt;p&gt;Surgeons usually use the system to record the basic clinical details of cases and help them keep on top of reporting requirements. But it also gives them access to statistical information on a large pool of patients (whose identities are concealed), which they can use for self-evaluation.&lt;/p&gt;
&lt;p&gt;While fellows of the college have been able to use the case-log system for some time, now it&apos;s open to anyone doing surgery in Haiti at a special Web address, Casey said.&lt;/p&gt;
&lt;p&gt;&quot;We thought, &apos;what do we have around that might be able to help people manage the stream of information that&apos;s coming in,&apos;&quot; Casey said. She and her colleagues decided the &quot;simple and streamlined tool&quot; already available was the best option.&lt;/p&gt;
&lt;p&gt;&quot;We just had to unlock the door&quot; to surgeons who weren&apos;t members of the college, she said.&lt;/p&gt;
&lt;p&gt;Data collected will be useful for tracking patients and outcomes as well as types of procedures, but will also help to identify areas where the response fell short or can be improved in future disasters, Casey said.&lt;/p&gt;
&lt;p&gt;The system is only a &quot;first iteration,&quot; she said. &quot;It will clearly have to be refined, because it wasn&apos;t designed for humanitarian purposes.&quot;&lt;/p&gt;
&lt;p&gt;Nonmembers of the college can register to use the tool at &lt;a href=&quot;https://acspbls.resiliencesoftware.com/Haiti-registration&quot; mce_href=&quot;https://acspbls.resiliencesoftware.com/Haiti-registration&quot; target=&quot;_blank&quot;&gt;https://acspbls.resiliencesoftware.com/Haiti-registration&lt;/a&gt;. Members can continue to use the tool as usual, but simply use &quot;Haiti&quot; as a locator, the college said.&lt;/p&gt;

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