THIS WEEK
June 1, 2000
in the New England Journal of Medicine

 


Sildenafil in Men with Coronary Artery Disease
graphSildenafil citrate (Viagra) promotes erectile function, but serious cardiovascular events have been reported after its use. This study examined the hemodynamic effects of sildenafil in men with severe coronary artery disease. Sildenafil had minimal or no effects on a variety of hemodynamic measures, including measures of coronary blood flow and flow velocity. The findings are reassuring to men who use sildenafil, but they do not rule out the possibility of uncommon adverse effects or drug interactions in men who also take nitrates.

Methotrexate to Maintain Remission in Crohn's Disease
Patients with Crohn's disease often relapse. Methotrexate induces remission in Crohn's disease, but its role in preventing relapse in those with quiescent disease is not known. In this 40-week, placebo-controlled study of patients who entered remission during treatment with methotrexate, no other treatments for Crohn's disease were permitted, and methotrexate was effective in maintaining remission.

Growth Hormone Therapy for Crohn's Disease
Treatments for Crohn's disease are not always effective and may have severe side effects. Growth hormone affects intestinal growth and repair. In this preliminary study, 37 patients with moderate-to-severe Crohn's disease gave themselves daily injections of growth hormone or placebo for four months and continued their other medications. Patients receiving growth hormone had significantly greater decreases in their scores on the Crohn's Disease Activity Index than those receiving placebo injections.

Polymerized Bovine Hemoglobin for Autoimmune Hemolytic Anemia
Transfusions in patients with autoimmune hemolytic anemia are complicated by autoantibodies that react with erythrocytes from virtually all donors. In rare cases, transfusions cannot sustain the hematocrit at a level compatible with life, because the autoantibodies rapidly destroy transfused red cells. The barrier presented by autoantibodies was circumvented in such a patient by the use of polymerized bovine hemoglobin for transfusion, and the patient eventually made a full recovery.

Coverage of Medications by the News Media

The news media are an important source of information about new medical treatments, but some coverage may be inaccurate and overly enthusiastic. This study of coverage in newspapers and on television focused on three medications used to prevent major diseases -- pravastatin,graphic alendronate, and aspirin. The investigators found that news stories were often inadequate or incomplete. Many stories did not quantify benefits. Those that did often reported relative benefits but not absolute benefits. Potential harm and the costs of medications were often not mentioned. In addition, the studies often failed to mention financial ties between researchers quoted in the stories and pharmaceutical manufacturers.