News in brief - June 5, 2006

Mumps vaccine advice from the CDC - FDA panel OKs HPV vaccine - Teen abuse of prescription, OTC drugs on the rise - FDA OKs new smoking cessation drug - Cholesterol-lowering drugs not tied to increased breast cancer risk

Mumps vaccine advice from the CDC

An ongoing outbreak of mumps in several Midwest states led the Centers for Disease Control and Prevention to revise its recommendations for determining evidence of immunity to the disease through vaccination.

Physicians and other health care professionals are asked to consider the following definition of immunity: one dose of live mumps virus vaccine for preschool children and adults not at high risk; two doses for children in grades K to 12 and adults at high risk (including those who work in healthcare facilities, international travelers and students at post-high school educational institutions).

The combined measles, mumps and rubella vaccine generally should be used and, for children ages 1 to 12, the measles, mumps, rubella and varicella vaccine can be used, the CDC said. Health care facilities also were asked to consider recommending one dose of measles, mumps and rubella vaccine for unvaccinated health care workers born before 1957 who do not have other evidence of mumps immunity.

The revisions were made by the CDC's Advisory Committee on Immunization Practices in a specially convened May 17 meeting and announced in a May 18 update of the CDC's Morbidity and Mortality Weekly Report.

During an outbreak, and depending on the age groups and institutions involved, the CDC recommends that a second dose of vaccine be considered for adults and children ages 1 to 4 who have received one dose.

As of May 2, 11 states had reported 2,597 cases of mumps. Iowa continues to report the majority of cases with the next highest totals from Kansas, Illinois, Nebraska and Wisconsin.

FDA panel OKs HPV vaccine

A Food and Drug Administration advisory panel voted unanimously May 18 to recommend that the agency approve a vaccine to prevent four strains of the human papillomavirus that can cause cervical cancer and genital warts.

The panel found that the vaccine, Gardasil, would be safe and effective for girls and women ages 9 to 26. In clinical trials, the vaccine was found to be 100% effective in preventing infection with HPV strains 16 and 18 which cause about 70% of cervical cancer cases. The vaccine, given in three injections over six months, was also 99% effective in preventing HPV strains 6 and 11, which cause genital warts, according to the trial results.

If the vaccine receives FDA approval, it also must be examined by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices, which makes recommendations on vaccine use. States will make the final decisions as to who should receive the vaccine -- the first to prevent HPV.

Cervical cancer currently causes 3,500 deaths among women in the United States each year and about 290,000 deaths worldwide. And since the vaccine is not 100% effective against HPV, it would not eliminate the need for cervical cancer screenings, including Pap tests.

Manufacturer Merck & Co. also asked that the advisory committee consider recommending its vaccine for use in boys to prevent genital warts, but the panel declined to vote on that question.

Teen abuse of prescription, OTC drugs on the rise

Abuse of prescription and over-the-counter medications is a widespread behavior among today's teen population, according to a national study released May 16 by the Partnership for a Drug-Free America.

The partnership's 18th annual Attitude Tracking Study surveyed more than 7,300 teenagers in grades 7-12. Respondents indicated that teens are more likely to have abused OTC and prescription drugs, including prescription medications such as Vicodin and Oxycontin (oxycodone), than illegal drugs such as ecstasy, cocaine, crack or meth. Specifically, nearly one in five teens reports abusing prescription medications and one in 10 reports abusing cough medicine to get high.

The study also found that teens believe a key reason for abusing prescription pain relievers is their widespread availability and easy access. More than three in five teens said prescription pain relievers are easy to get from parents' medicine cabinets.

"There is a world of difference between good medicine and bad behavior," said Michael Maves, MD, MBA, executive vice president and chief executive officer of the American Medical Association as well as a partnership board member.

FDA OKs new smoking cessation drug

Anti-tobacco activists are cheering the Food and Drug Administration approval of varenicline tartrate, the first new smoking cessation drug in nearly a decade. This drug helps smokers give up the habit by reducing withdrawal symptoms and blocking the effect of nicotine on the brain. It will be marketed as Chantix by Pfizer and be accompanied by a support program intended to address behavioral issues associated with smoking.

"The announcement that the FDA has approved a new medication aimed at helping smokers quit is very welcome news," said Thomas J. Glynn, PhD, director of cancer science and trends at the American Cancer Society.

Studies have shown that this drug is more effective than placebo and other smoking cessation modalities currently on the market. Patients need to take it for three months and may take it for an additional three months to increase the chance that they will stay non-smokers over the long term. Side effects include nausea, headache, vomiting, flatulence, insomnia, abnormal dreams and a change in taste perception.

Cholesterol-lowering drugs not tied to increased breast cancer risk

Statins do not increase the risk of breast cancer, and some versions of these drugs might even decrease the risk of this disease, according to a study funded by the National, Heart, Lung and Blood Institute and published in the Journal of the National Cancer Institute last month. Some prior studies suggested that these drugs could increase the risk while others have not found this to be the case. This paper analyzed data from the Women's Health Initiative on breast cancer risk factors and lipid-lowering medications. The risk of invasive breast cancer was the same whether the women took these drugs or not, although those who took hydrophobic statins had an 18% reduced risk.

"At a minimum, our findings suggest that women can now be reassured that they are not increasing their risk of developing breast cancer by taking these drugs," said Jane Cauley, DrPH, lead author and professor and vice chair for research in the department of epidemiology at the University of Pittsburgh School of Public Health. "Although we found that women who took hydrophobic statins actually lowered their breast cancer risk, we believe this finding needs to be confirmed in additional studies."