Study briefs, 01-31: Restless leg syndrome, colorectal cancer, pregnancy

 

A drug that affects a brain chemical may quell restless leg syndrome

THE QUESTION One theory holds that the tingling and tightening sensations and the nearly irresistible desire to move the legs that characterize restless legs syndrome may be related to dopamine, a chemical that carries signals between nerves that affect body movement. Might a drug that activates dopamine ease the symptoms of this disorder, including the inability to sleep well?

THIS STUDY randomly assigned 380 adults with restless legs and accompanying sleep disruption to take either ropinirole (Requip) or a placebo each night. After three months, both groups reported improvement, indicated by declining scores on a 40-point scale that measures restless legs symptoms. People taking the drug averaged a 14-point drop (from 22 to 8), compared with a 10-point drop (22 to 12) for the placebo group. Overall, about 73 percent of those in the ropinirole group were considered much or very much improved, vs. 56 percent of the placebo group. Results included better sleep, improved quality of life and less anxiety.

WHO MAY BE AFFECTED BY THESE FINDINGS? People with restless legs, believed to affect 12 million Americans, women more often than men.

CAVEATS Ropinirole can cause drowsiness and dizziness; nausea and vomiting were the most common side effects reported by study participants. The study was funded by

GlaxoSmithKline, which makes Requip; three of the main authors received fees from the company, and the other two were employees.

FIND THIS STUDY January issue of Mayo Clinic Proceedings; abstract available online at www.mayoclinicproceedings.com.

LEARN MORE ABOUT restless legs syndrome at www.rls.org and www.ninds.nih.gov/disorders.

Statin drugs do not appear to help with colorectal cancer

THE QUESTION Drugs intended for one purpose often end up being used successfully for another. Might that be the case with statins — widely acclaimed for their ability to lower cholesterol and protect against heart disease and being tested for possible benefits against colorectal cancer?

THIS STUDY analyzed medical data on 132,136 adults participating in an American Cancer Society study. During a four-year period, 815 people were diagnosed with colorectal cancer. Those who were taking cholesterol-lowering drugs, mainly statins, developed the cancer at basically the same rate as those who never took them; the same was true for people who had taken the drugs for five or more years.

WHO MAY BE AFFECTED BY THESE FINDINGS? People who take statins. Among Medicare recipients 65 and older, an estimated 11 million people take these drugs regularly.

CAVEATS The findings contradict those of a large Israeli study published in the New England Journal of Medicine, which calculated a 47 percent decrease in colorectal cancer risk for long-term statin users. Authors of the current study wrote that eight smaller studies reported results similar to theirs. Some study participants took cholesterol-lowering drugs other than statins.

FIND THIS STUDY Jan. 4 issue of the Journal of the National Cancer Institute; abstract available online at http://jncicancerspectrum.oxfordjournals.org.

LEARN MORE ABOUT colorectal cancer at www.cancer.org and www.cancer.gov/cancerinfo.

Periodontal disease may make premature delivery more likely

THE QUESTION Drinking or smoking during pregnancy, stress, a poor diet or a hormone imbalance can cause a preterm birth. So can an infection, including one far removed from the reproductive organs. Might periodontal disease — to which pregnant women are especially susceptible — be such an infection, affecting the chances of delivering early?

THIS STUDY monitored the dental health of 1,020 pregnant women, examining the gums and other support structures of their teeth at an average of 15 weeks into their pregnancies and again within three days after they gave birth. About 58 percent of the women had mild periodontal disease at the first exam, and 14 percent had moderate to severe disease. About 18 percent of the women gave birth before 37 weeks of gestation, which is considered preterm. Premature delivery was more common among those with moderate or severe periodontal disease (29 percent) than among women with mild disease (19 percent) or no periodontal problem (11 percent). Women who had periodontal disease that worsened during their pregnancy were nearly 2 1/2 times more likely to have a very early delivery (less than 32 weeks) than were women in whom the disease did not change.

WHO MAY BE AFFECTED BY THESE FINDINGS? Pregnant women. Pregnancy is known to cause hormonal changes that can increase the risk of developing periodontal disease.

CAVEATS The study suggested that periodontal disease may increase the likelihood of a preterm birth, but it did not establish an absolute cause-effect relationship.

FIND THIS STUDY January issue of Obstetrics & Gynecology; abstract available online at www.greenjournal.org.

LEARN MORE ABOUT dental care during pregnancy at www.clevelandclinic.org/health (search for “pregnancy,” click “written,” then search for “dental”); learn about preterm births at www.marchofdimes.com/prematurity (search for “prematurity facts”).