SEPTEMBER-OCTOBER 2012 NEWS

September – Ragle and Sawitzke reviewed “Nutraceuticals in the Management of Osteoarthritis” (Drugs Aging 29, 717-731 (2012) Abstract). Topics covered were glucosamine and chondroitin (alone or in combination), collagen hydrolysate, and avocado-soybean unsaponifiables. The authors concluded that “An overall recommendation to use nutraceuticals in the treatment of all patients with OA is not strongly supported by the available data.” However, some studies were supportive of the supplements for at least some patients, and they appear to be safe, so “use of nutraceuticals in select patients is appropriate.”

September 4 - A review concluded that "The published literature lacks strong evidence that organic foods are significantly more nutritious than conventional foods. Consumption of organic foods may reduce exposure to pesticide residues and antibiotic-resistant bacteria" (Smith-Spangler et al., Ann. Intern. Med. 157, 348-366 (2012) Abstract).

September 10 - A Cochrane Collaboration Review examined cranberries for preventing urinary tract infections. While earlier studies had indicated some benefits, the inclusion of 14 newer studies resulted in less support, such that “cranberry juice cannot currently be recommended for the prevention of UTIs.”

September 12 - A meta-analysis of 20 studies involving nearly 70,000 patients found that omega-3 fatty acids did not appear to reduce the risk of major heart disease events (Rizos et al., JAMA 308, 1024-1033 (2012) Paper) News story.

September 18 - A trial found that Ginkgo biloba “did not improve cognitive performance in persons with MS” (multiple sclerosis) (Lovera et al., Neurology 79, 1278-1284 (2012) Abstract).

October - An article by Smith was entitled “Against Homeopathy - A Utilitarian Perspective” (Bioethics 26, 398-409 (2012) Abstract). While Smith notes that there are “several potentially beneficial features of homeopathy, including non-invasiveness, cost-effectiveness, holism, placebo benefits and agent autonomy,” these are far outweighed by negative features: “failure to seek effective healthcare, wastage of resources, promulgation of false beliefs and a weakening of commitment to scientific medicine.” He concludes that “homeopathy is ethically unacceptable and ought to be actively rejected by healthcare professionals.” A later issue of the journal included four responses from advocates of homeopathy (pp. 501-507), along with a rebuttal from Smith (pp. 508-512).

October - A large trial of nearly 3000 subjects followed for five years examined whether Ginkgo biloba extract could prevent Alzheimer’s (Vellas et al., Lancet Neurol. 11, 851-859 (2012) Abstract) News story. No benefits were found.

October - A review by Ambrósio and others concluded that “Acupuncture appears to be a cost-effective intervention for some chronic pain conditions” (Complement. Ther, Med. 20, 364-374 (2012) Abstract).

October - Levin reviewed “Herbal Treatment of Headache” (Headache 52(S2), 76-80 (2012) Abstract). It was concluded that “evidence is sparse for most herbal treatments...Butterbur and feverfew are the 2 herbal oral preparations best studied, and they seem to have real potential to help many patients with migraine and perhaps other headache types.”

October 2 - The Department of Health and Human Services’ Office of Inspector General has issued a Report concerning the marketing of dietary supplements. According to a News story by G. Burke, the report “found that 20 percent of the 127 weight loss and immune-boosting supplements investigators purchased online and in retail stores across the country carried labels that made illegal claims to cure or treat disease. In addition, many of those and other supplements lacked the scientific studies recommended to support their suggested uses.”

October 3 - A trial found that supplementation with vitamin D “did not reduce the incidence or severity of URTIs [upper respiratory tract infections] in healthy adults” (Murdoch et al. (2012) JAMA 308, 1333-1339 Paper). An editorial by J. Linder (pp. 1375-1376 Preview) discusses the findings.

October 4 - Mangine and others studied the dietary supplements N-oleyl-phosphatidylethanolamine (NOPE) and epigallocatechin-3-gallate (EGCG), which are thought to help individuals comply with a low calorie diet (Lipids Health Disease 11, 127 Paper). The authors concluded that “Supplementing with a combination of 120 mg of NOPE and 105 mg of EGCG does appear to enhance compliance to a low caloric diet and improve mood for 4-weeks, but loses its effectiveness by week 8.”

October 14 - Edzard Ernst, a leading critic of alternative medicine, announced that he was beginning a blog on the subject, edzardernst.com.

October 17 - As part of a study of the effects of vitamins on women at high risk for heart disease, the ability of vitamins to protect against colorectal cancer was examined (Song et al. (2012) J. Natl. Cancer Inst. 104, 1562-1575 (2012) Abstract). A combination of folic acid, vitamin B₆, and vitamin B₁₂ had no protective effect. An Editorial by R. Ziegler discusses the findings.

October 18 - The Food and Drug Administration has issued a Letter pdf file to Stanislaw Burzynski noting that his websites are promoting antineoplastons for cancer treatment. Since antineoplastons are classified as an investigational new drug, they may not be legally promoted in this manner.

October 22 - A major review of acupuncture for chronic pain was reported by Vickers and others (Arch. Intern. Med. 172, 1444-1453 (2012) Abstract). As described by a News story by A. Jha in The Guardian, “Acupuncture could be a useful treatment in some cases of chronic pain, according to a study that pooled the results of 29 clinical trials on almost 18,000 people. But the overall benefits were small, compared with no acupuncture or sham acupuncture.” E. Ernst was quoted in the story as saying the results indicate that acupuncture effects are mostly placebo effects, and “The differences between the results obtained with real and sham acupuncture are small and not clinically relevant. Crucially, they are probably due to residual bias in these studies. Several investigations have shown that the verbal or non-verbal communication between the patient and the therapist is more important than the actual needling.” The April 22, 2013 issue of the journal (now renamed JAMA Internal Medicine) contained several critical letters, plus a response from Vickers (173, 711-714). Further critiques of the review were provided in the "Respectful Insolence" blog and by S. Novella in the Science-Based Medicine blog. Novella’s essay concludes, “...meta-analysis itself is an imperfect tool that often does not predict the results of large, rigorous, definitive clinical trials. The best acupuncture trials, those that are well-blinded and include placebo acupuncture, show no specific effects.” Vickers et al. provided responses to these and other critics (Acupunct. Med. 31, 98-100 (2013) Abstract).

October 24 - Stamuli and others studied the cost-effectiveness of acupuncture for irritable bowel syndrome (IBS) (BMC Gastroenterology 12, 149 (2012) Paper). They concluded that “Acupuncture as an adjunct to usual care is not a cost-effective option for the whole IBS population; however, it may be cost-effective for those with more severe irritable bowel syndrome.”

October 26 - P. Tullis has written a Story in the New York Times concerning a surgical procedure, promoted by Dr. Paolo Zamboni, for the treatment of multiple sclerosis. The procedure (also known as “liberation” treatment) is based on the idea that MS is caused by chronic cerebrospinal venous insufficiency (CCSVI). As noted in our May item, the FDA has issued a warning that the procedure is dangerous and there is not good evidence that it is effective. Most medical experts doubt that there is a connection between CCSVI and MS.

October 30 - Hutchinson and others reviewed the use of acupuncture for chronic non-specific low back pain (J. Orthoped. Sur. Res. 7, 36 (2012) Paper). In general, it appeared that acupuncture was more effective than no treatment, but there was no difference between “true” acupuncture and minimal or sham acupuncture.