JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENT
JAMA NEWS RELEASES
(Embargoed for Release: 3:00 p.m. CT, Tuesday, July 22, 2008)
JAMA NEWS RELEASES
USE OF SILDENAFIL ASSOCIATED WITH IMPROVEMENT IN ANTIDEPRESSANT-RELATED SEXUAL DYSFUNCTION IN WOMEN
STUDY HELPS IDENTIFY WHICH POPULATIONS OF FOREIGN-BORN PERSONS LIVING IN U.S. AT HIGHER RISK OF TB
TUBERCULOSIS PRESENTS MAJOR CHALLENGES TO HIV TREATMENT IN DEVELOPING COUNTRIES
JAMA REPORT (VIDEO SCRIPT)
VIDEO: Windows Media | Quicktime
VIAGRA APPEARS TO HELP TREAT ANTIDEPRESSANT RELATED SEXUAL SIDE EFFECTS IN WOMEN
INFORMATION CONTAINED IN THESE NEWS RELEASES IS PROTECTED BY COPYRIGHT. JOURNAL ATTRIBUTION IS REQUIRED.
TV Note: This week’s JAMA Report video is on treating women’s antidepressant-related sexual dysfunction with sildenafil. The report will be fed Tuesday, July 22, from 9:00 - 9:30 a.m. ET and 2:00 - 2:30 p.m. ET. Please note new coordinates: Galaxy 25 (C band), Transponder 15, downlink frequency: 4000 vertical, audio 6.2/6.8. For more information, call 312/464-JAMA.
SAVE THE DATE: JAMA will present new research on HIV/AIDS at a media briefing on Sunday, August 3, at the International AIDS Conference in Mexico City. Program information will be included in a future email. To register, go to www.jamamedia.org and click on the Events tab.
Please Note: The FOR THE MEDIA Web site now has a search feature to enable media to find previous JAMA/Archives news releases on specific medical topics. This search feature link is located on the home page at www.jamamedia.org.
JOURNALISTS CAN NOW ACCESS EMBARGOED JAMA/ARCHIVES STUDIES ONLINE
Go to www.jamamedia.org for more information and to apply for access.
Embargoed for Release: 3:00 p.m. CT, Tuesday, July 22, 2008
Media Advisory: To contact H. George Nurnberg, M.D., call Luke Frank at 505-272-3679.
USE OF SILDENAFIL ASSOCIATED WITH IMPROVEMENT IN ANTIDEPRESSANT-RELATED SEXUAL DYSFUNCTION IN WOMEN
CHICAGO—Women with sexual dysfunction caused by the use of antidepressants experienced a reduction in adverse sexual effects with use of sildenafil, commonly known as the erectile dysfunction medication Viagra, according to a study in the July 23/30 issue of JAMA.
Treatment-related sexual dysfunction is a frequent adverse effect occurring with medication use and is a major influence for early discontinuation of antidepressant treatment, which can lead to treatment failure. Sexual dysfunction is recognized as being associated with selective and nonselective serotonin reuptake inhibitor (SRI) antidepressants, which are the most frequently prescribed medications for outpatients age 18 to 65 years and represent 90 percent of the 180 million antidepressant prescriptions filled in the United States, according to background information in the article.
“Antidepressant treatment–associated sexual dysfunction is estimated to occur in 30 percent to 70 percent of men and women treated for major depression with first- or second-generation agents, a principal reason for a 3-fold increased risk of nonadherence that approaches 70 percent in the first months of treatment and leads to increased relapse, recurrence, disability, and resource utilization by affected patients,” the authors write. It is believed no randomized controlled trial has demonstrated an effective treatment for women experiencing sexual dysfunction associated with SRIs.
H. George Nurnberg, M.D., of the University of New Mexico School of Medicine, Albuquerque, N.M., and colleagues compared the efficacy of sildenafil against placebo for treatment of sexual dysfunction (such as orgasm delay or lack of arousal [lubrication]) associated with SRI treatment in 98 women (average age 37) with major depression in remission. The randomized controlled clinical trial was conducted between Sept. 2003 and Jan. 2007 at seven U.S. research centers. Participants were randomly assigned to take sildenafil (n = 49) or placebo (n = 49) at a flexible dose starting at 50 mg., adjustable to 100 mg., approximately one to two hours before anticipated sexual activity, for 8 weeks.
The researchers found that 73 percent of women taking placebo, compared with 28 percent of women taking sildenafil, reported no improvement with treatment. On a clinician-rated severity improvement scale, women in the sildenafil group showed greater improvement in sexual function than women in the placebo group.
Headache, flushing, and indigestion were reported frequently during treatment, but no patients withdrew because of serious adverse effects.
“These findings are important not only because women experience major depressive disorder at nearly double the rate of men and because they experience greater resulting sexual dysfunction than men but also because it establishes that selective phosphodiesterase type 5 inhibitors [such as sildenafil] are effective in both sexes for this purpose. By treating this bothersome treatment-associated adverse effect in patients who have been effectively treated for depression, but need to continue on their medication to avoid relapse or recurrence, patients can remain antidepressant-adherent, reduce the current high rates of premature medication discontinuation, and improve depression disease management outcomes,” the authors write.
(JAMA. 2008;300[4]:395-404. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
Go back to the top.
Embargoed for Release: 3:00 p.m. CT, Tuesday, July 22, 2008
Media Advisory: To contact Kevin P. Cain, M.D., call the CDC’s Media Relations Office at 404-639-8895.
STUDY HELPS IDENTIFY WHICH POPULATIONS OF FOREIGN-BORN PERSONS LIVING IN U.S. AT HIGHER RISK OF TB
CHICAGO—The relative yield of finding and treating latent tuberculosis is particularly high among higher-risk groups of foreign-born persons living in the U.S., such as individuals from most countries of sub-Saharan Africa and Southeast Asia, according to a study in the July 23/30 issue of JAMA.
“From 1993 to 2006, the number of tuberculosis (TB) cases in the United States decreased by 45 percent, from 25,107 to 13,779. This decline has occurred disproportionately among the U.S.-born population, for whom the number of cases has declined by 66 percent, while the number of TB cases among foreign-born persons in the United States increased by 5 percent,” the authors write. “In 2006, 57 percent of all reported TB cases were among foreign-born persons.” They add that current TB control strategies have not sufficiently addressed the high levels of TB disease and latent TB infection (LTBI; TB that is not active, or infectious) in this population.
Kevin P. Cain, M.D., of the Centers for Disease Control and Prevention, Atlanta, and colleagues conducted a study to examine which populations of foreign-born persons in the U.S. are at higher risk of TB and drug-resistant TB. The researchers analyzed data of foreign-born persons in the United States diagnosed with TB from 2001 through 2006.
A total of 46,970 cases of TB disease were reported among foreign-born persons in the U.S. from 2001 through 2006, of which 12,928 (28 percent) were among recent entrants (within 2 years of U.S. entry). Among the foreign-born population overall, TB case rates declined with increasing time since U.S. entry, but remained higher than among U.S.-born persons (more than four times higher in 2006), even more than 20 years after arrival. An average of 4,035 TB cases per year were reported among individuals born in high-risk countries (populations with annual case rates of 100 or greater per 100,000 persons among recent entrants).
Among recent entrants who were culture-positive for TB, isoniazid (antibacterial drug used to treat TB) resistance was found in 20 percent from Vietnam, 18 percent from Peru, 17 percent from the Philippines and 16 percent from China.
Individuals born in most countries of sub-Saharan Africa had annual case rates of greater than 250 per 100,000 persons during the first 2 years after U.S. entry, while individuals born in Central America, Eastern Europe, the Pacific Islands, and South, East, and Central Asia had annual case rates of greater than 100 per 100,000 persons in the first 2 years. On average, 250 individuals per year were diagnosed with smear-negative, culture-positive TB disease within 3 months of U.S. entry; 46 percent of these were from the Philippines or Vietnam.
“With more than 37 million foreign-born persons currently living in the United States, it is not possible to find and test all foreign-born persons for LTBI. This study assists in targeting LTBI screening efforts by examining risk of TB disease among subgroups of foreign-born populations. Finding and treating LTBI among some specific groups of foreign-born persons living in the United States is likely to provide high yield relative to some other TB control strategies. Given current immigration patterns, the impact of culture-enhanced overseas screening of immigrants and refugees is likely be greatest in the Philippines and Vietnam, but may have limited yield for most other countries of birth,” the authors write.
“Current strategies for TB control, as presently implemented, are not adequate for achieving TB elimination in the near future. TB control and elimination among foreign-born persons in the United States will require a multifaceted approach. In the future, preventing TB disease among legal immigrants to the United States might best be accomplished through overseas diagnosis and treatment of LTBI prior to immigration. The present use of a 9-month regimen for LTBI treatment makes this strategy impractical. This strategy may be both feasible and high yield when shorter, effective treatment regimens for LTBI become available. Increased investment in global TB control could also result in decreases in U.S. TB rates.”
(JAMA. 2008;300[4]:405-412. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
Go back to the top.
Embargoed for Release: 3:00 p.m. CT, Tuesday, July 22, 2008
Media Advisory: To contact Diane V. Havlir, M.D., call Jeff Sheehy at 415-597-8165.
TUBERCULOSIS PRESENTS MAJOR CHALLENGES TO HIV TREATMENT IN DEVELOPING COUNTRIES
CHICAGO—Human immunodeficiency virus (HIV) care and treatment programs in resource-limited settings must aggressively address tuberculosis (TB) and the emerging multidrug-resistant TB epidemic to save patient lives and to curb the global TB burden, a major cause of death for persons with HIV, according to an article in the July 23/30 issue of JAMA.
Tuberculosis is a threat throughout the course of HIV disease. “As HIV care expands further, there is both an opportunity and necessity for incorporation of TB control activities into these programs. Tuberculosis programs simply do not have the capacity to provide ongoing TB screening, prevention, and treatment for millions of individuals receiving HIV care,” the authors write.
Diane V. Havlir, M.D., of the University of California, San Francisco, and colleagues examined interactions between HIV and TB for HIV care programs and the framework for HIV programs to incorporate TB activities, and global progress in implementation.
The authors write that TB poses numerous challenges, including drug-resistance; difficulty in diagnosis and treatment in HIV-infected persons; and complications from drug interactions. “Finding and treating TB cases, administering antiretroviral therapy (ART) and isoniazid preventive therapy [IPT; an antibacterial drug], and infection control are critical activities to incorporate into HIV care programs, the first chronic care models to emerge in many developing countries. Because patients with HIV are at risk for TB throughout life, activities should be ongoing in pediatric and adult ART clinics, pre-ART clinics (keeping relatively healthy patients engaged in care), and maternal health programs.”
The authors propose several strategic approaches to reduce TB burden for HIV care and treatment programs. They include:
- TB Intensified Case Finding - Finding and treating TB promptly is the most effective TB control measure. Intensified case finding includes both active identification of TB among patients with HIV in care and screening their household members for active TB.
- Treating Individuals With Active TB – The authors propose expansion of a care model whereby TB is treated by HIV programs. HIV care staff are trained to diagnose and treat a wide array of infections associated with HIV disease. “Tuberculosis should be no exception.”
- Isoniazid Preventive Therapy - HIV programs may need to work with country policymakers to permit IPT administration, which in some countries is either against national policy or impossible because of the stringent requirements for the exclusion of TB before IPT initiation.
- Antiretroviral Therapy - ART is one of the most powerful weapons against TB. From the perspective of TB prevention, the earlier that ART is initiated, the less the risk for TB.
- TB Infection Control - One of the most challenging areas in TB infection control is the implementation of measures in both outpatient and inpatient health care facilities that will reduce the risk of TB transmission and protect health care workers. Tuberculosis infection control guidelines exist but are rarely implemented.
- TB Recording and Reporting - It is essential that HIV care programs adhere to TB reporting requirements. Standardized recording and reporting formats in accordance with national TB and AIDS control guidelines should be used.
- Joint HIV/TB Planning - The successful implementation of TB interventions in HIV services requires effective communication, coordination, and collaboration with TB control programs.
“HIV care programs must take a bold approach to TB prevention, diagnosis, and treatment to successfully address the catastrophic and intersecting epidemics of HIV and TB. HIV programs need to take advantage of new earmarked funds for HIV/TB activities from agencies such as PEPFAR and the Global Fund to Fight HIV, TB, and Malaria. They must push for access for rapid TB diagnostic tests, conduct operational research, and launch educational efforts in partnership with the community to reduce TB transmission. Shortages in the health care workforce and laboratory capabilities clearly represent the greatest obstacles. However, the possibility for progress has never been greater with the global commitment to health care infrastructure strengthening geared toward consolidating the momentum through disease-specific efforts such as HIV and TB,” the authors conclude.
(JAMA. 2008;300[4]:423-430. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
Go back to the top.
JAMA REPORTS
VIDEO: Windows Media | Quicktime
VIAGRA APPEARS TO HELP TREAT ANTIDEPRESSANT RELATED SEXUAL SIDE EFFECTS IN WOMEN
INTRO:
Antidepressants, known as SRIs or serotonin reuptake inhibitors, are the most frequently prescribed medications in the U.S. for adults with depression. For many women, who have almost twice the rate of depression compared to men, they can be very effective. But they are also associated with sexual side effects. Now a new study finds that sildenafil, also known as Viagra, a medication marketed to treat erectile dysfunction in men, may also help treat these sexual side effects in women. Jennifer Mitchell explains in this week’s JAMA Report.
VIDEO:
B-ROLL
Women walking on street
FILE : antidepressant pills being counted
Woman walking
AUDIO:
WOMEN DON’T OFTEN TALK ABOUT IT. BUT MANY WHO TAKE CERTAIN KINDS OF ANTIDEPRESSANTS ARE EXPERIENCING SEXUAL SIDE EFFECTS THAT THEY DIDN’T HAVE BEFORE.
VIDEO:
SOT/FULL
Super @: 11
Samuel Keith, M.D.
Psychiatrist
Runs: 09
AUDIO:
“The newer forms of antidepressants have had a problem with reaching orgasm. There’s a delay in reaching orgasm.”
VIDEO:
B-ROLL
Sildenafil pill video
Woman walking
AUDIO:
RESEARCHERS HAVE FOUND THAT SILDENAFIL (sill-den-a-fill), KNOWN TO MOST BY ITS BRAND NAME VIAGRA, APPEARS TO BE ABLE TO HELP ALLEVIATE A VARIETY OF MEDICATION-RELATED SEXUAL SIDE EFFECTS IN WOMEN.
VIDEO:
SOT/FULL
Super @: 31
George Nurnberg, M.D.
University of New Mexico School of Medicine
Runs: 09
AUDIO:
“We were assessing specifically whether there was an improvement in libido, the arousal phase of sexual function, orgasm and overall satisfaction.”
VIDEO:
B-ROLL
Doctor at desk
GRAPHIC:
Sexual Side Effect Study (title)
Women 18 to 50 years old
Depression in remission
Taking SRI antidepressant
Pill video
AUDIO:
DOCTOR GEORGE NURNBERG, A PSYCHIATRIST WITH THE UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE, LED A TEAM OF RESEARCHERS WHO FOLLOWED ABOUT ONE HUNDRED WOMEN OVER AN EIGHT WEEK PERIOD. WOMEN WERE REQUIRED TO BE BETWEEN EIGHTEEN AND FIFTY YEARS OLD, HAVE THEIR DEPRESSION IN REMISSION AND CONTINUE TAKING AN ANTIDEPRESSANT WITH A SEROTONIN REUPTAKE INHIBITOR OR SRI. HALF OF THE WOMEN WERE GIVEN SILDENAFIL TO TREAT SEXUAL SIDE EFFECTS, THE OTHER HALF, A PLACEBO.
VIDEO:
SOT/FULL
George Nurnberg, M.D.
University of New Mexico School of Medicine
Runs: 13
AUDIO:
“There was an overall improvement in sexual function on a global measurement but that the more specific finding was that orgasm delay, which was a symptom of SSRI sexual dysfunction, improved significantly.”
VIDEO:
B-ROLL
GXF/JAMA COVER
Dr. Keith walking
Women walking
AUDIO:
THE STUDY APPEARS THIS WEEK IN JAMA, JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. PSYCHIATRIST SAMUEL KEITH, WHO TREATS WOMEN WITH DEPRESSION, FEELS THE FINDING WILL HELP WOMEN REMAIN ON ANTIDEPRESSANT MEDICATION THEY NEED.
VIDEO:
SOT/FULL
Samuel Keith, M.D.
Psychiatrist
Runs: 10
AUDIO:
“We don’t need to change medications because they’re all basically similar and you can stay with the medication that worked but now you have a treatment for the side effect.”
VIDEO:
B-ROLL
Pills and bottle
Women legs only
Hand takes pill
Tight shot pills
AUDIO:
SILDENAFIL IS APPROVED BY THE FOOD AND DRUG ADMINISTRATION FOR TREATING ERECTILE DYSFUNCTION IN MEN. THE RESULTS OF THIS STUDY SUGGEST THE DRUG ALSO MAY BE HELPFUL FOR WOMEN WITH ANTIDEPRESSANT RELATED SEXUAL SIDE EFFECTS. JENNIFER MITCHELL THE JAMA REPORT.
TAG:
Women in the study were told to take sildenafil an hour or two before anticipated sexual activity. Researchers say about seventy percent of the patients who took sildenafil had improved sexual function compared to about thirty percent of the patients who took placebo. Some patients complained of having headaches while taking sildenafil but no serious adverse effects were reported. For more information about this study you can log on to www.jama.com.
