Pharmacy Research Today is a free monthly online journal that collates and summarizes the latest research about Pharmacy, including details on drug stores, prescriptions, health care.

Estrogen Receptor-Negative Breast Cancer Is Less Likely to Arise among Lipophilic Statin Users.

Kumar AS, Benz CC, Shim V, Minami CA, Moore DH, Esserman LJ

Department of Surgery, Kaiser Permanente Oakland Medical Center, Oakland, California; Department of Surgery, University of California-San Francisco; Department of Medicine, Division of Hematology and Oncology, and Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California; and Buck Institute for Age Research, Novato, California.

BACKGROUND: Preclinical studies have shown the anticancer potential of HMG-CoA reductase enzyme inhibitors (statins), whereas epidemiologic studies remain controversial. Because lipophilic statins show preclinical anticancer activity against hormone receptor [estrogen receptor (ER)/progesterone receptor (PR)]-negative breast cancer models, we explored the hormone receptor phenotype of breast cancers that arise in statin users. METHODS: We did a retrospective cohort analysis via electronic pharmacy records from the Kaiser Permanente Northern California Cancer Registry on 2,141 female patients listed in 2003 as incident cases of breast malignancy. Measures included tumor grade, stage, and receptor phenotype in statin users versus nonusers and controlled for hormone replacement therapy and race. RESULTS: 387 of the 2,141 breast cancer patients used lipophilic statins [lovastatin (85%), simvastatin, and atorvastatin]. Fifty-one women developed ER/PR-negative tumors. The age-adjusted odds ratio (OR) of developing an ER/PR negative tumor was 0.63 (95% confidence interval, 0.43-0.92; P = 0.02) for statin use >/=1 year before breast cancer diagnosis compared with statin use <1 year (including nonuse). Breast cancers in patients with >/=1 year of statin use were more likely to be low grade (OR, 1.44) and less invasive stage (OR, 1.42). CONCLUSIONS: Breast cancer patients with exposure to statins have proportionately fewer ER/PR-negative tumors that are of lower grade and stage. Although our data set cannot address whether statins affect the incidence of breast cancer, we show that statin use may influence the phenotype of tumors. This suggests a new potential strategy for breast cancer prevention, that of combining statins with agents that prevent ER-positive cancer (tamoxifen, aromatase inhibitors). (Cancer Epidemiol Biomarkers Prev 2008;17(5):1028-33).

Published 8 May 2008 in Cancer Epidemiol Biomarkers Prev.
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Articles on Pharmacy published 8 May 2008:

Clinical efficacy of novel unidirectional buccoadhesive vs. vaginoadhesive bromocriptine mesylate discs for treating pathologic hyperprolactinemia.   Fertil Steril.

OBJECTIVE: To test the clinical effectiveness of new bioadhesive unidirectional buccal and vaginal bromocriptine methylate discs in hyperprolactinemic patients. DESIGN: A preliminary randomized comparative study. SETTING: A pharmaceutical phase at the departments of Pharmaceutics, Faculties of Pharmacy, Assiut and El-Minea universities and a clinical phase at the Infertility Out-patient Clinic of Women's Health University Center, Assiut University, Assiut, Egypt. PATIENT(S): A total of 42 ... [Abstract] [Full-text]

Use of a mandatory declination form in a program for influenza vaccination of healthcare workers.   Infect Control Hosp Epidemiol, 29(4): 302-8.

Objective. @nbsp; To evaluate the utility and impact of using a declination form in the context of an influenza immunization program for healthcare workers. Methods. @nbsp; A combined form for documentation of vaccination consent, medical contraindication(s) for vaccination, or vaccination declination was used during the 2006-2007 influenza season in a healthcare system employing approximately 9,200 nonphysician employees in 3 hospitals; a skilled nursing care facility; a large, multisite, ... [Abstract] [Full-text]

Articles on Pharmacy published 7 May 2008:

Assessing the economic burden of breast cancer in a US managed care population.   Breast Cancer Res Treat, 109(2): 367-77.

BACKGROUND: Breast cancer is the most commonly diagnosed non-skin cancer and second leading cause of cancer deaths among women in the US. This study compared healthcare resource utilization and costs in women with breast cancer to a control group in a managed care population. MATERIAL AND METHODS: Women >/= 18 years with breast cancer were identified using ICD-9 codes from claims databases of five US health plans during 2004. A randomly matched control group of women without cancer served as ... [Abstract] [Full-text]

Use of palliative sedation for intractable symptoms in the palliative care unit of a comprehensive cancer center.   Support Care Cancer.

BACKGROUND: There is wide variation in the frequency of reported use of palliative sedation (PS) to control intractable and refractory symptoms in terminally ill patients. The aim of this study was to determine the frequency and outcomes of PS use and examine patterns of practice after establishment of a policy for the administration of midazolam for PS in our palliative care unit (PCU). MATERIALS AND METHODS: This retrospective study reviewed PCU admissions for 2004 and 2005 and pharmacy ... [Abstract] [Full-text]

Antimalarial drug quality in the most severely malarious parts of Africa - a six country study.   PLoS ONE, 3(5): e2132.

A range of antimalarial drugs were procured from private pharmacies in urban and peri-urban areas in the major cities of six African countries, situated in the part of that continent and the world that is most highly endemic for malaria. Semi-quantitative thin-layer chromatography (TLC) and dissolution testing were used to measure active pharmaceutical ingredient content against internationally acceptable standards. 35% of all samples tested failed either or both tests, and were substandard. ... [Abstract] [Full-text]

Articles on Pharmacy published 5 May 2008:

Case-finding algorithm for post-stroke depression in the veterans health administration.   Int J Geriatr Psychiatry, 23(5): 517-22.

OBJECTIVES: Post-stroke depression (PSD) is prevalent, often undiagnosed, and undertreated. The accuracy of detecting patients with post-stroke depression in administrative databases has not been examined.The objective was to validate a case-finding algorithm for post-stroke depression (PSD) among veteran stroke survivors. METHODS: We conducted a retrospective cohort study of veterans admitted to two local VHA facilities for an inpatient episode of care for acute ischemic stroke. Our cohort ... [Abstract] [Full-text]

Dispensed volumes of anti-asthmatic drugs related to the prevalence of asthma and COPD in Sweden.   Pharmacoepidemiol Drug Saf, 17(5): 461-7.

PURPOSE: To explore the possibility of using dispensed volumes asthma/COPD drugs as a proxy for the combined prevalence of asthma plus COPD. METHODS: The proportions of the Swedish population with inhalation drugs for asthma/COPD 2004 were obtained using three different databases. A pharmacy record database gave the volumes of dispensed drugs (defined daily doses, DDDs of R03A + R03B drugs) for each patient, 20 years and older. The X-plain database of Apoteket AB gave drug sales data for Sweden ... [Abstract] [Full-text]

Lessons learned from a multidisciplinary heart failure clinic for older women: a randomised controlled trial.   Age Ageing, 37(3): 282-7.

BACKGROUND: many heart failure disease management programs are primarily conducted in the male population. An approach incorporating disciplines such as physiotherapy, occupational therapy, social work, dietary and pharmacy in a standardized clinical pathway merits further investigation in older women with HF. METHODS: in this randomized controlled trial, female patients in the intervention group received the multidisciplinary clinical pathway consisting of a series of 12 visits over a 6-week ... [Abstract] [Full-text]

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