Clinical Research Briefs
Hypertension Drugs & Pancreatic Cancer
By Edyta Zielinska, Merrill Meadow | Illustrations by Jamie Cullen
Pancreatic cancer remains extremely difficult to treat, with only about 11% of patients surviving five years past diagnosis. But new research suggests that common anti-hypertension medications might significantly improve those survival rates.
The investigators — led by biostatistician Scott W. Keith, PhD, and population health professor Vittorio Maio, PharmD — used data on 3.7 million adults in Italy to perform the largest retrospective study of anti-hypertensive drugs’ impact on pancreatic cancer survival. “The associations we found in our results suggest that a randomized clinical trial is warranted,” says Dr. Keith, “especially because these are inexpensive therapeutics with relatively few side effects.”
In their study, the team constructed statistical models to predict and compare mortality risks for pancreatic cancer patients who had been prescribed either of two common types of blood-pressure medications — angiotensin receptor blockers (ARBs) or angiotensin-converting enzyme (ACE) inhibitors — versus patients who had not been prescribed those medications. These medications interact with the angiotensin system, which is normally responsible for narrowing blood vessels but has also been shown to interact with cancer-growth pathways.
The study found that patients prescribed ARBs after their pancreatic cancer diagnosis had a 20% lower mortality risk; and those prescribed ACE inhibitors had a 13% lower mortality risk within three years after diagnosis.
“We can’t reliably predict how long these medications might extend survival,” says Dr. Maio. “We urge academic, advocacy and pharmaceutical organizations to establish a collaborative, well-resourced prospective study to determine the potential benefits of ARBs and ACE inhibitors for pancreatic cancer patients.”
Anti-nausea Drugs Could Help Infants with Opioid Withdrawal Syndrome
By Marilyn Perkins | Illustrations by Jamie Cullen
As the opioid epidemic has mounted over the past two decades, so too have cases of neonatal opioid withdrawal syndrome (NOWS). NOWS is a condition in which infants born to people who have used opioids during pregnancy experience withdrawal symptoms after birth. Treatment for NOWS includes therapies like morphine to alleviate the potentially life-threatening withdrawal.
A study co-authored by clinical pharmacologist Walter Kraft, MD, and neonatalogist Susan Adeniyi-Jones, MD, suggests that a common antinausea medication called ondansetron may help ease the symptoms of NOWS. Previous research revealed that administration of ondansetron relieved opioid withdrawal symptoms in both mice and adult humans.
To determine if the drug would also help infants with NOWS, the researchers administered ondansetron or a placebo to mothers with opioid use disorder during labor and to their infants for five days after birth. The research team measured the efficacy of ondansetron by the severity of the infants’ withdrawal symptoms and number of infants in each treatment group who required morphine.
The researchers found that infants treated with ondansetron experienced significantly less severe NOWS symptoms, supporting the drug as a potential treatment. In addition, fewer of the ondansetron-treated infants required morphine compared to the placebo group; however, this difference was not statistically significant. Ondansetron does not easily enter the brain, so the researchers are planning to test higher doses or different routes of administration.
“If we could get the levels high enough,” says Dr. Kraft, “I think we could determine an endpoint that would demonstrate fewer babies requiring opioid treatment, which would be a major development in NOWS treatment.”