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Sunday, December 4, 2011
Saturday, December 3, 2011
Friday, December 2, 2011
Generic Lipitor Finally Available!
Lipitor, the brand name for generic atorvastatin, has been a major money maker for Pfizer by lowering bad cholesterol and more importantly, decreasing risk of heart attacks & death. Most recently, Lipitor was shown to be as effective as Crestor at reducing plaque buildup. The icing on the cake is that it is finally available as a generic, meaning that the price for lowering one's cholesterol will drop.
However, due to the arcane patent laws, the price of generic atorvastatin won't drop as quickly as we'd like as deals have been cut so that one manufacturer, Ranbaxy, has the generic market all to itself for the first 6 months before other manufacturers can step in & compete with their generic versions. What's more, Pfizer apparently will get a large percentage of revenue from Watson's sales of atorvastatin. Plus, Pfizer apparently plans to sell its own version of "generic" atorvastatin. What a strange world in which we live.
Just remember that if you need a statin, you can now have your cake & eat it, too (although this might not be a great choice). In other words, you can get one of the most powerful statins with a huge database of clinical outcome data for a generic price. In this miserable economy, the timing couldn't be better. But don't forget that you can always out eat any medication so you can't use your atorvastatin as an excuse to eat poorly.
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DHEA & Postmenopausal Women
Since I've admitted to falling behind in my reading, I might as well finish this week looking over yet another study published in the June issue of JCEM. Specifically, I wanted to point out this review of the literature regarding the use of DHEA in postmenopausal women. The authors reviewed over 100 studies published through November 2010 before concluding that fixed dose supplemental DHEA had no effect in postmenopausal women with regards to sexual function, sense of well-being, menopausal symptoms, metabolic effects, and cognitive performance. This article has a nice review of the physiology of DHEA and DHEA-S. It also goes into lengths to point out the observational studies demonstrating benefit compared to the randomized controlled trials that did not.
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Thursday, December 1, 2011
Updated Guidelines for Treating Adult Growth Hormone Deficiency
Better late than never I suppose. My reading hasn't been so good lately what with my increased responsibilities at the School of Medicine (which includes covering Student Health over at UNLV this week), making home visits all across Clark County (I need to refuel my car twice as frequently nowadays), working with a local hospice, and caring for my own patients. So I only just stumbled across the Endocrine Society's latest Clinical Practice Guideline for the evaluation and treatment of adult growth hormone deficiency (GHD) published earlier this summer in JCEM.
Ironically, Major League Baseball announced last week that it is prepared to start blood testing for illicit GH use this coming spring training. While I am not privy to the details, it appears that everyone (~1,200 professional baseball players) will be tested which will provide an interesting assessment as to the average level of innate GH at this high level of competition. Besides raw talent, I've always theorized that professional and high level amateur athletic competition self-selects for those blessed with greater natural GH production, perhaps the highest 2% of normal that are typically labeled as high on any given reference range.
So go get caught upon with your journal reading and familiarize yourself with the latest guidelines on growth hormone testing & use.
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