NMA: Nonprescription Medicines Academy

Quick Takes

April 17th, 2013

  • This year, for the first time, the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) has published the recommended immunization schedules for persons 0 through 18 years of age and adults 19 years of age and older simultaneously. The schedules – along with summaries of noteworthy changes – are available at http://www.cdc.gov/mmwr/preview/mmwrhtml/su6201a2.htm and http://www.cdc.gov/mmwr/preview/mmwrhtml/su6201a3.htm.
  • Lower levels of serum 25-hydroxyvitamin D (25OHD) in women with darker skin color most likely are due to decreased formation of vitamin D in skin, based on a randomized, prospective, placebo-controlled clinical trial involving 110 healthy older African American women. The women were randomly assigned to one of eight groups that received either daily vitamin D3 supplementation (400, 800, 1600, 2400, 3200, 4000, or 4800 IU daily) or a matched placebo; calcium supplements were given to maintain total calcium intake of 1200-1400 mg/day. The main outcome measures were change in serum 25OHD and serum PTH levels at 12 months. The increase in serum 25OHD among the African American women was similar to that seen in a parallel study group of Caucasian women, with no significant differences between serum 25OHD levels at any dose (no interaction between race and dose). According to the authors, the results imply that the absorption and metabolism of vitamin D are similar in African American and Caucasian women. (J Clin Endocrinol Metab. 2013;98(3):1137-46. Epub 2013 Feb 5.)
  • During the 2009 influenza A (H1N1) pandemic, vaccination itself was not associated with increased fetal mortality; rather, vaccination may have reduced the risk of influenza-related fetal death, according to data from a Norwegian cohort. There were 117,347 eligible pregnancies in Norway from 2009 through 2010; 54% of pregnant women in their second or third trimester were vaccinated. Vaccination during pregnancy substantially reduced the risk of an influenza diagnosis (adjusted hazard ratio [HR], 0.30; 95% CI, 0.25–0.34). The risk of fetal death was increased among pregnant women with a clinical diagnosis of influenza (adjusted HR, 1.91; 95% CI, 1.07–3.41). Maternal vaccination was associated with a reduced risk of fetal death (adjusted HR, 0.88; 95% CI, 0.66–1.17) that did not reach statistical significance. (N Engl J Med. 2013; 368(4):333-40. Epub 2013 Jan 16.)
  • Data from the National Health Interview Survey suggest that life expectancy is shortened by more than 10 years among current smokers, as compared with those who have never smoked. However, smoking cessation before the age of 40 years reduces the risk of death associated with continued smoking by about 90%. The analysis—titled “21st Century Hazards of Smoking and Benefits of Cessation in the United States” and available at http://www.nejm.org/doi/full/10.1056/NEJMsa1211128—is based on smoking and smoking-cessation histories from 113,752 women and 88,496 men 25 years of age or older who were interviewed between 1997 and 2004. (N Engl J Med. 2013;368(4):341-50.)
  • Free-radical–destroying antioxidative nutritional supplements may have caused more cancers than they have prevented, according to a novel hypothesis advanced by Nobel laureate James Watson in an Open Biology article. The hypothesis involves the role of oxidants and antioxidants in cancers that are currently incurable, notably late-stage metastatic cancers. Watson claims that antioxidants in late-stage cancers can promote cancer progression; he considers this theory to be “among my most important work since the double helix.” The full article is available at http://rsob.royalsocietypublishing.org/content/3/1/120144.full. (Open Biol. 2013 Jan 8;3(1):120144.)
  • Legislation in the United Kingdom to reduce pack sizes of paracetamol (acetaminophen; a maximum of 32 tablets in pharmacies and 16 tablets for non-pharmacy sales) was followed by significant reductions in deaths due to overdose, based on interrupted time series analyses to assess mean quarterly changes from October 1998 to the end of 2009. There was an estimated average reduction of 17 suicide/undermined deaths per quarter (95% CI, −25 to −9) involving paracetamol alone, with or without alcohol; this decrease represented a 43% reduction or an estimated 765 fewer deaths over the 11.25 years after the legislation. A similar effect was found when accidental poisoning deaths were included and when a conservative method of analysis was used. There was a 61% reduction in registrations for liver transplantation for paracetamol-induced hepatotoxicity (−11 registrations per quarter; 95% CI, −20 to −1) but no reduction in actual transplantations. (BMJ. 2013;346:f403.)
  • In the United States, the National Council for Prescription Drug Programs (NCPDP) has released an updated version of the white paper titled “NCPDP Recommendations for Improved Prescription Container Labels for Medicines Containing Acetaminophen.” According to the association, “Version 1.1” details the compelling progress made in response to the 2010 NCPDP call to action for industry stakeholders to address the public health issue of accidental acetaminophen overdose. The revised white paper also provides additional guidance to ensure full implementation of the NCPDP recommendations. The white paper is available for download at http://www.ncpdp.org/ind_WP.aspx.