BMJ -- Press Releases

Releases Saturday 21 September 2002
No 7365 Volume 325

Please remember to credit the BMJ as source when publicising an
article and to tell your readers that they can read its full text on the
journal's web site (http://bmj.com).

If your story is posted on a website please include a link back to
the source BMJ article (URL's are given under titles).

(1) MARRIED COUPLES' AT RISK OF SAME DISEASE

(2) URGENT NEED FOR MORE RESEARCH INTO
PREVALENCE OF CJD

(3) PEOPLE ARE UNLIKELY TO WITHDRAW CONSENT
FOR GENETIC RESEARCH

(4) NEW ARTHRITIS DRUGS LESS LIKELY TO CAUSE
SIDE EFFECTS

(1) MARRIED COUPLES' AT RISK OF SAME DISEASE

( Married couples' risk of same disease: cross sectional study )
http://bmj.com/cgi/content/full/325/7365/636

Married couples are significantly more likely to suffer the same
kind of disease, finds a study in this week's BMJ.

Researchers from the University of Nottingham set out to
determine whether people whose marital partners suffered
with a certain condition such as depression, high blood
pressure or asthma were at increased risk of suffering from the
same disease.

Over 8,000 married couples aged between 30 and 74 years
of age took part in the study. After adjustments were made for
age, obesity and smoking status in both partners it was found
that the partners of people with asthma, depression and peptic
ulcer disease were 70% more likely to suffer from the disease
themselves. People with partners suffering from other
conditions such as high blood pressure and hyperlipidaemia
(excess cholesterol in the blood) were also more likely to
suffer from the same conditions as their spouse.

The link is most likely to be caused by the environment within
which the couple live, with shared environmental factors
putting cohabiting partners at risk of developing the same
diseases. The finding for asthma may be due to shared diet or
shared exposure to allergens, whilst findings for hypertension
and hyperlipidaemia suggest that diet and the pattern of
physical exercise shared by couples has an important role in
the disease's cause. Another possible explanation for the
findings is that couples may share similar attitudes towards
healthcare and seeking health advice.

The researchers claim their findings could have implications for
screening and other interventions. Interventions targeted at
couples may prove more effective and screening spouses for
some diseases should be considered, they conclude.

Contact:

Julia Hippisley Cox, Senior lecturer in general practice,
Divison of General Practice, School of Community Health
Sciences, University of Nottingham, Nottingham, UK
Tel: +44 (0) 115 846 6923 or + 44 (0) 115 846 6915
Email: julia.hippisley-Cox{at}nottingham.ac.uk

(2) URGENT NEED FOR MORE RESEARCH INTO
PREVALENCE OF CJD

( Accumulation of prion protein in tonsil and appendix, BMJ )
http://bmj.com/cgi/content/full/325/7365/633

The first estimate of the number of people who are at
increased risk of vCJD, but who have not developed
symptoms, is published in this week's BMJ.

Researchers studied specimens from appendicectomies and
tonsillectomies carried out between 1995 and 1999. They also
examined samples removed at autopsy or during surgery from
patients with variant Creutzfeldt-Jakob disease. The samples
were tested for lymphoreticular accumulation of prion protein,
which is known to be a reliable marker of the disease in
animals.

Prion protein was detected in one of the 8318 samples
removed between 1995 and 1999. In the appendixes
removed before the onset of symptoms in the patients with
vCJD two out of three tested positive and in the specimens
removed at autopsy, the figure was 19 out of 20. The results
give an estimated detectable prevalence of prion protein
accumulation of 120 per million.

The margin of error for this figure is high and the authors stress
the need for large scale screening of tonsil tissue to obtain
precise data. Because half of tonsillectomies are in children
under 10, who have had little exposure to BSE, this
opportunity will diminish over time, they conclude.

Contact:

Peter Hildrew, Press Officer, Derriford Hospital,
Plymouth, UK
Tel: 01752 763300
E-mail: peter.hildrew{at}phnt.swest.nhs.uk

(3) PEOPLE ARE UNLIKELY TO WITHDRAW CONSENT
FOR GENETIC RESEARCH

( Informed consent for genetic research on blood stored for
more than a decade: a population based study )
http://bmj.com/cgi/content/full/325/7365/634

People are unlikely to withdraw consent for genetic research
even when samples were taken many years ago, research in
this week's BMJ suggests.

In 1990 1583 randomly selected people in Sweden donated
blood to a World Health Organisation project researching
cardiovascular disorders and diabetes. Eleven years later,
doctors sought their consent for genetic research, which was
not possible when the samples were taken.

The remaining participants were asked whether their blood
could be used for academic or commercial genetic research,
provided that an ethics committee gave approval and samples
were anonymised.

93% of the eligible participants gave their consent for both
academic and commercial research. 2.2% refused and 4.8%
did not reply or gave incomplete answers. Of those who gave
consent 22.3% wanted to be informed about, and give
consent for, each new genetic project. The rest gave general
consent to genetic research as long as it was approved by an
ethics committee. 2.5% of the participants did not give consent
for their blood to be used for commercial research.

The authors conclude that people's readiness to contribute to
genetic research is generally high. The results also demonstrate
that it is feasible to obtain individual consent many years after
blood was donated, and that consent is given nearly as often
for commercial research as academic research.

Contact:

Professor Kjell Asplund, Department of Public Health and
Clinical Medicine, Umea University Hospital, Sweden
Tel : +46 90 7852634

(4) NEW ARTHRITIS DRUGS LESS LIKELY TO CAUSE
SIDE EFFECTS

( Efficacy, tolerability, and upper gastrointestinal safety of
celecoxib for treatment of osteoarthritis and rheumatoid
arthritis: systematic review of randomised and controlled trials )
http://bmj.com/cgi/content/full/325/7365/619

( Observational study of upper gastrointestinal haemorrhage in
elderly patients given selective cyclo-oxygenase-2 inhibitors or
conventional non-steroidal anti-inflammatory drugs )
http://bmj.com/cgi/content/full/325/7365/624

( Editorial: Efficacy and safety of COX2 inhibitors )
http://bmj.com/cgi/content/full/325/7365/607

A new group of arthritis drugs recommended by NICE for
patients at risk of gastrointestinal complications may be safer
than traditional drugs, research in this week's BMJ suggests.

Claims that the drugs, known as selective COX2 inhibitors,
caused fewer gastrointestinal problems than traditional arthritis
drugs led to an increase in their use, but the research on which
they were based was criticised.

Two studies in this week's BMJ, however, show that the risk
of gastrointestinal complications associated with selective
COX 2 inhibitors is lower than that associated with
conventional non-steroidal anti-inflammatory drugs (NSAIDs).

In the first study researchers in Oxford reviewed all trials of
the safety and effectiveness of celecoxib, a COX 2 inhibitor
used in the treatment of rheumatoid arthritis and osteoarthritis.
It was found to be as effective as other NSAIDs and less
likely to cause problems such as ulcers.

In the second, researchers in Toronto compared the rates of
upper gastrointestinal haemorrhage in elderly users of COX2
inhibitors with those of users of other NSAIDs and a group
not using NSAIDs at all. They found that the risk of
haemorrhage with the COX2 inhibitors was significantly lower
than with conventional NSAIDs. In users of celecoxib, the risk
was as similar to that of the group not using NSAIDs at all. In
an accompanying editorial, Dr Roger Jones welcomes the
findings but points out that many questions remain
unanswered. Neither study comments on death rates and it
may not be appropriate to view COX 2 inhibitors as a
homogeneous group. More research is needed before doctors
can make rational decisions about the drugs, he concludes.

Contact:

Toronto study Julie Argles, Media Relations Officer,
Institute for Clinical Evaluative Sciences, Toronto
Tel: +1 416 480 4055 ex. 3602
E-mail: julie.argles{at}ices.on.ca

Oxford study
Phillipa Manning, Communications Manager, Pfizer Ltd,
UK Tel: + 44 (0) 1304 616161 (ext. 32164)
E-mail: Phillipa.manning{at}pfizer.com,

Editorial
Professor Roger Jones,
Tel: +44 (0) 20 7735 8881, (ext 443)
Email: roger.jones{at}kcl.ac.uk