/publications/issue/2010/December2010/WomensHealth-1210

Women's Health Watch

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Breast Cancer Drugs May Raise Heart Risk
Women undergoing treatment for breast cancer may face the added threat of heart disease, a new study shows. In a meta-analysis, researchers found that postmenopausal women who take aromatase inhibitors for breast cancer have a higher risk of developing cardiovascular disease.

“It appears that aromatase inhibitors have a significant increase in cardiotoxic side effects, such as heart attack, angina, and heart failure,” said study author Eitan Amir, MD, a senior fellow in the division of medical oncology and hematology at the Princess Margaret Hospital in Toronto, Canada.

Dr. Amir and colleagues examined data from 7 large randomized clinical trials comparing 2 standard breast cancer drug therapies: tamoxifen and aromatase inhibitors. Participants were postmenopausal women with early-stage breast cancer. When used for any length of time, aromatase inhibitors were associated with a 20% higher risk of cardiovascular disease.

Although the increase is relatively small, researchers said, it is substantial for patients with additional risk factors, such as obesity or a family history of heart disease. The analysis also showed that women who switched to aromatase inhibitors after tamoxifen therapy had a lower mortality risk compared with those who took aromatase inhibitors as an initial treatment.

The findings suggest that some women may benefit from initial treatment with tamoxifen before switching to aromatase inhibitors. “There may be side effects that build up the longer a woman is on a certain drug, but switching drugs may reduce the side effects,” Dr. Amir explained.

The results were presented in December at the 33rd Annual CTRC-AACR San Antonio Breast Cancer Symposium.

Text4baby to Reach 1 Million Mothers by 2012
Text4baby, a free service that uses cell phones to send new and expectant mothers basic information about infant and maternal health, announced its plan to reach 1 million mothers by 2012. The program is poised to meet that goal through a multiyear, multimillion dollar deal with its founding sponsor, Johnson & Johnson.

Launched just a year ago, text4baby has quickly emerged as a leader in mobile health. Driving the project’s success is a diverse network of public and private organizations text4baby counts as partners. Among its supporters are Pfizer, CareFirst BlueCross BlueShield, and WellPoint. MTV is a media sponsor, and the messages are delivered free of charge by participating wireless carriers.

The program’s federal partners extended text4baby’s reach by promoting it to users of government programs, such as Medicaid. Several federally funded research initiatives are working to evaluate text4baby’s benefits for underserved populations and military families, among other groups.

“We are extremely excited about the potential for text- 4baby to help moms take good care of themselves and their babies,” said Todd Park, chief technology officer for the Department of Health and Human Services. “Through text4baby, we hope to better understand how cell phones can be used to improve public health generally.”

Teens of Epileptic Mothers Perform Worse in School
Adolescents whose mothers took antiepileptic drugs (AEDs) while pregnant are more likely to lag behind peers in school, according to a large Swedish study. The effect was strongest among teens whose mothers took more than 1 AED, indicating a possible link between in utero exposure and cognitive function.

“Our results suggest exposure to several AEDs in the womb may have a negative effect on the child’s neurodevelopment,” said lead study author Lisa Forsberg, MD, of the Karolinska University Hospital in Stockholm, Sweden. Based on their findings, Dr. Forsberg and colleagues encourage pregnant women to curtail their use of AEDs to a single drug, if possible.

The researchers completed the study using data from national and local sources, including birth records, patient records, and school records. In their analysis of 1235 children, they found that those exposed to polytherapy (defined as 2 or more AEDs) were less likely to complete 9th grade, which marks the end of compulsory schooling in Sweden.

Although monotherapy did not significantly impact school performance, students born to mothers who took just 1 AED did have a reduced chance of earning a “pass with excellence” grade. “If possible, pregnant women should avoid using multiple anticonvulsants to treat their seizures,” said Dr. Forsberg. PT