(Press-News.org) Mexiletine, a decades-old drug previously used to treat abnormal heart rhythms, has been used to alleviate the symptoms of patients with nondystrophic myotonias (NDMs), rare diseases that affect the skeletal muscle and cause functionally limiting stiffness and pain.
The preliminary research, published today in The Journal of the American Medical Association, shows that taking mexiletine can improve patient-reported stiffness.
NDMs are estimated to affect about 1 in every 100,000 people. They are not life-threatening, but can be debilitating, as patients' muscles contract and won't relax, causing functionally limiting pain, stiffness and fatigue which can often be severe enough to stop the patient from being able to work.
The study was carried out in 59 patients at seven neuromuscular referral centres in four countries, the largest number of which were recruited through the NIHR Biomedical Research Centre at University College London Hospitals NHS Foundation Trust and University College London.
Professor Michael Hanna at the MRC Centre for Neuromuscular Diseases led a UCL team including MRC training fellow Dr Dipa Raja Rayan.
Professor Hanna, a senior author on the paper, says: "These disorders can be extremely severe and the effects can stop people from working. Patients who took the repurposed drug, mexiletine, reported that their stiffness improved, they had less pain and they also performed better on handgrip tests. The findings are exciting because this treatment can make the difference between patients being able to work and not, but further research is required.
"It is harder to do clinical trials in rare diseases such as nondystrophic myotonias because individual researchers aren't able to see the volume of patients required. However, if you are a patient with a rarer disease – something which is harder to study – you should still have access to research and treatment. That's why we set up this international collaboration to pool our resources and share information. Finding treatments for rarer diseases is an important goal for the NIHR University College London Hospitals Biomedical Research Centre."
Data on treatment of NDMs are largely anecdotal, consisting of case series and single-blind, controlled trials of several medications including mexiletine, according to background information in the article.
This new international study was conducted to determine the effects of mexiletine for symptoms and signs of myotonia (prolonged failure of muscle relaxation after contraction) in patients with NDMs. The randomized study, part of the National Institutes of Health-funded Rare Disease Clinical Research Network, was carried out between December 2008 and March 2011 and included 59 patients with NDMs.
The patients (33 men, 26 women; average age, 43 years) received either oral 200-mg mexiletine or placebo capsules three times daily for four weeks, followed by the opposite intervention for four weeks, with 1-week washout in between.
The main outcome measured for the study was a patient-reported severity score of stiffness, recorded on an interactive voice response (IVR) diary. Secondary outcomes included IVR-reported changes in pain, weakness, and tiredness; clinical myotonia assessment; quantitative measure of handgrip myotonia; and an Individualized Neuromuscular Quality of Life summary score.
Data from 57 participants who made telephone calls to the IVR diary were included in the analysis and the researchers found that mexiletine was associated with significantly improved levels of stiffness as reported.
There were significant improvements with mexiletine in most other outcomes in the study, including patient-reported outcomes, quality of life scales, and quantitative measures of myotonia (improved myotonia as measured on clinical examination by overall handgrip times in seconds).
"The most common adverse effect was gastrointestinal (9 mexiletine and 1 placebo). Two participants experienced transient cardiac effects that did not require stopping the study (1 in each group). One serious adverse event was determined to be not study related," the authors write in the paper.
"Our study provides preliminary evidence of the effectiveness of mexiletine for symptoms and signs of myotonia in NDMs," the researchers continue. "The clinical significance of the improvement in stiffness score on the IVR diary is supported by the broad improvement in clinical, quantitative, and electrophysiological measures of myotonia."
### END
Cardiac medication may reduce stiffness caused by certain muscle diseases
2012-10-03
ELSE PRESS RELEASES FROM THIS DATE:
Who was TV's first anchorman? IU professor's research finds it wasn't Walter Cronkite
2012-10-03
BLOOMINGTON, Ind. -- No kidding: The history of the first anchorman may have more to do with Will Ferrell than people might think, according to new research by a journalism historian at Indiana University.
While Ferrell is best known for playing Ron Burgundy in the 2004 comedy "Anchorman," he also famously parodied "Jeopardy" game show host Alex Trebek. Research by Mike Conway, an associate professor of journalism at IU, has found that the first "anchor man" was John Cameron Swayze, then a regular on the 1948 quiz show, "Who Said That?"
Some today may remember Swayze, ...
Discrimination from one's manager really bites
2012-10-03
Mental health workers are more likely to be depressed or anxious when they experience discrimination from their managers than when it comes from patients, a study has found.
Discrimination from the patients' visitors also causes more distress than discrimination from the patients.
A research team led by Professor Stephen Wood at the University of Leicester's School of Management looked at the effects of prejudice, including sex, racial and age discrimination, from different groups of people on mental health workers.
The study, funded by the Department of Health ...
Warning, automatic braking systems on autos will help save lives, research predicts
2012-10-03
The second highest cause of automobile crashes is rear-end collisions – 17 percent. Thousands of people die. The solution? "It is simple," said Clay Gabler, a professor of biomedical engineering at Virginia Tech. "Slow the striking vehicle."
The concept is simple. Execution is complex and expensive. But in a life-and-death scenario, it is worth the investment, agree Gabler and Kristofer Kusano of Herndon, Va., a doctoral student in mechanical engineering. In affiliation with the Virginia Tech-Wake Forest Center for Injury Biomechanics and the Virginia Tech Transportation ...
Memory and thought-process training show promise in managing breast cancer symptoms
2012-10-03
INDIANAPOLIS -- A new Indiana University study is the first of its kind to show it may be possible to improve memory and thought process speed among breast cancer survivors.
Diane M. Von Ah, Ph.D., R.N., assistant professor at the IU School of Nursing and a researcher at the Indiana University Melvin and Bren Simon Cancer Center, and colleagues studied two different treatment options for breast cancer survivors because they often report problems with memory or feelings of mental slowness, which can lead to depression, anxiety, fatigue and an overall poorer quality of life. ...
The brief but violent life of monogenetic volcanoes
2012-10-03
BUFFALO, N.Y. -- A new study in the journal Geology is shedding light on the brief but violent lives of maar-diatreme volcanoes, which erupt when magma and water meet in an explosive marriage below the surface of the earth.
Maar-diatremes belong to a family of volcanoes known as monogenetic volcanoes. These erupt just once before dying, though some eruptions last for years. Though not particularly famous, monogenetic volcanoes are actually the most common form of land-based volcano on the planet.
Despite their number, monogenetic volcanoes are poorly understood, said ...
The association of alcohol and tobacco with age at diagnosis among subjects with pancreatic cancer
2012-10-03
Background: Pancreatic adenocarcinoma (PancCa) is a deadly disease, with essentially 100% mortality. Screening for the early detection of such cancer has not been shown to be feasible, and is currently not advised for asymptomatic people. Except for a genetic link for a small percentage of patients who have familial disease, the causes of PancCa are not known. Among environmental factors that have been implicated in some studies are smoking, heavy alcohol use, high-fat diet, excessive intake of carbonated soft drinks, obesity, chronic pancreatitis, and diabetes.
Previous ...
Study finds faults in proposed mental disorder diagnosis
2012-10-03
Providence, RI - A much anticipated addition to the revised Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) is questionable according to research findings. The newly revised DSM-5, the first alterations since it was last revised in 1994, includes attenuated psychosis syndrome (APS), a new diagnosis that would identify those impaired by preliminary psychotic symptoms that do not meet the threshold for an existing diagnosis as having a psychotic disorder. In an effort to understand the impact this new diagnosis would have in a real clinical setting, ...
Rutgers study finds economic abuse affects maternal mental health, parenting
2012-10-03
NEW BRUNSWICK, N.J. – Mothers who experience economic and psychological abuse during the first year of a relationship with their child's father are more likely to become depressed and spank the child in year five, researchers from the Rutgers School of Social Work have found.
The Rutgers team, which studied the impact of intimate partner violence – known as IPV – and the effects of such violence over time on women, also determined psychological abuse experiences during the first year of the relationship had a significant effect on the level of mothers' engagement with ...
Understanding accents
2012-10-03
Montreal, October 3, 2012 – With immigration on the rise, the use of English as a second language is sweeping the world. People who have grown up speaking French, Italian, Mandarin or any other language are now expected to be able to communicate effectively using this new lingua franca. How understandable are they in this second language?
Instead of assuming that someone who sounds different is not communicating effectively, we need to listen beyond the accent, says Concordia University applied linguist Pavel Trofimovich and his University of Bristol colleague, Talia ...
Survey: Clinicians believe EHRs will have positive impact on health care
2012-10-03
October 3, 2012 -- Survey results released today reveal that an overwhelming majority of clinicians believe that the electronic exchange of health information will have a positive impact on improving the quality of patient care, coordinating care, meeting the demands of new care models, and participating in third-party reporting and incentive programs.
The American College of Physicians (ACP), the Bipartisan Policy Center, and Doctors Helping Doctors Transform Health Care developed the survey and analyzed 527 responses in the report Clinician Perspectives on Electronic ...