Category Archives: Medicine

Combination of Two Over-the-Counter Drugs Reduces COVID-19 Inpatient Death Rate

Birmingham, Ala. – Treating severe and critical hospitalized COVID-19 patients using two common over-the-counter (OTC) drugs reduced the inpatient death rates down to 15.5%, compared to published inpatient fatality rates of 21 to 25.7% in New York City, Louisiana, and the United Kingdom.  Thus, in essence the dual-drug treatment resulted in a one third reduction in the rate of death in hospitalized patients.  They also reduced the intubation rate down to only 16.4% in these high acuity inpatients. The clinical research findings were published in August 2020 in the journal – Pulmonary Pharmacology & Therapeutics.

The drug combination included an antihistamine and an antacid, commonly found on shelves and safely used for decades.  These two medications, cetirizine (e.g., Zyrtec(TM)) and famotidine (Pepcid(TM)), work to block H1 and H2 histamine receptors, producing a one-two punch against inflammation and presumably blocking the cytokine storm, according to Reed Hogan, II MD, of GI Associates in Jackson, Mississippi.  Hogan initiated this collaboration with pulmonologists from Jackson Pulmonary Associates, who were treating COVID-19 inpatients.  “I wanted to see if we blunt the cytokine storm with medications anyone in the world can find and afford,” said Hogan.

The physician-sponsored cohort study analyzed a group of 110 severe and critical inpatients with an average age of 63.7. Based in Mississippi, where general health is often compromised due to socio-economic issues, these very ill patients averaged a high 2.7 in co-morbidities, most notably hypertension, obesity, and diabetes. Of those patients, 59 percent were African-American and 59 percent female.

While many of the other current medical treatments for COVID-19 require expensive drugs or biologics, this protocol uses affordable drugs already on pharmacy shelves. The savings potential could reduce treatment to less than $50 in drug costs, a boon for people without health insurance.

While other research since the initial study shows that famotidine alone may not effective in hospitalized patients, the original study provides evidence of the treatment effectiveness of famotidine in combination with cetirizine in hospitalized patients.

It also appears that H1 histamine receptor antagonists alone are effective in elderly patients, but not in hospitalized elderly patients.

“The two OTC drugs are historically safe, inexpensive, and are readily accessible within both affluent and impoverished countries across the globe.  Blocking histamine to reduce inflammation in COVID-19 patients is logical,” said Thomas P. Dooley, Ph.D. a Birmingham, Ala.-based drug developer, collaborator, and coauthor on the study. The two histamine-blocking drugs are already approved for other medical indications by the Food and Drug Administration (FDA), therefore physicians may choose to use this new approach off-label. 

Testing on a larger scale in controlled randomized trials is warranted by these initial favorable results, according to Hogan.

SOURCE: Tom Dooley

Study compares discrimination claims of younger and older Americans with cancer

David Strauser – professor, Department of Kinesiology and Community Health (Photo by L. Brian Stauffer

Kinesiology and community health scientists found that younger and older adults with cancer differ in their experiences of employment discrimination.

CHAMPAIGN, Ill. — Researchers assessed the employment discrimination claims made by younger and older American adults with cancer and found substantial differences in the nature – and outcomes – of their claims.

Reported in the Journal of Cancer Survivorship, the research focused on Title I complaints made to the U.S. Equal Employment Opportunity Commission from 2009 to 2016. This included 1,001 claims from cancer survivors up to age 35 and 8,874 claims by adults over 35 with a history of cancer.

The Americans with Disabilities Act originally recognized that people with cancer and undergoing cancer treatment could experience declines in their physical and cognitive functioning. But these difficulties were thought to disappear at the end of treatment or when the cancer was in remission. The ADA was amended in 2009 to allow for the fact that even after treatment ends, people with a history of cancer and cancer treatment often experience lingering difficulties.

“Fatigue is the most common issue that people with cancer experience,” said David Strauser, a professor of kinesiology and community health at the University of Illinois Urbana-Champaign who led the new research. “Also, chemotherapy can affect their ability to concentrate, to focus on details or to process information as fast as they used to.”

Previous studies have found that “adult cancer survivors experience discrimination at a similar rate as other groups with disabilities,” Strauser said. While several studies have focused on older adults with cancer in the workplace, the employment discrimination experiences of younger adults with cancer have been overlooked, he said.

 A recent analysis of dozens of studies found that younger adult survivors of childhood cancer were nearly twice as likely to be unemployed as their healthy peers. Those with cancers of the central nervous system were nearly five times as likely to be unemployed.

All of the complaints that Strauser and his colleagues analyzed had been resolved by the EEOC – either by a finding of merit or with a determination that there was not enough evidence to proceed. The EEOC found that 26.6% of younger cancer survivors’ claims had merit. Older adults with a history of cancer had a higher success rate; 31.4% of their claims were found to have merit.

The primary complaints of older and younger adults with cancer involved what they saw as unfair working terms and conditions, harassment, discipline, failure to accommodate their disabilities and wrongful termination of their employment.

But younger cancer survivors were more likely than their older peers to claim discriminatory treatment in regard to opportunities for training and promotion. They also brought significantly more claims relating to reinstatement – being allowed to return to their jobs after taking leave for treatment – and the writing of references to potential future employers.

“What we’re seeing here is that younger cancer survivors have different needs related to employment than their older counterparts,” Strauser said. “Their discrimination claims tend to be related to issues around their career advancement.”

This finding suggests that employers may not be familiar with laws protecting the rights of people with disabilities that stem from chronic illness, Strauser said.

“I think employers get a lot of training and support on how to handle affirmative action issues and family leave for parents,” he said. “But when it comes to disability in relation to chronic illness, they tend to be less versed, and we don’t do a lot of training in that area. These results suggest we need to do more.”

The paper “The employment discrimination experiences of younger and older Americans with cancer under Title I of the Americans with Disabilities Act” is available online and from the U. of I. News Bureau.

DOI: 10.1007/s11764-020-00867-x

SOURCE: Credit: Diana Yates