Irritable Bowel Syndrome, Oncology, Weight Loss Supplements

Newswise — Three review articles published in the January/February 2004 Journal of the American Pharmacists Association (JAPhA) highlight medications for irritable bowel syndrome (IBS), cancer, and weight loss.

"Safety and Tolerability of Tegaserod in Irritable Bowel Syndrome Management" (p. 41) Rosemary R. Berardi

Tegaserod is an important addition to the therapeutic arsenal for treating patients with irritable bowel syndrome with constipation as the predominant symptom (IBS-C). Other agents, primarily aimed at single-symptom relief, have been largely ineffective at relieving the multiple symptoms of IBS. IBS affects up to 20% of the U.S. population, with an approximate 2:1 ratio of women to men.

Emerging Treatments in Oncology: Focus on Tyrosine Kinase (erbB) Receptor Inhibitors (p.52)Oday Hamid

Currently approved for first-line, second-line, and last-resort regimens, tyrosine kinase (TK) inhibitors (such as trastuzumab (Herceptin—Genentech) and gefitinib (Iressa—AstraZeneca) are effective in treating otherwise resistant neoplasms. Taking advantage of overexpression of the erbB protein and/or aberrations in the protein's structure in cancer cells, TK inhibitors are becoming increasingly important in cancer treatment and may become a part of first-line therapy for some solid tumors. Combined with development of other innovative biological therapies such as imatinib (Gleevec—Novartis), progress in research on erbB receptor inhibitors is changing the clinical approach to a wide variety of types of cancer, including both solid tumors and leukemias/lymphomas.

Supplemental Products Used for Weight Loss (p. 59)Thomas L. Lenz and William R. HamiltonAs a result of FDA's December 30 announcement of an impending ban on dietary supplements containing ephedra, Americans are looking for alternatives to help them in their quests to trim down. In this issue of JAPhA, authors review the use of dietary supplements for weight loss.

Ephedra is only one of approximately 50 individual supplemental products and hundreds of combination products promoted for weight loss, the authors note. As demonstrated by the adverse effects and past problems of several anoretic medications and ephedra, safety must be balanced against the benefits of weight loss. To be able to recommend supplements to patients, pharmacists and other health care professionals need more research and long-term safety data. The increasing serious problem of obesity and overweight in the United States demands attention, and research into potentially useful dietary supplements should be included the nation's response this emerging crisis.

Dietary supplements (conjugated linoleic acid [CLA], ephedra/ephedrine, chromium, Garcinia cambogia [hydroxycitric acid], chitosan, pyruvate) promoted for weight loss are poorly studied in overweight and obese subjects, according to this JAPhA review. The best effectiveness and safety data favor use of CLA and pyruvate, but data are insufficient to support health professionals in recommending that patients use these supplements for weight loss.

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