Risk for Late-Onset Epilepsy Linked to a Class of Protein, Smoking, Diabetes

Risk for Late-Onset Epilepsy Linked to a Class of Protein, Smoking, Diabetes

A recent study has shown that a class of proteins involved in the metabolism of fats in the body. Apolipoprotein E ε4 (APOE ε4) genotype and the presence of potentially modifiable risk factors such as smoking, hypertension, and diabetes in midlife are associated with a higher risk for late-onset epilepsy.

Participants from the Atherosclerosis Risk in Communities (ARIC) study were enrolled in it. At baseline, the investigators collected data on demographics, lifestyle factors, vascular status, and potential epilepsy risk factors. At first study visit, the median participant age was 55 years. The main outcome was the time to late-onset epilepsy development at age less than 60 years of age. Participants were followed from 1987-1989 through 2013.

During follow-up, a total of 596 patients developed late-onset epilepsy, representing a rate of 3.33 per 1000 person-years. Black patients had a higher incidence rate of late-onset epilepsy compared with white participants (4.71 per 1000 vs. 2.88 per 1000 respectively).

Patients who had hypertension at baseline were more likely to develop late-onset epilepsy during follow-up according to findings of the multivariable analysis. Additional baseline variables associated with a higher risk of late-onset epilepsy included diabetes, smoking, APOE ε4 genotype, incident stroke, and dementia. The risk for late-onset epilepsy was lower in patients with higher physical activity levels and moderate alcohol intake.

A limitation of the study included the use of claims codes for identifying epilepsy cases, which may have introduced misclassification of some patients.

Overall, the findings from the study suggest “a possible role of vascular disease and neurodegeneration in the development of late-onset epilepsy.”

Source: Neurology Advisor and JAMA Neurology

Note:  The apolipoprotein E ε4 (APOE ε4) is important in Alzheimer’s disease and cardiovascular disease. Lipoproteins are molecules composed of fats and proteins.


Nasal Spray for Memory?

Nasal Spray for Memory?

Insulin Detemir Nasal Spray May Improve Memory in Alzheimer’s

NasalSprayInsulin detemir delivered via nasal spray may improve working memory in patients with mild cognitive impairment or Alzheimer’s disease, according to data from a pilot study published in the Journal of Alzheimer’s Disease.

Previous studies have demonstrated the potential benefits of intranasal insulin in adults with mild cognitive impairment or Alzheimer’s disease, but no other research has evaluated the effects of intranasally administered insulin detemir, which is a long-lasting insulin analog.

For this study, the researchers assigned 60 adults diagnosed with mild cognitive impairment or mild to moderate Alzheimer’s disease to receive placebo (n=20), 20 IU of insulin detemir (n=21) or 40 IU of insulin detemir (n=19), administered nasally, for 21 days. (more…)

FTC refunds Seniors Who Paid Too Much for Epilepsy (and other) Meds at CVS Pharmacys

NEW YORK (AP) – The Federal Trade Commission said that it is mailing refund checks to 13,000 Medicare Part D beneficiaries who were overcharged for drugs because aCVS Caremark Corp. business understated the price of the medications.

The checks are being sent to seniors who paid significantly more than they should have for drugs used to treat epilepsy and symptoms of breast cancer, among other illnesses, and who were forced into the so-called “donut hole” as a result of the payments. The “donut hole” a gap in government insurance coverage in which no drug costs are reimbursed.

The FTC says its redress administrator Rust Consulting began mailing the checks Tuesday. The checks are valid for 60 days from the date they were issued and they must be cashed within that time.

The FTC said the seniors chose their prescription drug plans based on incorrect listings of prices for the drugs. The agency said RxAmerica, which is now a unit of CVS, submitted incorrect prices for the drugs and many Medicare Part D beneficiaries chose RxAmerica’s coverage plans based on those listed prices. In some cases, the drugs cost 10 times more than RxAmerica said they did.

CVS Caremark said RxAmerica accidentally published incorrect drug price information on a Medicare site and the FTC said the inaccurate information was also posted on third-party websites. The drugs were sold at CVS stores and Walgreen stores.

CVS Caremark agreed to pay $5 million in January to resolve the allegations. The inaccurate prices were listed from 2007 through at least November 2008. CVS bought RxAmerica in October 2008 when it acquired the Longs Drugs Stores chain.

Consumers who have questions about the settlement can call a toll-free FTC hotline at 1-888-773-8392.

CVS Caremark is based in Woonsocket, R.I. It runs one of the largest pharmacy benefits management companies in the U.S. and one of the largest drugstore chains.

Via – http://www.usatoday.com/money/industries/health/drugs/story/2012-09-04/cvs-settlement-checks/57579212/1