CATT Study Update 3 Avastin vs Lucentis – To Get Underway by Year’s End!

The following information was provided to me from the recent CATT Study training meeting held in Philadelphia.

(Please note the addended updates below.)

Patient enrollment for the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT Study) is set to begin before the end of the year, with enlistment beginning on December 1st.

The study will enroll about 1,200 patients with newly diagnosed wet AMD, randomly assigned to one of four treatment groups:

(Group1) Lucentis with four-week dosing, and after one year, re-randomization to Lucentis every four weeks or variable dosing as required based on diagnostic findings;

(Group 2) Avastin with four-week dosing, and after one year, re-randomization to Avastin every four weeks or variable dosing as required based on diagnostic findings;

(Group 3) Lucentis on a variable dosing schedule for 2 years; after initial treatment, with monthly evaluation and re-treatment based on signs of lesion activity; and

(Group 4) Avastin on a variable dosing schedule for 2 years; after initial treatment, with monthly evaluation and re-treatment based on signs of lesion activity.

The regimens are based upon the fact that Avastin is generally given on a variable basis and Lucentis has only been formally tested in a fixed regimen. The main objective will be changes in visual acuity, with secondary objectives including change in lesion size, fluid found in optical coherence tomography and cost, which the study chairman, Dr. Dan Martin of Emory University emphasized is not the sole purpose of the study.

The study will follow patients for two years and will take about four years to complete. One year follow-up data will be reported in late 2009. The study will be conducted in 47 centers in the US.

NEI/NIH is emphasizing that this is more than just a cost study, and that the primary goals are to better understand the safety and efficacy of intravitreal Avastin and to develop better dosing/re-treatment guidelines for both Avastin and Lucentis.

The Comparison of Age-Related Macular Degeneration Treatments Trials (CATT) is a set of multicenter, randomized clinical trials of treatments for neovascular age-related macular degeneration (AMD), the leading cause of blindness in the United States. The Lucentis-Avastin comparison trial is supported by the National Eye Institute (NEI) of the National Institute of Health (NIH).

I expect to have a list of participating centers, hopefully with contact information, by the end of this week and will attempt to put it online. If it becomes available from the University of Pennsylvania website, I will link to that source.

Update:

I now have the CATT clinical site information on 46 of the 47 sites that are believed to be interested in participating in the clinical trial. I have been asked not to publish the names until the contracts with Upenn have been signed. I plan to honor that request.

However, anyone wishing to know the names of the clinics in their state that will be recruiting patients for the study can email me (iarons(at)erols.com – or the link at the side of this page) and I will be happy to cut and paste and supply you with the names of local clinics. Just mention the state that you are interested in.

As soon as Upenn gives me the OK, I will publish the information – or link to their site if they put it online.

I have also learned, as of 10/20/07, that the CATT Study will not be effected by the recent decision by Genentech to cut off the supply of Avastin to compounding pharmacies.

UPenn will act as the compounding pharmacy and will supply the doses of Avastin needed for the study to the 47 participating clinics.

High Fructose Corn Syrup Vs Sugar

By Cliff Walsh

Healthy eating has had a sizable enemy for quite some time, according to a variety of news sources and public advocacy groups. It's called High Fructose Corn Syrup (HFCS). The onslaught against it has been so great that its producers have been attempting to rebrand it, corn sugar, in an attempt to avoid the bad reputation and increase profitability. Researchers at Princeton University released a paper indicating that Americans consume about sixty pounds per year, per person, of HFCS. They also highlight the concurrent rise in usage of HFCS and the rise in obesity rates. I have studied a wide variety of research from both sides of the argument. I will attempt to answer the question, is HFCS worse than sugar?

High Fructose Corn Syrup usage is rampant. The FD does not restrict its usage at all. HFCS's usage is typically in highly-processed junk food. Common ingredients that are often used with it are fat and salt, as well as a host of other chemicals. Sodas and other flavored/sweetened drinks often contain HFCS. It is also found in sauces, dressings, and breakfast bars and cereals.

HFCS does not differ significantly from sucrose (table sugar) from a chemical standpoint. It has about 5% more fructose and 5% less glucose. It's sweetness level is about the same as honey, while its glycemic index is a fair amount higher than table sugar (75 vs. 60). In order to make HFCS, it must undergo significant processing as all of the fructose contained within the syrup is artificially added. Fructose does not naturally occur in corn starch.

A 2011 study gave volunteers 25% of their daily calories in glucose, fructose, or high fructose corn syrup-sweetened beverages. In just two weeks, researchers indicated that the consumption of fructose and high fructose corn syrup increased cholesterol and subsequently, risk of cardiovascular disease. The participants who received glucose did not register such changes.

The body absorbs table sugar and HFCS differently, but they both digest rapidly, leaving little difference in blood sugar levels. But because fructose is added to the glucose (as is typical in HFCS production) and not naturally bonded, it allows the fructose to mainline directly to the liver, causing a domino effect: lipogenesis, a fatty liver, and ultimately, diabetes. It is also believed by many scientists that HFCS does not stimulate insulin production, meaning your body will not know it's full and can lead to overeating.

Based on existing research, HFCS looks to be more dangerous than sucrose by a fair amount. That being said, sugar is still dangerous. Added sugar should be avoided or used in very small amounts. It still carries significant risk of diabetes, heart complications, and significant weight gain, which creates a host of additional issues.

It is important to note that some people try to avoid all sugar and limit fruit because the majority of the carbs in fruit are sugar, but there appears to be a distinct difference in how the body metabolizes the sugar in fruit versus added sugar in a processed food or drink, like coffee. The sugar that needs to be limited is added sugar through any type of natural or artificial sweetener, not those that are naturally occurring.

About the Author:

Please see my website for additional information at reading food label ingredients or my blog at are artificial sweeteners bad for you

Fast Exercise vs Slow Yoga

by Nina 

Image "Borrowed" from The New York Times

The exercises should be performed in rapid succession, allowing 30 seconds for each, while, throughout, the intensity hovers at about an 8 on a discomfort scale of 1 to 10, Mr. Jordan says. Those seven minutes should be, in a word, unpleasant. The upside is, after seven minutes, you’re done. —New York Times

Did anyone else happen to see the recent New York Times seven-minute exercise routine? Well, I did. And my first response was irritation. Something seemed so wrong to me about the routine. At first, I thought it was the seven minutes part. That seemed to me a crazy amount of time for doing twelve exercises, and I thought it would be healthier and more effective to divide up the routine into, say, three or four different routines, and cycle between them on different days. That way, you could spend more time on each exercise and not do the same thing every day (which could lead to boredom or even injury).

But even after I had my private little rant about the subject, every time I saw that picture I continued to feel irritated; it was like a grain of sand in the soft belly of an oyster (not that this rant is going to turn out to be pearl, mind you). But it wasn’t until a few days later that I realized what was really bothering me: it was the phrase “seven minutes of steady discomfort.”

“In 12 exercises deploying only body weight, a chair and a wall, it fulfills the latest mandates for high-intensity effort, which essentially combines a long run and a visit to the weight room into about seven minutes of steady discomfort — all of it based on science.” — Gretchen Reynolds

It seems to me if exercise is something so unpleasant that you do just to get it over with, you’re never going to be able to incorporate it into your life on a regular basis, something people in our exercise-averse culture desperately need to do. I mean, why would you want to add seven unpleasant minutes to your life every day? I can’t help but feel that half an hour of enjoyable exercise has got to be better for you than seven minutes of “steady discomfort.” It’s kind of like the difference between fast food and slow food. For me, yoga asana practice is truly an enjoyable, sensual experience, where I'm present in my body and appreciating what it can do and how it feels. Why would I ever want to trade that for fast, efficient, and unpleasant? (Actually the phrase “all of it based on science” irritated me a bit, too. I’ve had food concocted by nutrition scientists and food made with love by friends and family members, and, of course, no contest there.)

Granted, sometimes it’s a bit hard for me to get started with my yoga practice—there’s a certain mental inertia that makes me reluctant to switch to that activity—but once I begin, I almost always enjoy myself. Of course, there are moments of unpleasantness (the mild painfulness of a stretch, the frustration of falling out of a balance pose, the feeling of mild fatigue after holding a strenuous pose for an extended period of time), but these are interspersed with moments of pleasure and even joyfulness. (I’m thinking now of a fellow student in my weekly class, who, when we do her favorite pose, now always says to me with a twinkle in her eye, “Oh, boy!”) Then, there’s the huge bonus that a mindful asana practice confers in addition to strength, flexibility, balance, and agility: stress reduction.

Maybe I’m preaching to the choir here, but for our physical and emotional health (not to mention healthy aging), we each need to find a form of exercise that is a life-affirming experience rather than a form of torture that we must submit to. And it’s worth the extra time, even just, say, 20 minutes rather than 7, to make that kind of practice a part of your life. Of course, I love yoga, so I’m always here singing its praises. But if you hate every minute of the yoga you’re currently practicing, try some different styles. And if you hate all the styles, maybe it’s not for you. Walk, run, cycle, swim, work out in a gym, dance, play golf, tennis, basketball or soccer, ski—get out there and live!

Subscribe to Yoga for Healthy Aging by Email ° Follow Yoga for Healthy Aging on Facebook ° Join this site with Google Friend Connect