An African study has found a link between a difficult childhood and alcohol consumption as a teenager. Researchers writing in BioMed Central’s open access journal Child and Adolescent Psychiatry and Mental Health studied the association between adverse childhood experiences and drunkenness among 9,189 adolescents aged 12-19 years living in Burkina Faso, Ghana, Malawi, and Uganda.

Dr. Caroline Kabiru and a team of researcher from the African Population and Health Research Center , Nairobi, Kenya conducted the study. They noted, “Overall, 9% of adolescents reported that they had been drunk in the 12 months preceding the survey. In general, respondents who had lived in a food-insecure household, lived with a problem drinker, been physically abused, or been coerced into having sex were more likely to report drunkenness”.

There has previously been little research into the determinants of alcohol use among adolescents in sub-Saharan Africa. The researchers’ work is supported by similar studies in other parts of the world, which also draw a link between adverse childhood experiences and future drinking. Speaking about the findings, Dr. Kabiru said, “Early treatment for traumatic childhood experiences may be an essential component of interventions designed to prevent alcohol abuse among adolescents”.

Notes:
Self-reported drunkenness among adolescents in four sub-Saharan African countries: associations with adverse childhood experiences
Caroline W Kabiru, Donatien Beguy, Joanna Crichton and Alex C Ezeh
Child and Adolescent Psychiatry and Mental Health 2010, 4:17 doi:10.1186/1753-2000-4-17

Source:
Graeme Baldwin

BioMed Central

Most people consume far too much salt, and a University of Iowa researcher has discovered one potential reason we crave it: it might put us in a better mood.

UI psychologist Kim Johnson and colleagues found in their research that when rats are deficient in sodium chloride, common table salt, they shy away from activities they normally enjoy, like drinking a sugary substance or pressing a bar that stimulates a pleasant sensation in their brains.

“Things that normally would be pleasurable for rats didn’t elicit the same degree of relish, which leads us to believe that a salt deficit and the craving associated with it can induce one of the key symptoms associated with depression,” Johnson said.

The UI researchers can’t say it is full-blown depression because several criteria factor into such a diagnosis, but a loss of pleasure in normally pleasing activities is one of the most important features of psychological depression. And, the idea that salt is a natural mood-elevating substance could help explain why we’re so tempted to over-ingest it, even though it’s known to contribute to high blood pressure, heart disease and other health problems.

Past research has shown that the worldwide average for salt intake per individual is about 10 grams per day, which is greater than the U.S. Food and Drug Administration recommended intake by about 4 grams, and may exceed what the body actually needs by more than 8 grams.

Johnson, who holds appointments in psychology and integrative physiology in the College of Liberal Arts and Sciences and in pharmacology in the Carver College of Medicine, published a review of these findings in the July issue of the journal Physiology & Behavior with Michael J. Morris and Elisa S. Na, UI graduate students. In addition to reporting their own findings, the authors reviewed others’ research on the reasons behind salt appetite.

High levels of salt are contained in everything from pancakes to pasta these days, but once upon a time, it was hard to come by. Salt consumption and its price skyrocketed around 2000 B.C. when it was discovered as a food preservative. Roman soldiers were paid in salt; the word salary is derived from the Latin for salt. Even when mechanical refrigeration lessened the need for salt in the 19th century, consumption continued in excess because people liked the taste and it had become fairly inexpensive. Today, 77 percent of our salt intake comes from processed and restaurant foods, like frozen dinners and fast food.

Evolution might have played an important part in the human hankering for salt. Humans evolved from creatures that lived in salty ocean water. Once on land, the body continued to need sodium and chloride because minerals play key roles in allowing fluids to pass in and out of cells, and in helping nerve cells transfer information throughout the brain and body. But as man evolved in the hot climate of Africa, perspiration robbed the body of sodium. Salt was scarce because our early ancestors ate a veggie-rich diet and lived far from the ocean.

“Most of our biological systems require sodium to function properly, but as a species that didn’t have ready access to it, our kidneys evolved to become salt misers,” Johnson said.

Behavior also came to play a key role in making sure we have enough salt on board. Animals like us come equipped with a taste system designed to detect salt and a brain that remembers the location of salt sources — like salt licks in a pasture. A pleasure mechanism in the brain is activated when salt is consumed.

So the body needs salt and knows how to find it and how to conserve it. But today scientists are finding evidence that it’s an abused, addictive substance — almost like a drug.

One sign of addiction is using a substance even when it’s known to be harmful. Many people are told to reduce sodium due to health concerns, but they have trouble doing so because they like the taste and find low-sodium foods bland.

Another strong aspect of addiction is the development of intense cravings when drugs are withheld. Experiments by Johnson and colleagues indicate similar changes in brain activity whether rats are exposed to drugs or salt deficiency.

“This suggests that salt need and cravings may be linked to the same brain pathways as those related to drug addiction and abuse,” Johnson said.

Notes:

STORY SOURCE: University of Iowa News Services, 300 Plaza Centre One, Suite 371, Iowa City, Iowa 52242-2500

Source: Nicole Riehl

University of Iowa

Welcoming the publication of the Health Committee’s Stage 1 Report for the Alcohol Bill yesterday [Thursday 27 May 2010], Dr Brian Keighley, Chairman of the BMA in Scotland, said:

“This report provides a thorough and detailed description of the evidence given to the Health Committee. However because of the division of opinion amongst the membership, the report doesn’t really offer any clear guidance to the Parliament on how to progress the Bill.

“It is disappointing that the strong evidence presented to the Health Committee has not persuaded all members of the case for minimum pricing. However, I am pleased that there is a recognition that efforts to address pricing will, as part of a wider strategy, help to tackle Scotland’s culture of heavy drinking. The BMA also welcomes the report’s indication that minimum pricing is likely to be legal.

“The BMA supports a strategy to tackle alcohol that includes legislative and non-legislative measures. We support minimum pricing as the most effective mechanism to increase the price of the cheapest alcohol alongside measures to ban alcohol advertising and sponsorship, and a programme of education and awareness. We also support the concept of a social responsibility levy which is used to fund services targeted towards reducing alcohol related harm.

“As we approach the first vote on this Bill, I would urge MSPs to put aside party differences and vote for health by progressing this legislation to the next stage.”

Link to report

Source
British Medical Association

Men with serious injuries, such as traumatic brain injury or spinal cord injury, must deal with a range of emotions. If these men have strong traditional masculine ideas and abuse alcohol, it becomes even more difficult to help them heal and come to terms with their emotions and situations. A University of Missouri psychology researcher studied these challenging factors to find better ways to understand and treat men who fit this mold, such as the injured soldiers coming back from Iraq and Afghanistan.

“It is really a triple whammy,” said Glenn Good, professor of educational, school and counseling psychology in the MU College of Education. “Counselors face many challenges when it comes to helping men deal with emotions surrounding serious injuries. Newly injured men often face adjustments in the level of personal assistance they require, and this may result in struggles with some aspect of the traditional masculine role, such as a ‘go it alone’ mentality. When three factors – injury, traditional male role and alcohol abuse – occur together, the rehabilitation process may be a challenge. In this study, we examined the combination of all three factors with the aim of better understanding how to treat men with several challenges.”

Good and his colleagues found that a young man with a serious injury would often report a greater pursuit of status, higher drive for dominance and increased risk taking. However, they were more open to accepting assistance. Older men in the study tended to hold to the masculine attitude that they could do everything on their own and did not need any help, presenting a greater challenge.

“Unfortunately, we are going to have a country full of men like this coming back from Iraq and Afghanistan,” Good said. “Soldiers have been trained to be hyper-masculine and, after a serious injury, could easily turn to alcohol use to deal with their new challenges. We have to confront this problem and create interventions that address all of these issues and not just one behavior or problem at a time. Our systems of care for people with spinal cord injuries, veterans and non-veterans, must address these issues proactively and with adequate resources to face these multiple challenges.”

Good found alcohol use was common regardless of age. In the study, binge drinking was defined as five or more drinks per occasion.

“Some men are drinking instead of seeking appropriate help, but some have been heavy drinkers all along,” Good said. “The binge drinking is problematic. Some may drink to suppress their bad feelings about being injured and their perceived loss of masculinity. They may think they are being strong by not seeking help when in fact turning to alcohol could be even more detrimental.”

The study – “Men with serious injuries: relations among masculinity, age and alcohol use” – was published in the most recent American Psychological Association’s journal Rehabilitation Psychology.

Source: Jennifer Faddis

University of Missouri-Columbia

Alcohol is the most damaging drug to the drinker and others overall, heroin and crack are the second and third most harmful, Professor David Nutt and colleagues wrote in the medical journal The Lancet today. When all factors related to self harm and harm to others are considered, alcohol comes out top. The authors explain that drugs, including tobacco products and alcohol are major contributors to damage to individuals as well as society as a whole.

The harms that are caused by drugs need to be comprehensively assessed so that policy makers can be properly advised regarding health, social care and policing, the authors write; not an easy undertaking because drugs can cause damage in so many different ways.

Professor Nutt and colleagues had previously tried to do this (Lancet 2007) by asking experts to give each drug a score according to nine criteria of harm, which included the drug’s intrinsic harms as well as the social and health care burdens. The report triggered widespread debate and interest. However, there were doubts regarding the differential weights of each criterion used.

In this latest report, Nutt and colleagues say they have addressed these concerns by using a multicriteria decision analysis (MCDA) when reviewing drug harms. MCDA technologies have been effectively used to help decision making in areas where factors, features and characteristics are complex and often conflicting, as may be the case when deciding policy on nuclear waste disposal.

Nine criteria related to harm to an individual from a drug, while six looked at harm to others – both in the United Kingdom and other countries. The harms were gathered into five subgroups that covered social, psychological and physical harms. Scoring was done with points up to 100, with 100 being the most damaging and zero no damage. Weighting then compared the impact a score of 100 had on all the other criteria, thus identifying the 100-points-scoring-drugs which were more harmful than other 100-points-scoring-drugs.

The authors wrote (in explanation of their model):

In scaling of the drugs, care is needed to ensure that each successive point on the scale represents equal increments of harm. Thus, if a drug is scored at 50, then it should be half as harmful as the drug that scored 100.

The nine harm-to-self categories of a drug were:

dependence
drug-related damage
drug-related impairment of mental functioning
drug-related mortality
drug-specific damage
drug-specific impairment of mental function
injury
loss of relationships
loss of tangibles

The harm-to-others categories of a drug were:

crime
decline in community cohesion
economic cost
environmental damage
family conflict
international damage

With the MCDA modeling method, alcohol came top as the most harmful drug overall. Below are some highlights of their findings:

Alcohol, overall harm score 72
Heroin, overall harm score 55
Crack, overall harm score 54
Crystal meth, overall harm score 33
Cocaine, overall harm score 27
Tobacco, overall harm score 26
Speed/amphetamines, overall harm score 23
Cannabis, overall harm score 20
GHB, overall harm score 18
Valium (benzodiazepines), overall harm score 15
Ketamine, overall harm score 15
Mephedrone, overall harm score 13
Butane, overall harm score 10
Khat, overall harm score 9
Ecstasy, overall harm score 9
Anabolic steroids, overall harm score 9
LSD, overall harm score 7
Buprenorphine, overall harm score 6
Mushrooms, overall harm score 5
The most harmful drugs to the individual are heroin, crack and crystal meth
The most harmful drugs to others are alcohol, heroin and crack

Not only is alcohol the most harmful drug overall, the authors write, but is nearly three times as harmful as tobacco or cocaine, according to the new ISCD MCDA modeling.

Mephedrone, which was recently a legal-high in the UK before it was re-categorized as a Class B controlled drug this year. Alcohol is over five-times as harmful as mephedrone.

Ecstasy is just one-eighth as harmful as alcohol, despite all its media attention and public concerns.

Professor Nutt said (direct quote, not found in article):

What a new classification system might look like would depend on what set of harms-to self or others-you are trying to reduce. But if you take overall harm, then alcohol, heroin and crack are clearly more harmful than all others so perhaps drugs with a score of 40 or more could be class A; 39 to 20 class B; 19-10 class C and 10 or under class D.

The MCDA procedure is an effective and powerful means for dealing with the complex issues related to drug misuse, the authors wrote.

They said:

The issue of the weightings is crucial since they affect the overall scores. The weighting process is necessarily based on judgment, so it is best done by a group of experts working to consensus.

(conclusion) Our findings lend support to previous work in the UK and the Netherlands, confirming that the present drug classification systems have little relation to the evidence of harm. They also accord with the conclusions of previous expert reports that aggressively targeting alcohol harms is a valid and necessary public health strategy.

In an associated Comment, also in The Lancet, Dr. Jan Van Amsterdam, National Institute for Public Health and the Environment, Netherlands, and Dr Wim van den Brink, Amsterdam Institute for Addiction Research, Academic Medical Center, University of Amsterdam, Netherlands, wrote:

A major point not addressed in the study, because it was outside their scope, is polydrug use, which is highly prevalent among recreational drug users. Notably, the combined use of alcohol with other drugs often leads in a synergistic way to very serious adverse effects.

They also explain that consuming combinations of these drugs can significantly alter their adverse events and harm impacts. For example, magic mushrooms on their own have a very low incidence of adverse events, but individuals who consume mushrooms as well as alcohol have a much higher risk of accidents that result in death. Other examples of combinations mentioned include alcohol with cocaine, leading to cocaethylene – an extremely toxic compound, or alcohol with cannabis which can seriously affect an individual’s ability to drive properly.

The Comment authors concluded:

Nutt and colleagues’ ranking of the licit and illicit drugs is certainly not definitive, because the pattern of recreational drug use is dynamic: the popularity and availability of the drugs, and the pattern of polydrug use, might change within a decade. The ranking of the drugs. should therefore be repeated at least every 5-10 years. Finally, for the discussion about drug classification, it is intriguing to note that the two legal drugs assessed-alcohol and tobacco-score in the upper segment of the ranking scale, indicating that legal drugs cause at least as much harm as do illegal substances.

“Drug harms in the UK: a multicriteria decision analysis”
Prof David J Nutt FMedSci a Corresponding AuthorEmail Address, Leslie A King PhD b, Lawrence D Phillips PhD
The Lancet, Early Online Publication, 1 November 2010
doi:10.1016/S0140-6736(10)61462-6

Misuse and Addictions Week, an awareness week supported by the home office runs from June 23-30th. During this week treatment agencies have an open door policy allowing addiction-treatment providers, referrers and commissioeinrs along with the general public to learn what services are available to them to help curb addiction. The awareness campaign coincides with the United Nations International Day Against Drug Abuse which is held on June 26th. The UN Office on Drugs & Crime launches this day every year to raise awareness.

Dan Butcher, founder of The Recovery Network (a social networking internet platform that provides real time education, a support network and social assistance to anyone affected by addiction) has been lobbying for some time now to have June 26th recognized as not only a global day of awareness but also UK Day against Drug Abuse. He’s had several meeting in the house of Lords in order to achieve this goal. He hopes awareness campaigns such as these will help people to realise that it is an illness rather than a weakness. The Recovery Network launched on November 5th 2007 and the website currently helps to support an online community of over 2,000 registered members. Its members consist of addicts wishing to confront their addiction for the first time, recovering addicts and the friends and family members of both.

Recovering Coke Addict and Founder Dan says: “This campaign is only one step in winning the war on addiction. The UK government needs to take a much more active role in supporting those affected by addiction. Millions of people have been affected either directly or indirectly by the devastating implications of drug addiction’.

As well as tackling drugs and reducing drug-related crime in communities across the country, National Drugs Tackling Week will also highlight support services available such as The Recovery Network. Dan Butcher aims to create as much awareness as possible during this crucial week.

trntv.co

Catalyst
Pharmaceutical Partners, Inc. (Nasdaq: CPRX), a biopharmaceutical company
that acquires, in-licenses, develops and commercializes prescription drugs
for the treatment of drug addiction, announced that it has initiated
enrollment of patients for its 180- patient, U.S. Phase II clinical trial
evaluating the use of CPP-109 in treating patients with cocaine addiction.
CPP-109, an orally administered, small molecule drug which inhibits
psychostimulant-induced dopamine release, is Catalyst’s lead compound,
vigabatrin.

The Phase II trial is designed as a randomized, double-blind, placebo-
controlled, intent-to-treat, multi-center study to evaluate the safety and
efficacy of CPP-109 as a treatment for cocaine addiction. Under the study
protocol, patients will be treated for a period of 12 weeks, with an
additional 12 weeks of follow-up. The primary objective of the study is to
demonstrate that a larger proportion of CPP-109-treated subjects than
placebo- treated subjects are cocaine-free during their last two weeks of
treatment (weeks 11 and 12). Additionally, Catalyst will be measuring a
number of secondary endpoints based on reductions of cocaine use and
craving.

Catalyst’s web site catalystpharma includes a listing of the
CPP- 109 study sites and relevant contact information. For more information
about enrolling in this study, please contact the study sites directly.
Additional detailed information can be found on clinicaltrials
(search for Catalyst).

Patrick J. McEnany, Chief Executive Officer of Catalyst, commented: “We
are very pleased to announce the start of active enrollment in our study of
CPP-109 as a potential treatment for cocaine addiction. We expect to add
more clinical trial sites to the 10 previously disclosed in order to
complete the trial as soon as possible. We anticipate initial top-line
results from this trial to be available by year-end.”

Douglas Winship, Catalyst’s Vice President of Regulatory Operations,
stated: “Vigabatrin has previously shown the potential to be a safe and
effective non-addictive drug treatment for cocaine and methamphetamine
addiction in a Phase II double-blind, placebo-controlled trial and two
pilot studies conducted in Mexico. We are excited to now evaluate the
therapeutic benefit of CPP-109 in cocaine-addicted patients enrolled in a
large, double- blind, placebo-controlled trial conducted in the U.S. under
our sponsorship. There are currently no prescription drugs approved for the
treatment of this population. As a result, drug therapies are desperately
needed which can improve abstinence achievement rates of behavioral therapy
administered by addiction treatment specialists, and reduce recidivism. We
have worked diligently with regulatory authorities and the independent
institutional review boards at each of the clinical sites where our trial
will be conducted to be able to finalize and implement our protocol for
this trial.”

On December 7, 2007, Catalyst announced positive initial top-line
results from a 103-patient, investigator-initiated Phase II double-blind,
placebo- controlled trial, in which vigabatrin met its primary efficacy
endpoint of abstinence during the last weeks of treatment for cocaine
addiction. Additional results of this study will be reported when they
become available.

About CPP-109

CPP-109 works by inhibiting an enzyme that normally breaks down gamma
aminobutyric acid (GABA), a dopamine-modulating neurotransmitter. The
resulting excess GABA suppresses the increase in dopamine release caused by
cocaine. All addictive drugs elevate dopamine levels in the parts of the
brain associated with reward and reinforcement. It is thought that this
reinforcing effect is the primary biochemical explanation for addiction.
CPP-109 indirectly keeps dopamine levels in the normal range without
impairing normal dopamine-based mechanisms. It is also thought that this
effect may reduce craving, an effect in addicts which makes it very
difficult for them to stop their drug habit.

About Catalyst Pharmaceutical Partners

Catalyst Pharmaceutical Partners, Inc. is a biopharmaceutical company
focused on the development and commercialization of prescription drugs for
the treatment of addiction. The Company has obtained from Brookhaven
National Laboratory an exclusive worldwide license for nine patents and
four patents pending in the United States relating to the right to use
vigabatrin to treat a wide variety of substance addictions and
obsessive-compulsive disorders. Catalyst has also been granted rights to
Brookhaven’s vigabatrin-related foreign patents or patents pending in more
than 30 countries.

The Company’s initial product candidate is CPP-109, also known as
vigabatrin. CPP-109 has been granted “Fast Track” status by the FDA for the
treatment of cocaine addiction. This indicates that the FDA has recognized
that CPP-109 is intended for the treatment of a serious or life-threatening
condition for which there is no effective treatment and which demonstrates
the potential to address unmet medical needs. CPP-109 was selected as one
of the five most promising drugs entering Phase II trials in the
July-September 2007 issue of The Ones To Watch, published by Thomson
Scientific, a Thomson Corporation publication.

This press release contains forward-looking statements. Forward-looking
statements involve known and unknown risks and uncertainties which may
cause the Company’s actual results in future periods to differ materially
from forecasted results. A number of factors, including the Company’s
ability to successfully complete the clinical trials required for it to
file a new drug application for CPP-109, its ability to complete such
trials on a timely basis within the budgets established for such trials,
whether the Company’s trials, which are being conducted in the U.S. under
FDA good clinical practice guidelines, will evidence that CPP-109 is safe
and effective for the treatment of cocaine addiction and methamphetamine
addiction, the Company’s ability to protect its intellectual property and
those other factors described in the Company’s Annual Report on Form 10-K
for 2006 and the Company’s Quarterly Report on Form 10-Q for the quarter
ended September 30, 2007 that the Company has previously filed with the
U.S. Securities and Exchange Commission (“SEC”), could adversely affect the
Company. Copies of the Company’s filings with the SEC are available from
the SEC or may be obtained upon request from the Company. The Company does
not undertake any obligation to update the information contained herein,
which speaks only as of this date.

Catalyst Pharmaceutical Partners, Inc.
catalystpharma

The Texas House recently voted 71-60 to approve a provision in a Medicaid bill (SB 10) that would establish the state’s first needle-exchange program in Bexar County, Texas, which includes San Antonio, the Fort Worth Star-Telegram reports. Rep. Ruth McClendon (D), who sponsored the provision, initially tried to add an amendment that would have created a statewide program. However, the program was limited to the San Antonio area after the broader program failed to gain support in the House. The details of the program have not been worked out, the Star-Telegram reports.

According to McClendon, needle-exchange programs help to curb the spread of bloodborne diseases, including HIV and hepatitis C, among injection drug users. Rep. Dianne White Delisi (R), who sponsored the Medicaid bill, did not dispute the potential public health benefits of an exchange program but said that Texas residents are concerned about whether “promoting the free exchange of needles for the illegal use of intravenous drugs is something the state should be doing” (Dyer, Fort Worth Star-Telegram, 5/22). According to the Houston Chronicle, Texas is the only state that does not have a needle-exchange program (Elliott, Houston Chronicle, 5/22).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Mustafa al’Absi, Ph.D., professor of behavioral sciences at the University of Minnesota Medical School – Duluth Campus, and director of the Duluth Medical Research Institute, has received funding and launched a new first-of-its-kind international research initiative: “Khat Research Program: Neurobehavioral Impact of Long-Term Use”.

In conjunction with several international universities, al’Absi has scheduled an inaugural symposium for the Khat Research Program (KRP), scheduled within the 9th Society of Neuroscientists of Africa (SONA) Conference, at Sharm El-Sheikh, Egypt, December 11, 2009. In addition to al’Absi, speakers will include: Stephan Bongard (Frankfurt University, Germany); Richard Hoffman (University of Minnesota Medical School-Duluth), Nilesh Patel (University of Nairobi, Kenya), Abdul Mohammed (V?¤xj?¶ University, Sweden), Michael Odenwald (University of Konstanz, Germany).

Khat, a psychostimulant plant widely used in Africa and the Middle East, is associated with serious health effects among young people and women in many countries in Africa and the Middle East where use of Khat also threatens sustainable development. Khat use also has grown significantly among immigrants in several countries in Europe and North America.

The KRP will establish a multidisciplinary research and training program focusing on the concurrent use of nicotine and khat. The program has two primary goals: a) to develop collaborative relationships and provide needed capacity-building resources that will include a series of research training workshops, relevant training on ethical standards of research, and semi-annual meetings to develop future programmatic research; and b) to complete preliminary research to determine biobehavioral consequences of long-term khat and tobacco use.

The KRP will be coordinated by al’Absi from the University of Minnesota Medical School – Duluth campus, with collaborators from other universities in the U.S., Europe, Africa, and the Middle East.

Mustafa al’Absi received an R21 grant from the National Institute of Health to launch the research. The award was funded within the NIH initiative titled “Brain Disorders in the Developing World: Research Across the Lifespan (BRAIN)” and is the first-step in developing an R01-funded program. It will help in assessing research and training needs and generating preliminary data for the collaborative research to be proposed in the follow-up R01 submission.

Source: Michelle Juntunen

University of Minnesota

Barcelona, Spain, Friday 15 June 2007: New data presented today at EULAR 2007, the Annual European Congress of Rheumatology in Barcelona, Spain, suggests that alcohol may protect against rheumatoid arthritis, with three units a week exhibiting protective effects and ten units a week being more protective still. An alcohol consumption of three units per week or more also reduced the risk by smoking or by a genetic predisposition to RA.

An increased alcohol (ethanol) consumption of three or more units per week was associated with a decreased risk of developing RA (odds ratio 0.5, 95%; confidence interval 0.4 0.7). The findings could improve understanding of the effects of lifestyle on the risk of developing RA and pave the way for new potential treatment approaches based on the apparently beneficial effects of alcohol.

Henrik K?¤llberg at the Karolinska Institutet, Stockholm, Sweden, who is a PhD student said, “Several previous studies have indicated a suppression of the immune system by alcohol and a recent study showed that it prevented development of destructive arthritis. However, until now, epidemiological investigations on the effects of alcohol on RA were scarce and inconsistent. These data now show not only that alcohol can protect against RA and reduce the risk conferred by smoking or susceptible genes, but also gives an idea of the relevant alcohol doses necessary.”

The EIRA research team that Henrik K?¤llberg belongs to conducted a population-based case-control study of incident cases of RA (according to American College of Rheumatology (ACR) 1987 criteria) among those aged 18-70 years in a defined area of Sweden. Cases and randomly-selected controls completed an extensive questionnaire regarding lifestyle factors, including alcohol consumption and smoking habits. DNA from 1,204 cases and 871 controls was examined to detect the presence of HLA-DRB1 SE alleles (a marker indicating genetic risk factor for RA) and all cases were classified by presence of anti-CCP2 antibodies (anti-cyclic citrullinated peptide antibodies) to identify RA subtypes.

Gender-specific odds ratios for anti-CCP positive RA were calculated with 95% confidence intervals for subjects with different consumptions of alcohol (none, 3-5 units per week, >5 units per week), smoking and HLA-DRB1 SE alleles, compared with subjects less exposed to alcohol (0-3 units per week), using logistic regression models with adjustments made for possible confounders.

Professor Tore Kvien, President of EULAR, said, “These are very interesting findings and are the first observation, from epidemiological data, which now should be confirmed by further clinical studies before a firm conclusion can be achieved. Furthermore, we assert the need for caution in the interpretation of these data. The misuse of alcohol is associated with a number of social and medical problems and any positive implications of alcohol must be coupled with the importance of moderation in alcohol consumption in accordance with standard national guidelines.”

EULAR CONGRESS PRESS OFFICE
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eular