SCOTTISH HOSPITAL NEWS


WORRYING LINK ESTABLISHED BETWEEN ANTIDEPRESSANTS AND SUICIDE


The first ever review of trials of antidepressants taken by healthy adults with no signs of a mental disorder has established that antidepressants doubled the harms related to suicide and violence. The analysis, which was recently published by the Journal of the Royal Society of Medicine, was undertaken because the harms of antidepressants, including the risk of suicide, are often explained away as if they are disease symptoms, or only a problem in children.


Thirteen double-blind, placebo- controlled trials were included in the systematic review and meta-analysis undertaken by the research team from the Nordic Cochrane Centre and the University of Copenhagen. The researchers believe that the review actually underestimates the harms of antidepressants since they had access to only the published articles for eleven of the thirteen trials, rather than being able to analyse the full data held by the drug companies.


‘While it is now generally accepted that antidepressants increase the risk of suicide and violence in children and adolescents, most people believe that these drugs are not dangerous for adults,’ said lead author Professor Peter Gøtzsche, of the Nordic Cochrane Centre. ‘This is a potentially lethal misconception. The reporting of harms in drug trials is generally poor. Our review established that the trials did not report much about their methodology and that the reporting of adverse events was generally inadequate.


‘It is well documented that drug companies under-report seriously the harms of antidepressants related to suicide and violence, either by simply omitting them from reports, by calling them something else or by committing scientific misconduct.’


Professor Gøtzsche and his colleagues find it likely that antidepressants increase suicides in all ages.


WELCOME RULING FOR SCOTTISH LUNG CANCER PATIENTS


LUNG CANCER IS A SIGNIFICANT HEALTH BURDEN IN SCOTLAND. IN 2014, APPROXIMATELY 5,300 PEOPLE WERE DIAGNOSED AND 4,100 PEOPLE DIED FROM THE DISEASE – MORE THAN BREAST, COLORECTAL AND PROSTATE CANCERS COMBINED.


The majority of lung cancer patients are diagnosed at an advanced stage and the prognosis for survival in these patients is poor. In fact, in Scotland, only ten per cent of patients diagnosed with lung cancer will survive five years or more.


Now, the Scottish Medicines Consortium (SMC) has recommended the potentially life-extending cancer drug nivolumab to treat Scottish NHS patients with the most common form of advanced lung cancer.


Nivolumab is the first in an innovative class of medicines (PD-1 immune


FUNDING BOOST FOR GENETIC SWITCH SEARCH


SCIENTISTS AT THE UNIVERSITY OF ABERDEEN ARE SEARCHING FOR THE GENETIC SWITCHES THAT COULD CONTRIBUTE TO OBESITY AND ALCOHOL ABUSE AFTER SECURING A RESEARCH GRANT OF £412,200 FROM THE BBSRC.


Gene switches make sure that the proteins produced by the body’s genes are produced in the right cells at the right time and in response to the right signals.


The study will examine whether environmental factors in childhood can interact with genetics to affect how these switches operate later in life.


Mounting evidence suggests that mutations in the gene switches, and not the genes themselves, are the main causes of human illness.


It is also highly likely that these switches are the major targets of a process (epigenetic modification by DNA-methylation), that responds to environmental factors such as early life stress caused by social deprivation and poverty. In this way, gene switches act as the interface between our genetics and our environment that are essential for health but can


checkpoint inhibitors) for the treatment of lung cancer patients. It has a mode of action that works by harnessing the ability of the immune system to fight this type of advanced lung cancer, as well as advanced forms of kidney cancer and melanoma (a type of skin cancer).


This means that Scottish patients are the first in the UK to be treated with nivolumab on the NHS for locally advanced or metastatic non- squamous non-small cell lung cancer (NSCLC), where the disease has progressed after prior chemotherapy.


The decision also broadens funding for the medicine following the SMC approval of nivolumab for a smaller group of NSCLC patients - those with squamous NSCLC - earlier this year.


‘We are very happy for advanced also make us ill.


Dr Alasdair MacKenzie and Prof Mirela Delibegovic, who are experts in genomics and metabolism from the University of Aberdeen’s Institute of Medical Sciences, will collaborate with Dr Chris Murgatroyd, a gene- environment interactions expert from Manchester Metropolitan University.


‘We will start by looking at the switches that control the production of a protein called galanin,’ said Dr MacKenzie. ‘Galanin production in an area of the brain called the hypothalamus increases the desire to consume fatty food and alcohol. We have found the switch that controls galanin production in the hypothalamus and have evidence that genetic mutations and environmental factors interact at this switch to change its activity. We will explore the possibility that these changes contribute to alcohol abuse or excess fat intake in humans.’


The study will be based on a mouse model, using a cutting edge technique called CRISPR genome editing. This will allow the group to subtly alter these gene switches in mice in weeks rather than years and to test the effects of these changes on fat and alcohol intake.


lung cancer patients in Scotland who will now have the option of treatment with nivolumab on the NHS,’ said Benjamin Hickey, General Manager, Bristol-Myers Squibb UK & Ireland. ‘The SMC has recognised that lung cancer patients are in urgent need of a new treatment option that has the potential to help them live longer and give them more time with their families. However, because the NICE process has been ongoing for many months, NHS patients in England, Northern Ireland and Wales face the desperately unfair situation of not having the same access to nivolumab treatment as those across the border in Scotland. We are exploring all possible options in order to resolve this disparity as soon as possible.’


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