News Briefs: Clinical Practice Updates

This roundup includes the following brief clinical practice updates: FDA Warns About Risk of Wearing Patches During MRIs; Updates Recommendations for Irritable Bowel Syndrome; AAD Issues New Guidelines on Managing Psoriasis With Topical Agents; Exercise Lowers Risk for Colon Cancer, Study Says; Academy Adopts USPSTF Clinical Services Recommendations; and Study Shows Promise in Treating Peanut Allergies.

The FDA has issued a public health advisory, warning patients that certain transdermal patches pose a safety risk. The agency said the patches, if worn during MRI scans, can conduct electricity, generate heat and cause skin burns.

The patches in question contain metallic components, such as aluminum or other metals, in the backing of the patches. Both brand-name and generic products and both prescription and OTC products are included in the advisory.

Although many of these products already carry a warning about the risk of skin burns, FDA officials have determined that not all manufacturers include such safety warnings.

The FDA recently completed a review of the labeling and composition of available medicated patches to identify those with metallic components that do not provide warnings about the burn risk and has posted a list of these patches online. FDA staff now will work with the manufacturers of these products to ensure that the necessary warnings are added.

Until this process is complete, the FDA recommends that physicians identify patients in their practices who wear such patches. If referring a patient who uses one of these patches for an MRI scan, the physician should advise the patient about the procedures for removing and disposing of the patch before the scan.

The FDA urges health care professionals and patients to report cases of patch-related burns suffered during an MRI to the agency through its MedWatch program online or by calling (800) FDA-1088.

The American College of Gastroenterology, or ACG, has published new recommendations (40-page PDF; About PDFs) for the treatment of irritable bowel syndrome, or IBS.

The recommendations, which appear in an evidence-based systematic review document created by the ACG Task Force on IBS and published as a supplement to the January American Journal of Gastroenterology, note that only a small number of therapies have been shown to be of benefit for all symptoms of IBS, and physicians may need to try more than one combination of treatments.

Highlights of the recommendations include

The American Academy of Dermatology, or AAD, has released new guidelines for the treatment of psoriasis with topical therapies. (17-page PDF; About PDFs)

According to the AAD guidelines, of the nearly 7 million Americans affected by psoriasis, about 80 percent of patients have mild to moderate disease. Although treatment must be tailored to each individual, the majority of these patients can be treated effectively with topical agents, either alone or as an adjunct to other therapies, says the AAD. However, treatment with topical therapies alone should not routinely be recommended for patients with more severe psoriasis.

The guidelines also cover topics such as matching patient expectations with practical considerations when formulating treatment goals, details of topical agent application, use of concurrent therapies and encouraging patient adherence.

A study published recently in the British Journal of Cancer reports that people who exercised the most were 24 percent less likely to develop colon cancer than subjects who exercised the least.

An inverse association between physical activity and the risk of colon cancer already has been demonstrated, but researchers from Harvard University in Boston and the Washington University School of Medicine in St. Louis sought to estimate the magnitude of potential risk reduction by reviewing more than 50 previous studies examining the relationship between exercise and colon cancer risk.

The researchers said in a news release that the protective benefits applied to all types of exercise -- whether that activity was recreational, such as jogging, biking or swimming, or job-related, such as walking, lifting or digging -- for both men and women.

Three sets of clinical recommendations have been adopted by the AAFP and added to the Academy's Summary of Recommendations for Clinical Preventive Services.

The U.S. Preventive Services Task Force, or USPSTF, issued revised recommendations late last year on screening for colorectal cancer and on behavioral counseling to prevent sexually transmitted infections, or STIs. The USPSTF also recommended interventions to promote and support breastfeeding.

Briefly, the task force and the AAFP now recommend screening adults for colorectal cancer using fecal occult blood testing, sigmoidoscopy or colonoscopy beginning at age 50 and continuing until age 75.

The groups also recommend high-intensity behavioral counseling for all sexually active adolescents and for adults at increased risk for STIs.

The recommended interventions for breastfeeding include

Researchers at Duke University Medical Center in Durham, N.C., and Arkansas Children's Hospital in Little Rock report that a carefully administered daily dose of peanuts has been successfully used as a therapy for peanut allergies.

"It appears these children have lost their allergies," Wesley Burks, M.D., chief of the Division of Pediatric Allergy and Immunology at Duke, said in a news release. "This gives other parents and children hope that we'll soon have a safe, effective treatment that will halt allergies to certain foods."

Duke and Arkansas Children's Hospital began enrolling children in studies five years ago to determine if incremental doses of peanut protein could change how the immune system responds to peanut allergen. The study doses started as small as 1/1000 of a peanut. Less than a year later, the children were ingesting up to 15 peanuts per day.

Burks said research is ongoing and cautioned parents and doctors against testing on their own. He also said some people are too sensitive to peanuts to undergo the therapy.