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VOLUME 8 NUMBER 4 • NOVEMBER 2011
EASD WATCH
SA JOURNAL OF DIABETES & VASCULAR DISEASE
Novo Nordisk (Pty) Ltd. Reg. No.: 1959/000833/07. PO Box 783155, Sandton, 2146. Tel: (011) 202 0500 Fax: (011) 807 7989 NN/DUO/4145/07/10/VER1
ence of (1) macrophage colony-stimulating
factor (M-CSF) and RANKL, (2) M-CSF,
RANKL and neutralising antibody to TNF-
α
,
and (3) M-CSF, RANKL and neutralising
antibody to IL-6.
The addition of neutralising antibody
to TNF-
α
to the cultures with M-CSF and
RANKL led to a marked decrease in the
osteoclastic resorption only in patients with
Charcot osteoarthropathy. The addition of
neutralising antibody to IL-6 had a variable
effect on the osteoclastic resorption in the
three groups. It led to a significant decrease
in osteoclastic resorption in patients with
acute Charcot osteoarthropathy and to a
non-significant decrease in healthy con-
trols. Unexpectedly, it led to a significant
increase in bone resorption in patients with
diabetes.
The potential role of agents reducing
pro-inflammatory cytokines remains uncer-
tain in treatment of Charcot foot.
Source: Petrova NL,
et al
. The proinflammatory cytokines
TNF-
α
and IL-6 modulate RANKL-mediated osteoclas-
tic resorption in vitro in patients with acute Charcot
osteoarthropathy. Presentation 11.
FIELD study: fenofibrate reduction
of amputations explored
In this large study of type 2 diabetes patients
on treatment with co-micronised fenofibrate
200 mg per day, foot sensation as measured
by monofilament test improved. This is likely
to be the basis of the 37% reduction in
amputations found in the added fenofibrate
arm of the FIELD study.
The presence of peripheral neuropathy
was assessed by standard 10-G monofila-
ment at baseline, year two, and at study
close after five years; 17.2% of participants
had features of peripheral neuropathy
at baseline (1 125 with symptoms only,
564 had abnormal monofilament assess-
ment).
Prevalence of abnormal monofilament
test at the end of the study was signifi-
cantly lower in the fenofibrate arm (6.9 vs
8.2%). The NNT to avoid a first on-study
amputation over the five-year study was
only 16.
Source: Keech AC,
et al.
Predictors of peripheral neu-
ropathy and effects of fenofibrate among 9,795 sub-
jects with type 2 diabetes: the fenofibrate intervention
and event lowering in diabetes (FIELD) study. Presenta-
tion 180.
Cardiovascular diary for 2012 congresses
DATE
PLACE
CONFERENCE
1–3 February
New Orleans, USA
Internatioanl Stroke Conference
18 February
Frankfurt, Germany
TrenD 2012 – Transcatheter renal denervation
18–21 April
Dubai, United Arab Emirates
World Congress of Cardiology
3–5 March
Southern Sun Cape Sun, Cape
Town, South Africa
17th Biennial Congress of the SA Hypertension Society Congress (SAHS)
17–20 May
Berlin, Germany
Congress on cardiac problems in pregnancy (CPP 2012)
27 June
Frankfurt, Germany
ICI 2012 – Imaging in cardiovascular interventions
28 June
Frankfurt, Germany
CSI 2012 – Catheter interventions in congenital and structural heart disease
19–22 July
Sun City, South Africa
13th Annual SA Heart Congress
25–29 August
Munich, Germany
2012 ESC – European Society of Cardiology Congress
