Disabled Resource Team

Study for Treatment of Autism in Adolescents. Nasal Oxytocin vs. Placebo!

No significant differences were noted on caregivers' or clinicians' observation measures, but parents who believed their child received oxytocin reported greater improvements.

Nasal oxytocin's popularity among consumers is evidenced by >200,000 Google hits, >46,000 Google scholar citations, and 175 products available on Amazon.com (accessed 8/9/14). The widespread interest, especially as a treatment for autism in children, contrasts with the paucity of repeated-dose trials in children, although single-dose studies had promising results (NEJM JW Psychiatry Dec 23 2013). In a randomized, double-blind, placebo-controlled study, researchers in Australia examined the efficacy of oxytocin nasal spray (18–24 IU) twice-daily for 8 weeks in 50 high-functioning autistic adolescent boys (age range, 12–18 years; active treatment, 26 boys; placebo, 24). Children were assessed by caregivers' and clinicians' observation measures at baseline, 4 and 8 weeks, and 3-month follow-up.

No significant differences were noted between groups on the primary outcome measures — change in caregiver-reported social responsiveness and clinician-rated global improvement — or on most secondary measures. Of note, parents who believed that their children were on active medication reported greater improvements, but most of these instances were in children who actually received oxytocin. The only serious adverse effect was in one placebo recipient.

Comment

This investigation did not include evaluation of oxytocin plasma levels or genetic polymorphisms. These are relevant because recent data suggest that heritable oxytocin plasma level and oxytocin gene variants affect social functioning in both healthy and autistic children (Proc Natl Acad Sci U S A 2014; 111:12258). Thus, future studies of nasal oxytocin that include plasma and genetic measures might help identify predictors of response.

Parents of autistic children frequently inquire about oxytocin treatment. They can now be informed that nasal oxytocin treatment is not yet scientifically based, but is not known to cause immediate serious adverse effects.

Dated:August 22, 2014
Source:NEJM
Reviewed by:Barbara Geller, MD

Experimental Treatment for Marburg Virus Shows Promise in Primates

An experimental treatment resulted in 100% survival in primates infected with Marburg virus, a filovirus — like Ebola — that causes hemorrhagic fever, according to a study in Science Translational Medicine. Currently, there are no Marburg vaccines or treatments approved for human use.

Twenty-one rhesus macaques were infected with lethal doses of Marburg-Angola virus. Sixteen were given 7 daily intravenous doses of the treatment, a lipid-encapsulated, small-interfering RNA that interferes with how the virus grows once it enters a cell.

By day 9, all monkeys given the control treatment had died, whereas all animals given the active treatment survived, even those who didn't start treatment until 72 hours after infection, when clinical symptoms tend to appear.

The researchers, some of whom hold a patent for the therapy studied, previously published research showing that a similar approach protected monkeys from Ebola virus.

Author:Kelly Young
Dated:August 21, 2014
Source: NEJM
Edited: Susan Sadoughi, MD