COLUMBUS, Ohio – It’s no secret that exercise improves mood, but new research suggests that working out to music may give exercisers a cognitive boost.

Listening to music while exercising helped to increase scores on a verbal fluency test among cardiac rehabilitation patients.

“This is the first study to look at the combined effects of music and short-term exercise on mental performance,” said Charles Emery, the study’s lead author and a professor of psychology at Ohio State University.

“Evidence suggests that exercise improves the cognitive performance of people with coronary artery disease,” Emery said. “And listening to music is thought to enhance brain power. We wanted to put the two results together.”

Those results appear in a recent issue of the journal Heart & Lung.

The study included 33 men and women in the final weeks of a cardiac rehabilitation program. Most participants had undergone bypass surgery, angioplasty or cardiac catheterization.

Coronary artery disease may compromise cognitive ability, Emery said; that’s why he and his colleagues chose cardiac rehabilitation patients for this study.

The researchers asked participants to complete a verbal fluency test before and after two separate sessions of exercising on a treadmill. The workouts were scheduled a week apart and lasted about 30 minutes. Participants listened to classical music – Vivaldi’s “The Four Seasons” – during one of the sessions.

“We used ‘The Four Seasons’ because of its moderate tempo and positive effects on medical patients in previous research,” Emery said. “But given the range of music preferences among patients, it’s especially important to evaluate the influence of other types of music on cognitive outcomes.”

As a way to measure anxiety and depression, participants completed a 30-item checklist before and after exercise. The list included adjectives to describe the patient’s current mood. The researchers also tested each person’s verbal fluency before and after each exercise session by asking participants to generate lists of words in specific categories.

“This kind of task challenges the part of the brain that handles planning and abstract thought as well as a person’s capacity for organized verbal processing,” Emery said.

Participants reported feeling better emotionally and mentally after working out regardless of whether or not they listened to music. But the improvement in verbal fluency test performance after listening to music was more than double that of the non-music condition.

“Exercise seems to cause positive changes in the nervous system, and these changes may have a direct effect on cognitive ability,” Emery said. “Listening to music may influence cognitive function through different pathways in the brain. The combination of music and exercise may stimulate and increase cognitive arousal while helping to organize cognitive output.”

Emery conducted the study with Evana Hsiao and Scott Hill, both with Ohio State, and David Frid of Pfizer, Inc.

A grant from the National Heart, Lung and Blood Institute helped fund this research.

Contact: Charles Emery, (614) 688-3061; Emery.33osu.edu
Holly Wagner, (614) 292-8310; Wagner.235osu.edu

Physical rehabilitation has traditionally consisted of arduously retraining the body on weight machines and other resistance devices, but with the growing interest in “smart fluids,” NU engineering professor Constantinos Mavroidis envisions a simple brace that can increase the resistance on a healing joint with the turn of a dial.

“Smart fluids,” is a generic term for any particle-filled, oil-based suspension which changes its consistency in a magnetic or electric field. Mavroidis is working with electro-rheological fluids (ERFs) which go from liquid to solid the instant an electric field is applied; remove the field and the paste-like substance reverts to liquid.

The possible applications for ERFs have exploded over the last decade, including automotive technology and industrial uses, and Mavroidis and his co-researchers have already developed prototypes for a leg brace that could increase pressure on a joint simply by increasing the voltage from a small battery. Mavroidis is optimistic about starting human trial this fall in association with Spaulding Rehabilitation Hospital in Boston.

The power of smart fluid could transform the rehabilitation process for millions of people. According to the National Health Interview Survey on Assistive Devices, 3.5 million individuals in the United States have used orthotic devices for rehabilitation or mobility assistance. Currently, the most effective types of orthoses consist are often noisy, cumbersome, or difficult to conceal. ERF-powered orthothics, which are efficient and streamlined, would revolutionize rehabilitation therapy.

Northeastern University, located in the heart of Boston, Massachusetts, is a world leader in cooperative education and recognized for its expert faculty and first-rate academic and research facilities.

Through co-op, Northeastern undergraduates alternate semesters of full-time study with semesters of paid work in fields relevant to their professional interests and major, giving them nearly two years of professional experience upon graduation.

The majority of Northeastern graduates receive a job offer from a co-op employer. Cited for excellence in programs integrating classroom and work place experience two years running by U.S. News & World Report, Northeastern was named a top college in the northeast by the Princeton Review 2003/04. In addition, Northeastern’s career services was awarded top honors by Kaplan Newsweek’s “Unofficial Insiders Guide to the 320 Most Interesting Colleges and Universities,” 2003 edition.

For more information, please visit northeastern.edu
Contact:Genevieve Haas 617-373-5470
G.haasneu.edu

Extending supervised outpatient rehabilitation by six months helps elderly patients more fully recover from hip fractures, according to the first controlled study of its kind. The study also showed for the first time that these patients, previously thought to be too frail for weight training, can benefit from progressive resistance exercise training.

The study, conducted by researchers at Washington University School of Medicine in St. Louis, challenges the current standard therapy. It will appear in the Aug. 18 issue of the Journal of the American Medical Association.

“Hip fractures are a very prevalent problem in the elderly, and research shows that most patients have significant difficulty performing daily activities even after the standard four to 16 weeks of home-based therapy,” says principal investigator Ellen F. Binder, M.D., assistant professor of medicine in the Division of Geriatrics and Nutritional Sciences and staff physician at Barnes-Jewish Hospital. “Our goal is to help elderly hip fracture patients live independently in their own homes for as long as possible, which is usually an important component of their quality of life.”

Typically, rehabilitation, covered by Medicare and most third-party insurance plans, involves up to 16 weeks of therapy conducted in the home, but most patients do not get referred to outpatient facilities after that.

Binder’s team randomly assigned 90 hip fracture patients who had just completed the standard course of acute therapy to one of two groups: One group received six months of supervised physical therapy and exercise training, while the other group received instructions and brief training in exercises to be performed at home for six months.

The supervised rehabilitation program consisted of two consecutive phases that lasted a total of 6 months. Participants attended three exercise sessions per week on site at Washington University in both phases of the program.

Exercises in the first phase were conducted in a group format and focused on flexibility, balance, coordination, motor speed and, to a modest extent, strength. Therapists adapted exercises for each individual’s needs and made them progressively more difficult as patients improved.

During the second exercise phase, progressive resistance training using weight machines was added.

The home-based therapy group received a prescribed home-exercise program based on standard approaches to hip-fracture rehabilitation. After a one-hour training session, participants were instructed to perform a series of exercises on their own at home at least three times per week, with one follow-up training session per month. This group did not perform any weight-training exercises.

Participants in both groups were prescribed standard dosages of calcium and vitamin D replacement therapy. The researchers not only took measurements of the participants’ muscle strength, balance and flexibility, they also evaluated functional improvements using standardized tests of daily tasks and physical abilities directly relevant to mobility. They also took measurements of bone density.

Participants who received supervised rehabilitation therapy that included resistance training improved on functional, strength, balance, mobility and quality of life measures significantly more than those who received a prescribed, home-based regimen. In addition, for participants in both groups, bone density did not decline over the course of the study. Previous research has shown that bone density declines up to four percent in the first year after a hip fracture.

“The most important thing about our study is that we show functional improvements,” Binder says. “It’s great to improve strength and balance, but the key is whether that translates into being able to do more with less outside help.”

Binder EF, Brown M, Sinacore DR, Steger-May K, Yarasheski KE, Schechtman KB. Effects of extended outpatient rehabilitation after hip fracture. Journal of the American Medical Association, Vol. 292(7), pp. 837-846, Aug. 18, 2004.

Funding from the National Institute on Aging, the Washington University General Clinical Research Center, the Washington University Clinical Nutrition Research Center and the Barnes-Jewish Hospital Foundation supported this research.

Washington University School of Medicine’s full-time and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked second in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

Contact: Gila Z. Reckess
reckessgwustl.edu
314-286-0109
Washington University School of Medicine

The study of 1,821 patients from Olmsted County, Minn., who had heart attacks between 1982 and 1998 and survived to go home from the hospital, found that nearly half (48 percent) of the deaths within three years of hospital discharge were attributable to not participating in cardiac rehabilitation.

“On average, for patients who participated in cardiac rehab, it was almost as if the heart attack never had happened. They had the same three-year survival as what would be expected from area residents of the same age and sex who had not suffered heart attacks,” says Veronique Roger, M.D., the Mayo Clinic cardiologist who led the study. “Increased participation in cardiac rehabilitation could lead to improved survival among a large proportion of heart attack patients.”

Cardiac rehabilitation is a medically supervised exercise program that helps patients regain strength after a heart attack, bypass surgery or angioplasty. Olmsted County’s cardiac rehab participation is higher than the national average, so this study highlights the significant potential nationwide for improving survival if more patients get into exercise programs.

Women tend to have their heart attacks at older ages, and both women and elderly patients in the study had more accompanying illnesses that made exercise more difficult. But Dr. Roger says women still were less likely to participate in cardiac rehab, even after taking these factors into account.

“Our study was not designed to answer exactly why some groups are less likely to participate, but some key issues for women may be a lack of transportation and support networks,” says Dr. Roger. “They may not see rehab as important, or they may need to care for a spouse who may also be ill.

“Hopefully this study will encourage physicians to give all of their patients, but especially women, that extra nudge to participate in rehab. And for patients, hopefully it will encourage them to follow their doctor’s advice. There needs to be a partnership between the patient and the physician. Participation in cardiac rehab is one very important element of an effective treatment plan,” Dr. Roger concludes.

Other authors of the paper include Brandi Witt, M.D.; Steven Jacobsen, M.D., Ph.D; Susan Weston; Jill Killian; Ryan Meverden; Thomas Allison, Ph.D.; and Guy Reeder, M.D.

To obtain the latest news releases from Mayo Clinic, go to www.mayoclinic/news. MayoClinic (www.mayoclinic) is available as a resource for your health stories. For more information about research at Mayo Clinic, go to www.mayo.edu/research.

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Contact: Lee Aase
newsbureaumayo.edu
507-284-5005
Mayo Clinic

Routine physiotherapy for mild to moderate low back pain is no more effective than a single advice session with a physiotherapist, finds a study in this week’s BMJ (British Medical Journal).

Physiotherapists in the British NHS treat around 1.3 million people for low back pain each year, but there is very little evidence for its effectiveness. International guidelines vary but generally recommend advice to remain active.

The study involved 286 patients with low back pain of more than six weeks’ duration; 144 received therapy and 142 received advice only. Level of disability was measured at two, six, and 12 months. Patient perceived benefit of treatment was also assessed.

Patients in the therapy group were more likely to report benefits from treatment, but there was no evidence of a long term effect of physiotherapy. There were no differences in disability scores between the groups at 12 months.

Routine physiotherapy seems to be no more effective than one session of assessment and advice from a physiotherapist, conclude the authors.

Contact:

Sarah Stewart-Brown, Professor of Public Health, University of Warwick, UK

(Randomised controlled trial of physiotherapy compared with advice for low back pain)
bmj/cgi/content/full/329/7468/708

(Editorial: Back pain and physiotherapy)
bmj/cgi/content/full/329/7468/694

Susan Taylor, 29, from Edinburgh, Scotland has been jailed for three years for putting methadone – a heroin substitute – in a baby’s pacifier (dummy) to stop him crying. Ms. Taylor admitted to a charge of culpably and recklessly causing the baby to ingest methadone, to the danger of his life in November, 2008.

Ms. Taylor said he was a “grumpy” baby. She says she rolled the pacifier in her methadone measuring cup before putting it in his mouth. He sucked on it for about five minutes and then passed out – his faced turning gray and his lips blue.

The 10-week-old child almost died, the court heard. A “huge” quantity of methadone was found in the baby’s urine. Advocate depute Morag Jack, prosecuting, told the High Court in Edinburgh that it is too early to tell whether the child will suffer any lasting effects.

The case could not be reported until today because her partner was facing trial – she had admitted the charge in September, 2009.

Lynn Cowan, 28, was also jailed because Ms. Taylor had told her she had given the baby methadone – information she failed to pass on to doctors when they took him to the Royal Hospital for Sick Children.

The baby cannot be identified for legal reasons. The court was told the baby is no longer in the care of either woman.

Sequence of events:

Baby cries a lot.
Taylor gives baby methadone to stop the crying.
Baby passes out.
Cowan comes in wondering what is wrong with the baby.
Taylor tells Cowan what happened.
They take the baby to hospital, but neither of them tells the doctors about the methadone.
A urine test reveals tells doctors there is methadone in the baby’s system.

What is methadone?

Methadone is a synthetic opiate, commonly used as a legal substitute for heroin in treatment programs for (heroin) drug addiction.

Although medical rehabilitation patients are spending less time as inpatients at facilities, their functional outcomes
have not declined. However, the death rate following discharge has increased nearly 4 percent from 1994 to 2001, according to
a study in the October 13 issue of JAMA.

Changes in reimbursement have reduced length of stay (LOS) for patients receiving inpatient medical rehabilitation, according
to background information in the article. The impact that reduced LOS has had on rehabilitation outcomes including functional
status, living setting, and death has not been known.

Kenneth J. Ottenbacher, PhD, O.T.R., of the University of Texas Medical Branch, Galveston, Texas, and colleagues examined
changes in LOS for persons receiving inpatient medical rehabilitation from 1994 through 2001. The researchers analyzed
information from the Uniform Data System for Medical Rehabilitation. In addition to exploring trends in LOS for 5 major
impairment groups (stroke, brain dysfunction, other neurologic conditions, spinal cord dysfunction [traumatic and
nontraumatic], and orthopedic conditions), the researchers also examined changes in rehabilitation effectiveness, efficiency,
discharge to home, living setting at 3- to 6-month follow-up, and death. The authors hypothesized that decreasing LOS would
be associated with reduced functional status and decreased community living at follow-up.

The study included 744 inpatient medical rehabilitation hospitals and centers located in 48 U.S. states. A total of 148,807
patient records were examined. The patients’ average age was 67.8, the sample was 59 percent female and 81 percent
non-Hispanic white.

The researchers found that the LOS decreased from 20 to 12 days from 1994 to 2001. The proportional decrease in average LOS
was greatest (42 percent) for patients with orthopedic conditions. Functional status was clinically stable, while efficiency
(functional status change divided by LOS) increased significantly. Rates of discharge to home and living at home at follow-up
remained stable, ranging from 81 percent to 93 percent. However, mortality at 80- to 180-day follow-up increased from less
than 1 percent in 1994 to 4.7 percent in 2001.

“No clinically significant change in daily living skills such as dressing and bathing was seen, despite a significant
reduction in LOS,” the authors write. “Determining the causes of the increase in rehabilitation efficiency and mortality
requires further study. Our goal was to document the recent change in LOS and examine its association with functional status,
living setting, and mortality. This goal is important in view of the introduction of a prospective payment system for
inpatient medical rehabilitation by Centers for Medicare & Medicaid Services in January 2002. Our findings provide a baseline
with which to compare future LOS, effectiveness, efficiency, mortality, and other outcomes important to health care
professionals, researchers, and consumers to help evaluate how change in LOS influences patient care and outcomes.”

(JAMA. 2004; 292:1687-1695. Available post-embargo at www.jama)

Editor’s note: This research was supported by grants from the National Institutes of Health.

Editorial: Inpatient Rehabilitation Outcome Trends – Implications for the Future

In an accompanying editorial, Peter C. Esselman, M.D., of the University of Washington and Harborview Medical Center,
Seattle, writes that perhaps the most provocative finding, as well as the outcome most difficult to explain in the study by
Ottenbacher et al is the increase in the death rate.

“That mortality increased in all the impairment groups would indicate that some factor influencing mortality is common to
different diagnostic groups. Potential factors related to increased mortality such as more comorbidities, older age, or lower
admission Functional Independence Measure score were not significantly different,” he writes. “The medical stability of the
patients admitted over this time may have changed due to the pressure to decrease the acute care LOS and to move patients to
inpatient rehabilitation earlier in their recovery.”

“In summary, the reason for increased mortality over time remains obscure but may reflect changes in admission criteria and
medical stability of patients admitted to inpatient rehabilitation facilities that were not measured in the study by
Ottenbacher et al. The relationship between earlier acute care discharge, rehabilitation admission criteria, and LOS requires
further study to understand changes in mortality,” Dr. Esselman writes.

(JAMA. 2004; 292:1746-1748. Available post-embargo at www.jama)

Contact: Jennifer Reynolds-Sanchez
409-772-6397
JAMA and Archives Journals Website

A new folding, commode-shower wheelchair developed by Milwaukee and Tampa VA researchers, addresses a clear need of the
more than 200,000 people with spinal cord injuries and other individuals with disabilities in the United States, most of whom
require a special commode wheelchair for personal hygiene.

The wheelchair is the first commercial product collaboratively designed by researchers at the Milwaukee Institute of Art &
Design (MIAD), the Veterans Affairs Medical Centers in Milwaukee, and Tampa, and the Medical College of Wisconsin in
Milwaukee. It address the serious problems of injuries and falls posed by current commode-shower wheelchairs while adding
esthetic design and function that can significantly improve the quality of life for these and other wheelchair-bound
patients.

The wheelchair’s development was funded by $230,000 in merit grants from the Merit Intramural Research Program of the
Department of Veterans Affairs in Washington DC, and jointly patented with the Medical College of Wisconsin Research
Foundation. A commercial version of the wheelchair will be displayed for the first time on Oct. 26, 2004, at the Medtrade
show in Orlando. The wheelchair will be produced commercially by Activeaid, Inc., located in Redwood Falls, Minn.

According to Joseph Hill, Ph.D., director of the Medical College of Wisconsin Research Foundation, “This unique collaboration
enabled the team to develop a useful product that addresses need, function, and aesthetics. The last piece was an experienced
technology transfer office to help identify an appropriate commercial partner and put in place a reasonable patent license
agreement. This required managing expectations, bridging the designer’s vision and the company’s knowledge of the
marketplace. So, with a little give and take, the well conceived, assistive device will be competitively priced.”

“Current wheelchairs have serious problems that can contribute to significant health complications. Yet little design
research focusing on this problem has been done until now,” says Pascal Malassignй, professor of industrial design at MIAD
and the lead research industrial designer at the Milwaukee VA Medical Center.

A survey conducted by the design team revealed that 42 percent of veterans with spinal cord injuries consider the brakes on
existing commode wheelchairs to be ineffective. More than 47 percent felt unsafe when transferring to a commode wheelchair
and more than 35 percent reported one of more falls from commode-shower wheelchairs. Of those, more than 23 percent were
hospitalized for between one month and four years from the fall.

These problems were brought to the attention of Prof. Malassignй by Audrey Nelson, R.N., Ph.D., director of the Patient
Safety Center at Tampa VA Medical Center, who had been treating veterans with spinal cord injuries. Later, Prof. Malassignй
and his design team rolled out prototypes of a folding wheelchair for use over a toilet and in the shower. Patients who tried
the prototypes considered them far superior to their current wheelchairs. Ninety-five percent wanted one for home use and 89
percent would use them on trips. Joining Malassignй on the design team on this project were Dr. Nelson, at the Tampa VA
Medical Center, and Robert P. Jensen, then industrial designer in the department of physical medicine & rehabilitation at the
Medical College, and a MIAD instructor.

“For the more than 200,000 persons with spinal cord dysfunction in the United States and the countless other Americans living
with a disability, this newly designed commode-shower wheelchair is a safe and dignified way to manage basic hygiene needs”,
says Dr. Nelson, past president of the American Association of Spinal Cord Injury Nurses. “Designed to maximize patient
independence and reduce caregiver strain, this new wheelchair will reduce falls and prevent pressure ulcers which were all
too common in other commode-shower wheelchair designs”, she adds.

Activeaid has been manufacturing quality medical equipment since 1963, specializing in shower commode wheelchairs, bath
chairs, and tilt chairs for the rehabilitation market. Their products are designed in collaboration with clinicians, patients
and caregivers. With 40 employees in Redwood Falls, and 40 sales representatives across the United States the company will
use “just-in-time” manufacturing procedures to produce up to 40 commode-shower wheelchairs per week beginning in November
2004.

The wheelchairs will be distributed in Wisconsin by National Seating and Mobility, Inc., and Westhill Rehab from their
locations in Appleton, Madison, Franklin, Oak Creek and Wauwatosa. Some of first wheelchairs will be placed in the Spinal
Cord Injury Center of the Milwaukee and Tampa VA Medical Centers and the Spinal Cord Injury Center at Froedtert Hospital in
Milwaukee. Froedtert is a major teaching facility of the Medical College.

Chip Nearing, Activeaid’s Vice President and COO, notes “This product is a tremendous opportunity for our company – it fits
perfectly within our core business. We are pleased to help provide the Department of Veterans Affairs and the Medical College
a return on their R&D investment.”

“It is fitting that the largest purchaser of the wheelchair will likely will be the U.S. government, through VA hospitals and
Medicare reimbursements, which funded the wheelchair’s development,” Dr. Hill says.

Medical College of Wisconsin
8701 Watertown Plank Rd.
Milwaukee, WI 53226
United States
Phone 414-456-4700
Fax 414-456-6550
mcw.edu

Retina specialists and ophthalmologists are encouraged by promising new scientific approaches that could have the
potential to reduce the devastating effects of wet AMD for patients and offer the medical community a new paradigm of care,
according to presentations made at the 2004 Annual Meeting of the American Academy of Ophthalmology in New Orleans.

Many experts consider AMD, the leading cause of blindness in Americans over age 50, as a growing public health epidemic.
Diagnoses for AMD are expected to double by 2020.

“The epidemic of AMD is fueled by the aging Baby Boomers, the fact that people are living longer, and the increasing
incidence of the disease,” said presenter Paul Sternberg Jr., M.D., Chairman of the Vanderbilt Eye Institute. “Fortunately,
new approaches to treating the disease may soon become available with several therapies in late-phase clinical trials or
pending FDA approval showing great promise for stabilizing wet AMD and preserving vision.”

Saving Eyes, Saving Lives: The Physical and Emotional Impact of Vision Loss

AMD is a chronic, progressive disease that results in the loss of central vision. As the disease advances, simple tasks such
as reading, writing NEW ORLEANS, LA, October 25, 2004 – As more Americans age, the threat of blindness is increasing, and the
search for new ways to prevent and treat diseases such as age-related macular degeneration (AMD) has become a high priority
in the eye care community., recognizing faces and driving become difficult, if not impossible. The disease not only takes a
physical toll on its patients, but also can have a devastating emotional impact on them, their families and caregivers.

“Even a little vision loss to a fully sighted adult can compromise function more globally than any other impairment,
increasing the risk of falls and injuries, medication mix-ups, poor nutrition, social isolation and clinical depression,”
said presenter Lylas G. Mogk, M.D., founding director of the Visual Rehabilitation and Research Center at the Henry Ford
Health System Eye Care Services. “For most people, losing both legs would actually impact our lives less than losing our
central vision. So it’s not a surprise that sighted Americans fear vision loss second only to loss of mental capacity.”

Living with vision loss does not have to be such a lonely and isolating experience. Today, vision rehabilitation services are
available to maximize independence and preserve quality of life for the hundreds of thousands of Americans living with
age-related macular degeneration. Between six and ten percent of patients with AMD progress to the wet form of the disease,
characterized by the growth of abnormal blood vessels. Currently only 25 percent of patients with wet AMD have a treatment
option approved by the U.S. Food and Drug Administration (FDA). In addition to vision rehabilitation, innovations in
biotechnology have the potential to fill the large unmet medical need by offering new treatments to wet AMD patients.

Hope on the Horizon: Anti-VEGF, Anti-Angiogenic and Angiostatic Treatments

Dr. Carmen A. Puliafito, Chairman of the Bascom Palmer Eye Institute at the University of Miami, said that a new treatment
paradigm for wet macular degeneration is emerging. This new treatment paradigm is based on the use of drugs which block VEGF
(vascular endothelial growth factor), the molecule which promotes the growth of abnormal blood vessels in wet macular
degeneration. These drugs can be delivered directly into the eye by injection and attack abnormal VEGF in the retina and
adjoining tissues in eyes with wet macular degeneration.

“There are several reasons why anti-VEGF treatment for macular degeneration is so exciting. For the first time, we will have
a treatment option for all new cases of wet age-related macular degeneration; right now we only treat a limited number of
angiographically defined subtypes,” said Dr. Puliafito. “These agents also offer a unique strategy for restoring retinal
function and structure in eyes with wet AMD.”

Evaluating Emerging Wet AMD Therapies: Is a Bright Future Ahead?

Data presented at this year’s American Academy of Ophthalmology meeting show that significant progress is being made to bring
new therapies to wet AMD patients at the earliest possible time.

Two anti-VEGF treatments currently in development include pegaptanib sodium (to be marketed as MacugenTM by Eyetech
Pharmaceuticals and Pfizer Inc), an anti-VEGF aptamer that binds to one particular form of VEGF in the eye, thereby
neutralizing its activity, and ranibizumab (to be marketed as LucentisTM by Genentech Inc and Novartis Ophthalmics), an
antibody fragment that also binds to VEGF and inhibits its activity. New clinical trial data on pegaptanib presented during
the Retina Subspecialty symposium showed that wet AMD patients benefit from two years of treatment with pegaptanib, which
demonstrates that longer-term use may be beneficial for patients suffering from this chronic disease. Pegaptanib is currently
under priority review by the FDA and the agency expects to make its decision on the drug by mid-December. Genentech’s
ranibizumab is currently in phase III clinical trials.

Data from another investigational treatment known as anecortave acetate, an angiostatic cortisene that inhibits the abnormal
growth of blood vessels, was also presented at the AAO meeting. Initial analysis of the one-year data from a comparative
study of anecortave acetate versus photodynamic therapy in the treatment of wet AMD showed there was no statistical
difference between the two therapies. Additional analyses of treatment interval and drug reflux, two controllable factors
that some say negatively affected the results, were presented during the meeting. The company is continuing to analyze the
data and plans to submit its New Drug Application to the FDA by the end of the year.

Donald D’Amico, M.D., professor of ophthalmology at Harvard University and associate chief of ophthalmology for clinical
affairs at the Massachusetts Eye and Ear Infirmary, is optimistic about the future of treatment. “The future looks brighter
for people with wet AMD,” said D’Amico. “Investigational therapies have the potential to usher in a new era in treatment for
wet AMD and offer hope to patients where once there was little or none. Patients have been waiting for new treatment options
and the data presented at this meeting show that we are getting closer to making these important new therapies available to
wet AMD patients and the physicians who treat them.”

The American Academy of Ophthalmology is the world’s largest association of eye physicians and surgeons–Eye M.D.s–with more
than 27,000 members.

Please Note: Media relations staff are unable to answer inquiries from the general public. If you want more information on
eye health, please visit our partner Web site, the Medem Network, at medem/eyemd.

Contact: Media Relations
mediaaao
415-561-8534
American Academy of Ophthalmology

View drug information on Photodynamic Therapy.

There need to be better rehabilitation services for those who go blind, according to the course director at the RNIB school of Rehabilitation Studies for the University of Central England.

Richard Cox wants legislation to be introduced that will make it compulsory for blind people to be offered rehabilitation care and support.

Speaking on BBC Radio Four’s ‘In Touch’, Mr Cox called for a policy that would force local authorities to provide an adequate level of services for the blind.

“The fact is that there is no law that directly says that blind or partially sighted people should get rehabilitation to help them,” said Mr Cox

“There are different laws about in general what people who have disabilities should get in the way of help. But no one, for example, says that a local authority must employ someone who can teach blind or partially sighted people how to cross the road.”

Mr Cox also raised concerns that there is a national shortage of rehabilitation officers. He said that figures from the RNIB suggest more than 100 people a day are losing their sight, but there are only 700 specialist rehabilitation workers to deal with them.

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