Tag: 2/10/25

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Common Arthritis Drug Reveals Hidden Benefit

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Methotrexate, a common medication used to treat rheumatoid arthritis, has a newly recognised useful secondary effect to lower blood pressure and potentially reduces the risk of heart disease in people with this condition.

A new study, led by Flinders University and Southern Adelaide Local Health Network (SALHN) researchers, has shown that methotrexate significantly lowers blood pressure when compared to another arthritis drug, sulfasalazine. The findings, published in Annals of Medicine, mark the first clear evidence of this effect in newly diagnosed patients.

Occurring in about one in 100 people, rheumatoid arthritis (RA) is a common autoimmune disease which leads to inflammation and pain in the connective tissue of a patient’s joints.

Over six months, the South Australian and Italian researchers followed 62 newly diagnosed adults who had not yet started treatment.

Half were given methotrexate and the other half received sulfasalazine. Researchers then measured their blood pressure, joint inflammation, and stiffness in their arteries at the beginning of the study, then again after one and six months.

Lead author of the study, Professor Arduino Mangoni, from Flinders University’s College of Medicine and Public Health, and SALHN’s Department of Clinical Pharmacology, says they wanted to see if methotrexate could lower systolic blood pressure, which indicates how much pressure your blood is exerting against artery walls when your heart beats.

“We found that methotrexate lowered systolic blood pressure by an average of 7.4mmHg compared with people taking sulfasalazine,” says Professor Mangoni, Strategic Professor of Clinical Pharmacology.

“This kind of reduction is considered meaningful because even a small drop in blood pressure can lower the risk of serious heart problems like heart attacks and strokes.”

Interestingly, this benefit did not seem to be linked to changes in either arthritis symptoms or the stiffness of arteries, suggesting that it might be helping the heart in other ways, like calming inflammation or improving how blood vessels work.

Professor Arduino says the findings are exciting because they show methotrexate might do more than just treat rheumatoid arthritis.

“We’ve known for a while that methotrexate helps with inflammation, but now we’re seeing that it may also help lower blood pressure, which is a major risk factor for heart disease,” he says.

“This could be a big step forward in how we care for people with rheumatoid arthritis.”

The researchers also looked at how genetics might play a role in how well methotrexate works and found that certain genetic traits made some people more likely to experience a drop in blood pressure while taking the drug.

“In short, if someone has specific gene variants, methotrexate might add a heart health benefit to its usual role in treating rheumatoid arthritis by the positive effect on blood pressure,” he says.

The researchers say that this opens the door to more personalised treatment options, where doctors could use genetic testing to predict who might benefit most from methotrexate’s heart-protective effects.

Study coordinator and medical scientist, Dr Sara Tommasi, says that although more research is needed to confirm these findings and understand exactly how methotrexate lowers blood pressure, the results are promising.

“The results suggest that this well-known arthritis drug could also play a role in protecting heart health, especially in people who are at higher risk due to inflammation,” says Dr Tommasi from the College of Medicine and Public Health and South Adelaide Local Health Network.

Source: Flinders University

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SAHPRA Clarifies that Paracetamol is Safe to Use in Pregnancy, at Recommended Doses

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Pretoria, 28 September 2025 – The South African Health Products Regulatory Authority (SAHPRA) wishes to reassure the public that paracetamol remains a safe and recommended option for the relief of pain and fever during pregnancy, when used short-term at recommended doses.

Paracetamol is one of the most widely used medicines globally and has been extensively studied for decades. There is currently no scientific evidence that using paracetamol in pregnancy causes attention-deficit hyperactivity disorder (ADHD) and autism.

SAHPRA will continue to monitor emerging evidence on the safety of paracetamol.

Advice for healthcare professionals

Paracetamol remains a recommended safe treatment for pain or fever in pregnant women. Pregnant women should be reassured that there is no evidence that taking paracetamol during pregnancy causes autism or ADHD in children. Healthcare professionals are encouraged to provide counselling to patients about the side effects of paracetamol, as detailed in the product’s professional information and patient information leaflet (https://pi-pil-repository.sahpra.org.za/).

Advice for healthcare professionals to provide to patients

Pregnant women and those planning a pregnancy should be advised to use paracetamol only when needed and at the lowest effective dose for the shortest possible time. Untreated fever and pain may pose risks to the unborn baby, and it is therefore important to seek treatment if recommended by a healthcare professional. Pregnant women should consult a healthcare professional if pain or fever persists or if they have any concerns about medicine use during pregnancy. Pregnant women should also be advised to avoid combining paracetamol with other medicines without first seeking medical advice.

Report any suspected adverse drug reactions

Healthcare professionals and members of the public are urged to report any suspected adverse drug reactions (ADRs) related to the use of paracetamol and other health products to SAHPRA via the eReporting link available on the SAHPRA website (www.sahpra.org.za) or complete an ADR reporting form accessible via the SAHPRA website and email it to adr@sahpa.org.za. Alternatively, reporting can be done via the Med Safety App, downloadable through Google Play or the Apple App Store.

SAHPRA remains committed to ensuring the safety of medicines available in South Africa and will update the public if new scientific evidence changes current recommendations.

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Rooibos Extracts Demonstrate Protective Effects in Preliminary Breast Cancer Research

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Rooibos, South Africa’s beloved herbal tisane, with proven benefits for the heart, diabetes management and brain health, is now revealing even more potential in preliminary breast cancer research led by Dr Nicky Verhoog, senior lecturer of biochemistry at Stellenbosch University.

Caption: Dr Nicky Verhoog, senior lecturer of biochemistry at Stellenbosch University.

Oestrogen’s role in breast cancer

While the research is still in its early stages, initial findings suggest that Rooibos extracts may counteract the activity of oestrogen in breast cancer cells – a discovery that has prompted the South African Rooibos Council (SARC) and the Department of Science, Technology and Innovation (DSTI) Sector Innovation Fund Programme to continue to support the work of Dr Verhoog with further studies in animal models scheduled to begin next year.

Oestrogen is often described as a kind of driver of breast cancer growth, because many breast cancer tumours carry receptors that respond to it. Although oestrogen doesn’t always start the cancer, it can speed up its growth once the disease has developed. Some newer studies also show that it may sometimes play a more direct role in triggering changes in cells that lead to cancer. Because so many breast cancers are sensitive to oestrogen, the possibility that Rooibos might help block its effect makes these findings especially significant.

Breast cancer in South Africa

Breast cancer remains a major health concern in the country. According to the latest statistics, between 11 000[1] and 15 000[2] women are diagnosed with breast cancer annually and the disease accounts for approximately 24% of all cancer cases in South African women. Early detection is critical – when identified at an early stage, breast cancer survival rates can exceed 90%, highlighting the importance of regular screening and self-examination.

Caption: Warning signs of breast cancer. Source: CANSA (cansa.org.za)

Rooibos under the microscope

Against this backdrop, Dr Verhoog’s team conducted an in vitro (cell) study to examine whether Rooibos could influence oestrogen receptor-positive breast cancer cells. In the past, there has been some uncertainty about whether Rooibos might interact with oestrogen in ways that could affect women with hormone-sensitive breast cancer. This study set out to clarify its role – whether Rooibos could potentially act like estrogen or conversely, help block its activity – and to assess whether it influences cancer cell behaviour.

“To better understand how Rooibos interacts with natural hormones like estrogen, our team wanted to gather clearer scientific evidence,”

Dr Verhoog explains. “We also looked at whether Rooibos could influence the growth and spread of cancer cells, which is especially important for women with hormone-sensitive breast cancer.”

In the laboratory, the researchers worked with well-known breast cancer cell models that carry two types of estrogen receptors: one that can encourage tumour growth (ERα) and another that helps to suppress it (ERβ). They then added Rooibos extracts to see how the cells would respond – in terms of growth, movement and spread.”

The results were encouraging. The extracts acted against oestrogen, in a way similar to fulvestrant, a treatment commonly used to block oestrogen activity in breast cancer treatment. Rooibos slowed down oestrogen-induced cell growth and prevented the cells from spreading. Interestingly, the extracts showed a preference for activating ERβ, the receptor associated with tumour suppression.

“Rooibos appears to act in a protective way against oestrogen-driven breast cancer cells in the lab. It doesn’t mimic oestrogen, but rather inhibits its action. Importantly, we also found that it didn’t interfere with the effect of tamoxifen, a standard breast cancer therapy, which suggests Rooibos could be safely consumed by women undergoing treatment. Of course, this needs confirmation through in vivo (animal) studies.”

Next steps: pre-clinical trials in 2026

While the findings are promising, Dr Verhoog stresses the limitations of in vitro research.

“Lab studies involve single cell types and don’t replicate the complexity of the human body,” she says. “We need to see how Rooibos behaves when metabolised in the body, which is why our next step is pre-clinical trials planned for 2026.”

The next phase of research will move beyond cell studies to look at how Rooibos behaves in a pre-clinical model system. This step is important to confirm its safety for women with oestrogen-sensitive breast cancer and to better understand its effects in the body. The aim is not to test Rooibos as a treatment, but to ensure that it can be safely enjoyed alongside conventional therapies.

Rooibos’s broader health benefits

Rooibos is already celebrated for its wide range of health benefits. Rich in antioxidants and free from caffeine and added sugars, it is a popular alternative to sugary drinks, contributing to overall hydration and general wellness. Previous studies have also highlighted its potential protective effects against other cancer types, including prostate, liver and colon cancers, thanks to its potent antioxidant properties.

“While we are still in the early stages, our research adds to the growing evidence of Rooibos’ multifaceted biological actions. It’s a step toward understanding how this uniquely South African tisane may support health in a variety of ways,” emphasises Dr Verhoog.

Experts stress that these findings should not be interpreted as evidence that Rooibos can prevent or treat breast cancer. Rather, they reinforce its safety for consumption and provide a foundation for future research.

With October recognised as Breast Cancer Awareness Month, the study also underscores the urgent need for continued scientific investigation into the disease, while reminding women that regular screening, awareness of family history and early detection remain the most effective strategies for reducing breast cancer risk and improving outcomes.

[1] https://www.nicd.ac.za/wp-content/uploads/2025/04/NCR_ASR_tables_2023.pdf According to the National Cancer Registry (NCR), 10 980 cases of breast cancer were recorded in 2023. However, CANSA has highlighted significant underreporting, particularly in rural and under-serviced communities, suggesting that the actual number of cases is likely much higher. The available figures are based on pathological diagnoses.

[2] https://pmc.ncbi.nlm.nih.gov/articles/PMC10881925/

The statistics provided by the International Agency for Research on Cancer (IACR) differ from those reported by the South African NCR, with the number of new breast cancer cases in 2020 being much higher in the IACR data than in the NCR data (15,491 versus 9259). These differences are due to the different strategies used to tally the statistics. The NCR is a collection of pathology-based cancer surveillance figures based on the curation of cancer diagnosis data from histology, cytology and bone marrow aspirate and trephine samples; these samples have been collected, analysed and then reported on annually [4]. The IACR data are based on the South African NCR and Eastern Cape Province Cancer Registries.

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Missing First Mammogram Raises Breast Cancer Death Risk

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Women who miss their first mammogram run a higher risk of being diagnosed with advanced breast cancer and dying from the disease. This is shown in a new study from Karolinska Institutet published in The BMJ.

Since the early 1990s, women in Sweden have been offered regular mammograms, which has contributed to a decrease in breast cancer mortality. Despite this, a significant proportion choose not to attend their first examination. The researchers behind the new study wanted to investigate the long-term consequences of this. 

The study is based on data from the Swedish mammography screening program and national health registries, and covers almost 433 000 women in Stockholm between 1991 and 2020, with follow-up for up to 25 years. 

The results show that 32% of all women who were invited to their first screening declined. These women were also less likely to participate in future examinations, which often led to a later diagnosis and poorer prognosis.

“Skipping the first mammogram is a strong indicator of who is at risk of late detection and higher mortality. Our results show that missing the first mammogram is not just a one-time choice, but often marks the beginning of a long-term pattern of not attending check-ups,” says the study’s first author, Ziyan Ma, a doctoral student at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.

Were detected at a more advanced stage

When women who skipped their first screening were later diagnosed with breast cancer, the disease was more often detected at a more advanced stage. The risk of developing stage III cancer was approximately 1.5 times higher, and for stage IV, the risk was as much as 3.6 times higher compared to those who participated in the first mammogram. Over a 25-year follow-up period, almost 1 percent of those who did not participate had died of breast cancer, compared with 0.7 percent among the participants – a difference that corresponds to a 40 percent higher risk of dying from the disease. 

However, the total proportion of women who developed breast cancer was almost the same in both groups, approximately 7.7%. According to the researchers, this shows that the increased mortality is mainly due to delayed detection rather than more cases of the disease.

“Family history is a well-known, unchangeable risk factor for breast cancer. Our study shows that missing the very first screening examination carries a similar mortality risk – but unlike family history, this is a behaviour that we can change. Since over 30 percent of women skip their first screening, increased participation could save many lives. Since this group can be identified early, decades before deaths occur, healthcare providers have a chance to intervene with reminders or support to encourage participation, says the study’s last author, Kamila Czene, professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet

Source: Karolinska Institutet

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Supercharging the Wound Healing Properties of Vinegar

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Image credit: Flinders University

A new study suggests adding microscopic particles to vinegar can make them more effective against dangerous bacterial infections, with hopes the combination could help combat antibiotic resistance.

The research, led by researchers at QIMR Berghofer, Flinders University and the University of Bergen in Norway, has resulted in the ability to boost the natural bacterial killing qualities of vinegar by adding antimicrobial nanoparticles made from carbon and cobalt.

Wounds that do not heal are often caused by bacterial infections and are particularly dangerous for the elderly and people with diabetes, cancer and other conditions.

Acetic acid (more commonly known as vinegar) has been used for centuries as a disinfectant, but it is only effective against a small number of bacteria, and it does not kill the most dangerous types.

The findings have been published in the international journal ACS Nano.

Flinders University and QIMR Berghofer molecular biologists Dr Adam Truskewycz and Professor Nils Halberg found these particles could kill several dangerous bacterial species, and their activity was enhanced when added to a weak vinegar solution.

As part of the study, Dr Truskewycz and Professor Halberg added cobalt-containing carbon quantum dot nanoparticles to weak acetic acid (vinegar) to create a potent antimicrobial treatment.

They used this mixture against several pathogenic species, including the drug-resistant Staphylococcus aureus, Escherichia coli (E. coli) and Enterococcus faecalis.

Dr Truskewycz says the acidic environment from the vinegar made bacterial cells swell and take up the nanoparticle treatment.

“Once exposed, the nanoparticles appear to attack dangerous bacteria from both inside the bacterial cell and also on its surface, causing them to burst. Importantly, this approach is non-toxic to human cells and was shown to remove bacterial infections from mice wounds without affecting healing,” he says.

The anti-bacterial boost in vinegar found in the study could potentially be an important contribution towards the ongoing battle against the rising antimicrobial resistance levels worldwide, with an estimated 4.5 million deaths associated with a direct infectious disease.

Professor Halberg adds this study shows how nanoparticles could be used to increase the effectiveness of traditional bacterial treatments.

“Combination treatments such as the ones highlighted in this study may help to curb antimicrobial resistance. Given this issue can kill up to 5 million people each year, it’s vital we look to find new ways of killing pathogens like viruses, bacteria and fungi or parasites,” he says.

The article, ‘Cobalt-Doped Carbon Quantum Dots Work Synergistically with Weak Acetic Acid to Eliminate Antimicrobial-Resistant Bacterial Infections’ (2025) by Adam Truskewycz, Benedict Choi, Line Pedersen, Jianhua Han, Melanie MacGregor and Nils Halberg has been published in ACS Nano.

Source: Flinders University