The bill would have made the RAC an independent organization within the VA, require that a majority of the RACs members be appointed by Congress instead of the VA, and authorized the RAC to release its reports without needing prior approval from the VA Secretary. The RAC is responsible for investigating Gulf War illness, a chronic multisymptom disorder affecting returning military veterans of the 1990–91 Gulf War.In the year prior to the consideration of this bill, the VA and the RAC were at odds with one another. The VA replaced all but one of the members of the RAC, removed some of their supervisory tasks, tried to influence the board to decide that stress, rather than biology was the cause of Gulf War illness, and told the RAC that it could not publish reports without permission. The RAC was created after Congress decided that the VAs research into the issue was flawed, and focused on psychological causes, while mostly ignoring biological ones.The RAC was first authorized under the Veterans Programs Enhancement Act of 1998 (Section 104 of Public Law 105–368, enacted November 11, 1998, and now codified as 38 U.S.C. § 527 note). While the law directing its creation mandated that it be established not later than January 1, 1999, the RACs first charter was not issued until January 23, 2002, by VA Secretary Anthony Principi. The RAC convened for its first meetings on April 11–12, 2002.
Asfotase alfa, sold under the brand name Strensiq, is a medication used in the treatment of people with perinatal/infantile- and juvenile-onset hypophosphatasia.The most common side effects include injection site reactions, hypersensitivity reactions (such as difficulty breathing, nausea, dizziness and fever), lipodystrophy (a loss of fat tissue resulting in an indentation in the skin or a thickening of fat tissue resulting in a lump under the skin) at the injection site, and ectopic calcifications of the eyes and kidney.The enzyme tissue non-specific alkaline phosphatase (ALP) plays a key role in creating and maintaining healthy bones, and managing calcium and phosphate in the body. People with hypophosphatasia cannot make enough working ALP, which leads to weak bones. Asfotase alfa is a version of the human ALP enzyme and serves as a replacement, thereby increasing levels of working ALP. Medical uses
In the United States, asfotase alfa is indicated for the treatment of people with perinatal/infantile- and juvenile-onset hypophosphatasia (HPP).In the European Union, asfotase alfa is indicated for long-term enzyme replacement therapy in people with paediatric-onset hypophosphatasia to treat the bone manifestations of the disease. Adverse effects
The most common adverse effects in studies included injection site reactions (pain, itching, erythema, etc. ), headache, limb pain, and haematoma. Possible rare side effects could not be assessed because of the low number of patients. Interactions
Asfotase alfa interferes with alkaline phosphatase measurements. As asfotase alfa is a glycoprotein (as opposed to a small molecule), no relevant interactions via the cytochrome P450 liver enzymes are expected.