Therapeutics

On July 21, 2006, in Therapeutics
A slew of new drugs is a sign that the pharmaceutical giants are shaking off their addiction to the blockbuster drug business model in favor of pharmacogenomic drugs with much smaller “niche” markets. That does not mean they are ignoring blockbusters: With the global demand for diabetes drugsexpected to reach US$25 billion by 2011, drug makers are investing heavily in their development, and many are showing promise. 

They are also investing in novel approaches to drug development, including a supercomputing approach to cancer drugs, which is paying off in the form of handsome venture capital injections for a firm that models protein bindings on a supercomputer in order to fabricate drugs that target those bindings.

In other news:

  • A vaccine for shingles, approved by the FDA, could end suffering from this extremely painful condition. 

     

  • At least two vaccinesfor Alzheimer’s are in the works. 

     

  • Intestinal wormsappear to play a role in keeping our immune system in shape, and may make a comeback in overly sanitized societies as a treatment for inflammatory bowel disease. 

     

  • The first drug produced from a transgenic animal has been approved for use in Europe. If no long-term issues develop, it marks a major step in reducing development and production costs for a variety of drugs.

Flood of Cancer Drugs

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Most of the major pharmaceutcal companies preferred making drugs for chronic diseases to treatments for cancer, a market divided into different types of cancer and whose patients often die within months, writes Andrew Pollack in the New York Times. Neither Glaxo, Pfizer, nor Wyeth had much of a presence in the cancer business several years ago, he notes. Today, about 400 cancer drugs from 178 companies are now in clinical trials, according to the Pharmaceutical Research and Manufacturers Association. “That is twice the number of drugs in trials for illnesses like Alzheimer’s disease and depression and nearly three times as many as for heart attack and stroke,” says Pollack. Analysts at Merrill Lynch recently said that for many types of cancer, the number of drugs in the final phase of clinical trials exceeds the number already on the market.

Why the change? For one thing, high prices have transformed what was considered a niche market. Gleevec, which is used primarily for two relatively rare cancers — chronic myelogenous leukemia and gastrointestinal stromal tumor — earned US$2.2 billion in 2005. For another, cancer is becoming, in some cases, a chronic disease. Ninety percent of the people who took Gleevec in an early clinical trial were still alive after five years — without it, half of them would have died within that period. “[T]he disease is controlled, not cured,” writes Pollack, and “If the patients stop taking their daily Gleevec pills, the leukemia generally comes back.”

Genentech’s hugely successful anti-angiogenic colon cancer drug Avastin seems to have awakened Big Pharma’s attention to biologics. Anti-angiogenic drugs Sutent from Pfizer and Nexavar, developed by Bayer and Onyx Pharmaceuticals, have been approved by the US Food and Drug Administration in recent months, and Wyeth seems to be on track with temsirolimus, which has also done well in a late-stage clinical trial. The awakening of the sleeping giant should also arouse biotech companies and investors, one analyst told Pollack. Genentech in particular is under threat as Glaxo’s new breast cancer drug Tykerb challenges Herceptin and others challenge Avastin.

Diabetes “Blockbusters”

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Since Amylin Pharmaceuticals and Eli Lilly’s injectable Byetta was introduced in June 2005, it has “stirred especially high hopes” because it was proven to cause dramatic weight loss in many diabetic patients instead of the significant weight gain caused by existing treatments. Pfizer’s inhalable insulin Exubera, which received FDA approval in January, is expected to increase compliance with insulin regimens because it eliminates injections. In addition, two pill therapies are expected to receive FDA approval by early next year. Novartis’s Galvus and Merck’s Januvia work by raising the levels of a naturally occurring hormone that is released into the stomach and intestines during eating.

Oral Cancer Drug from Supercomputer

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Clinical trials of an oral compound to treat cancer, designed with the help of a 2.3 teraflop (trillion calculations a second) supercomputer, are in planning. The small-molecule drug designated LP-261 will be safety-tested this Fall in patients with advanced metastatic tumors and blood cancers.

The privately held developer has deals with major players including Dow AgroSciences, Amgen, and Eli Lilly, who are using its technology to make or improve their own drugs. The approach could substantially lower the cost of drug discovery and increase the speed of getting therapies to clinical trials and the market.

Shingles Vaccine Approved

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Merck’s Zostavax, a new and more potent version of the chickenpox vaccine, has been approved by the US Food and Drug Administration for the prevention of shingles (also called herpes zoster) in adults over age 60 who previously have had chickenpox.

“Zostavax does not prevent the initial infection by the virus,” reports Andrew Bridges for the Associated Press, “nor does it treat active cases of shingles. Instead, the vaccine helps prevent the reemergence or resurgence of the virus by boosting a patient’s immunity.”

Merck research showed the vaccine reduced the incidence of shingles by half and pain and discomfort by nearly two-thirds. Anyone who has had chickenpox can develop shingles. Merck estimates that half of all people who reach age 85 will develop shingles during their lifetime. The vaccine has been shown to be effective for at least four years. A dose will cost US$152.50.

Vaccine for Alzheimer’s

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A DNA-based Alzheimer’s vaccine which earlier proved successful in mice is now being tested in monkeys at the Tokyo Metropolitan Institute for Neuroscience in Japan. Human tests could begin within three years. In the mice, the vaccine reduced plaque deposits by 15.5 to 38.5 percent with no major side effects, includiong none of the brain swelling that occurred in tests of another vaccine. However, the reasons for the brain swelling in the earlier tests have been determined, and new forms of that therapy are now being tested.

Worms May Stage a Comeback

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A Michigan State University microbiologist is among a number of researchers proposing to use intestinal parasites called whipworms to treat inflammatory bowel disease (IBD), whose most common forms are Crohn’s disease and ulcerative colitis. The latter is becoming increasingly common in industrialized countries, yet is almost unheard of in developing countries. One hypothesis to account for the difference is that increasing levels of hygiene in developed countries starve the immune system of the dirt, bacteria, and worm-induced infections it needs in order to keep in shape.

A research team at the University of Iowa already has tried treating human patients with a whipworm egg and Gatorade cocktail, with promising results, according to the Associated Press. When given to patients with inflammatory bowel disease, the worms can help to counteract the inflammation and “actually reset the immune system to be in better balance,” as the MSU researcher described it.

Whipworms are relatively safe. They may be eliminated naturally or with the help of anti-worm drugs.

Transgenic Drug Approved in Europe

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The European Medicines Agency (EMEA) has approved Atryn, the first medicine produced from a genetically modified animal. Atryn is extracted from the milk of goats engineered to carry a human gene involved in inhibiting blood clots, and is approved for surgery on patients lacking the gene for anti-thrombin, a natural anticoagulant. Replacement anti-thrombin has until now been extracted from human blood plasma, which carries the risk of transmitting other diseases Artyn is a replacement anti-thrombin taken from the milk of goats genetically modified to produce the human gene for anti-thrombin. Atryn’s developer, GTC Biotherapeutics, said one goat produces the equivalent of 90,000 blood collections.

 

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