Showing posts with label Drugs. Show all posts
Showing posts with label Drugs. Show all posts

Tuesday, 5 November 2013

By Robert Lowes
Medscape Medical News

Nov. 1, 2013 -- The cholesterol-lowering drug Crestor (rosuvastatin) was the nation's most prescribed drug in the past 12 months, according to a new report from research firm IMS Health. New prescriptions and refills of the drug totaled 23.7 million.

The report looks at the top 100 selling drugs in the U.S., by prescriptions and sales. It tracked data over a 12-month period through September.

On the sales side, the antipsychotic drug Abilify (aripiprazole) racked up the highest sales with nearly $6.4 billion. Abilify is prescribed to treat schizophrenia, depression, and bipolar disorder, plus other things.

The 10 top-selling drugs reflect little change since calendar year 2012, according to IMS Health.

Here are the top 10 drugs by number of prescriptions:

Crestor: 23.7 millionSynthroid: 23.4 millionNexium: 20.7 millionCymbalta: 19.4 millionVentolin HFA: 17.5 millionAdvair Diskus: 16.6 millionDiovan: 13.1 millionVyvanse: 10.4 millionSpiriva Handihaler: 9.6 millionLantus: 9.4 million

Here are the top 10 drugs by total sales:

Abilify: $6.4 billionNexium: $6 billionCymbalta: $5.4 billionHumira: $5.4 billionCrestor: $5.3 billionAdvair Diskus: $5.1 billionEnbrel: $4.7 billionRemicade: $4 billionCopaxone: $3.8 billionNeulasta: $3.5 billion

The complete list can be found on Medscape.


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Friday, 28 June 2013

Leukotriene pathway modifiers, also known as leukotriene blockers, are a relatively new type of asthma drug. The Food and Drug Administration approved Singulair (montelukast sodium), the first drug in this class, in 1998.

These medications, which can be taken in a once-a-day pill form, improve lung function by treating the underlying inflammation of asthma over the long term. These drugs are used for persistent cases of asthma and should be taken once a day, whether or not your child is experiencing asthma symptoms.

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Friday, 21 June 2013

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Antihypertensive agents from different classes significantly reduced beta-amyloid protein plaques in a mouse model of Alzheimer's disease. Also this week: a master gene for autoimmune disease.

Antihypertensives for Alzheimer's?

Certain antihypertensives have the unintended side effect of reducing the accumulation of beta-amyloid in the brains of mice with Alzheimer's disease, researchers found.

Giulio Maria Pasinetti, MD, PhD, of Mount Sinai School of Medicine in New York City, and colleagues screened 1,600 FDA-approved drugs to look for any that might have activity either inhibiting or promoting the formation of beta-amyloid. They identified 184 drugs that reduced levels of the protein by more than 30%, including 13 cardiovascular drugs.

Of those, seven antihypertensives in different classes -- carvedilol, propranolol, valsartan (Diovan), losartan, hydralazine, nicardipine, and amiloride -- provided concentration-dependent reductions of beta-amyloid in vitro.

Propranolol, nicardipine, and carvedilol were then given to mice with Alzheimer-like amyloid pathology. After 1 month of treatment, each drug reduced the amount of beta-amyloid in the animals' brains by about 40%.

"This line of investigation will lead to the identification of common medications that are potentially beneficial or detrimental to Alzheimer's disease as a reference for physicians to consider when prescribing the most appropriate drugs for their patients, particularly for treating chronic disorders among the growing geriatric population," the researchers wrote in PLoS ONE.

-- Todd Neale

Gene Oversees Immune Checks and Balances

Mutations in a single gene may be responsible for the immune disruptions that result in disparate conditions ranging from allergies to type 1 diabetes, lupus, and Crohn's disease, researchers from the National Institutes of Health reported.

The gene, BACH2, regulates the process by which T cells differentiate into either immune system activators -- spurring inflammation in response to external threats -- and immune system restrainers that put the brakes on those inflammatory processes when the threat has been eliminated.

Writing in Nature, the researchers, led by the scientific director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, John O'Shea, MD, demonstrated that mice lacking BACH2 developed lethal autoimmune inflammation in the lungs and spleen within months of birth, along with autoantibodies similar to those found in patients with lupus.

They then found that replacing BACH2 in these knockout mice through gene therapy restored the normal immune balance, suggesting that this gene may be a suitable target for therapeutic manipulation.

-- Nancy Walsh

One Better Than Two in GVHD

Acute graft-versus-host disease, or GVHD, occurs after allogeneic transplant of hematopoietic stem cells because donor T cells, transplanted with the graft, attack the recipient's major histocompatibility complex antigens. But it has not been clear which T cells are responsible.

Now researchers led by Paul Allen, PhD, of Washington University in St. Louis, think they may have an answer: the culprit cells are the rare ones that have two T-cell receptors on their surface. Building on experiments in mice, they report in Science Translational Medicine that stem cell transplant patients with acute GVHD have significantly more such cells than do healthy controls or patients who didn't develop GVHD.

And such cells have pathologic activity in the test tube, they reported. Dual-receptor T cells from patients with acute GVHD significantly increased production of the inflammatory cytokines interferon-gamma and interleukin-17a, compared with dual-receptor cells from healthy controls or patients without GVHD.

-- Michael Smith

Naturalistic Model for Parkinson's Disease

Mice bred to overexpress a protein that drives progression of Parkinson's disease developed many of the age-related motor symptoms and changes in sleep seen in patients with Parkinson's disease.

The mice overproduced alpha-synuclein, the essential building block for the characteristic Lewy bodies that form in the nerves of humans with Parkinson's disease. As compared with normal mice, aging transgenic animals with a specific mutation of the alpha-synuclein gene developed progressively worse motor function on a standardized test.

The transgenic mice also exhibited fragmented nighttime behavior, consistent with disturbed sleep that occurs in many patients with Parkinson's disease. However, the animals did not exhibit signs of increased anxiety and depression that often affects patients.

Currently, most preclinical Parkinson's research is conducted in rodents injected with chemical toxins that destroy dopaminergic neurons, which reproduces the motor symptoms of the human disease but not its spontaneous onset, molecular pathology, or progressive course.

Though not a perfect mimic of human Parkinson's, the transgenic mice may prove useful in studying certain aspects of Parkinson's disease, Sarah M. Rothman, PhD, of the National Institute on Aging, and colleagues reported in the Journal of Parkinson's Disease.

-- Charles Bankhead

Sweetening T Cells to Fight Cancer

Giving a little sugar to T cells might enhance their ability to fight cancer cells, researchers reported.

When cancer cells consume much of the available sugar in the same dish as T cells, the latter are rendered impotent to make inflammatory, tumor-fighting compounds, said researchers at Washington University in St. Louis.

But when the researchers fortified the T cells with extra sugar, they produced twice as much of their inflammatory weaponry, according to a report in the June 6 edition of Cell.

"It's like an on-off switch, and all we need to do to flip it is change the availability of sugar," said lead researcher Erika Pearce, PhD, in a press release. "T cells often can go everywhere -- tumors, inflammation, infections -- but sometimes they don't do anything. If we can confirm that this same switch is involved in these failures in the body, we might be able to find a way to put the fight back into those T cells."

-- Kathleen Struck

Wednesday, 19 June 2013

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By John Gever, Deputy Managing Editor, MedPage Today

WASHINGTON -- Two new drugs for metastatic or inoperable melanoma, dabrafenib (Tafinlar) and trametinib (Mekinist), were approved by the FDA on Wednesday.

The agency also approved a companion diagnostic test for both agents to detect certain mutations in the BRAF gene that render melanoma cells susceptible to the drugs.

Dabrafenib is an inhibitor of the BRAF gene when it carries the so-called V600E mutation. Trametinib inhibits a target known as MEK and is effective primarily against melanomas carrying either the V600E or V600K mutations.

Approximately half of patients with malignant melanoma are marked by BRAF mutations, the FDA said.

The agency noted that dabrafenib and trametinib were approved separately as stand-alone drugs, not as a combination, although therapy with both drugs together has been tested clinically and appeared to be better than dabrafenib alone.

The diagnostic product, called the THxID BRAF test, was evaluated in the same clinical trials supporting the two drugs' approvals. It was used to select patients for the trials.

Dabrafenib's approval was based primarily on a trial in 250 patients randomized to the drug or a standard chemotherapy agent, dacarbazine. The BRAF inhibitor prolonged progression-free survival by 2.4 months, the FDA said.

Trametinib's pivotal trial involved 322 patients with a chemotherapy regimen as the comparator. Progression-free survival was extended by 3.3 months with trametinib. However, patients previously treated with other BRAF inhibitors, including dabrafenib, did not benefit from trametinib, according to the FDA.

Both drugs had a variety of side effects. For dabrafenib, these included hyperkeratosis, headache, fever, arthralgia, alopecia, hand-foot syndrome, and noncancerous skin lesions. More seriously but less commonly, some patients experienced cutaneous squamous cell carcinomas, hypotensive fever, dehydration, rigors, kidney failure, and hyperglycemia that sometimes required initiation of anti-diabetic drugs.

Adverse effects seen with trametinib included heart failure, pulmonary inflammation, skin infections, and vision loss, as well as less serious effects such as rash, diarrhea, peripheral edema, and acne-like skin eruptions.

Both of the new agents are manufactured by GlaxoSmithKline. The BRAF mutation test is sold by bioMerieux.

John Gever

Senior Editor

John Gever, Senior Editor, has covered biomedicine and medical technology for 30 years. He holds a B.S. from the University of Michigan and an M.S. from Boston University. Now based in Pittsburgh, he is the daily assignment editor for MedPage Today as well as general factotum on the reporting side. Go Pirates/Penguins/Steelers!