Tag Archives: drugs

Warning on Two Cholesterol Drugs

Journal Issues Warning on Two Cholesterol Drugs

Two widely prescribed cholesterol-lowering drugs, Vytorin and Zetia, may not work and should be used only as a last resort, The New England Journal of Medicine said in an editorial published on Sunday.

The journal’s conclusion came as doctors at a major cardiology conference in Chicago saw for the first time the full results of a two-year clinical trial that showed that the drugs failed to slow, and might have even sped up, the growth of fatty plaques in the arteries. Growth of those plaques is closely correlated with heart attacks and strokes.

Merck and Schering-Plough, the companies that make Vytorin and Zetia, said on Sunday that despite the results of the trial, they would continue to promote their medicines as first-line treatments for high cholesterol.

Related: Drug Price CrisisNew Questions on Treating CholesterolLifestyle Drugs and Risk

Drug Price Crisis

I don’t think the suggestion below really solves the drug price crisis. But I do think it is an example of an educational and research institution actually proposing sensible role for themselves. As I have said too many universities now act like they are for-profit drug or research companies: Funding Medical Research. For some background on drug prices read my post on the Curious Cat Management blog from 2005.

Solving the drug price crisis

The mounting U.S. drug price crisis can be contained and eventually reversed by separating drug discovery from drug marketing and by establishing a non-profit company to oversee funding for new medicines, according to two MIT experts on the pharmaceutical industry.

Following the utility model, Finkelstein and Temin propose establishing an independent, public, non-profit Drug Development Corporation (DDC), which would act as an intermediary between the two new industry segments — just as the electric grid acts as an intermediary between energy generators and distributors.

The DDC also would serve as a mechanism for prioritizing drugs for development, noted Finkelstein. “It is a two-level program in which scientists and other experts would recommend to decision-makers which kinds of drugs to fund the most. This would insulate development decisions from the political winds,” he said.

Book – Reasonable Rx: Solving the Drug Price Crisis by Stan Finkelstein and Peter Temin

Related: Lifestyle Drugs and RiskFrom Ghost Writing to Ghost Management in Medical JournalsUSA Spent $2.1 Trillion on Health Care in 2006Measuring the Health of NationsEconomic Strength Through Technology LeadershipUSA Paying More for Health Care

Funding Medical Research

Cheap, ‘safe’ drug kills most cancers

It sounds almost too good to be true: a cheap and simple drug that kills almost all cancers by switching off their “immortality”. The drug, dichloroacetate (DCA), has already been used for years to treat rare metabolic disorders and so is known to be relatively safe. It also has no patent, meaning it could be manufactured for a fraction of the cost of newly developed drugs.

Evangelos Michelakis of the University of Alberta in Edmonton, Canada, and his colleagues tested DCA on human cells cultured outside the body and found that it killed lung, breast and brain cancer cells, but not healthy cells. Tumours in rats deliberately infected with human cancer also shrank drastically when they were fed DCA-laced water for several weeks.

DCA attacks a unique feature of cancer cells: the fact that they make their energy throughout the main body of the cell, rather than in distinct organelles called mitochondria. This process, called glycolysis, is inefficient and uses up vast amounts of sugar.

Until now it had been assumed that cancer cells used glycolysis because their mitochondria were irreparably damaged. However, Michelakis’s experiments prove this is not the case, because DCA reawakened the mitochondria in cancer cells. The cells then withered and died

The University of Alberta is raising funds to further the research. Some look at this and indite a funding system that does not support research for human health unless there is profit to be made. Much of the blame seems to go to profit focused drug companies. I can see room for some criticism. But really I think the criticism is misplaced.

The organizations for which curing cancer is the partial aim (rather than making money) say government (partial aim or public health…), public universities (partial aim of science research or medical research…), foundations, cancer societies, private universities… should fund such efforts, if they have merit. Universities have huge research budgets. Unfortunately many see profit as their objective and research as the means to the objective (based on their actions not their claims). These entities with supposedly noble purposes are the entities I blame most, not profit focused companies (though yes, if they claim an aim of health care they I would blame them too).

Now I don’t know what category this particular research falls into. Extremely promising or a decent risk that might work just like hundreds or thousands of other possibilities. But lets look at several possibilities. Some others thoughts on where it falls: Dichloroacetate to enter clinical trials in cancer patients, from a previous post here – Not a Cancer Cure Yet, The dichloroacetate (DCA) cancer kerfuffle, CBC’s ‘The Current’ on dichloroacetate (DCA), Dichloroacetate (DCA) Phase II Trial To Begin (“Like hundreds (if not, thousands) of compounds being tested to treat cancer, DCA was shown by Michelakis’ group earlier this year to slow the growth of human lung tumors in a preclinical rodent model.”).
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Nanoengineers Use Tiny Diamonds for Drug Delivery

Nanoengineers Mine Tiny Diamonds for Drug Delivery

Northwestern University researchers have shown that nanodiamonds — much like the carbon structure as that of a sparkling 14 karat diamond but on a much smaller scale — are very effective at delivering chemotherapy drugs to cells without the negative effects associated with current drug delivery agents.

To make the material effective, Ho and his colleagues manipulated single nanodiamonds, each only two nanometers in diameter, to form aggregated clusters of nanodiamonds, ranging from 50 to 100 nanometers in diameter. The drug, loaded onto the surface of the individual diamonds, is not active when the nanodiamonds are aggregated; it only becomes active when the cluster reaches its target, breaks apart and slowly releases the drug. (With a diameter of two to eight nanometers, hundreds of thousands of diamonds could fit onto the head of a pin.)

“The nanodiamond cluster provides a powerful release in a localized place — an effective but less toxic delivery method,” said co-author Eric Pierstorff, a molecular biologist and post-doctoral fellow in Ho’s research group. Because of the large amount of available surface area, the clusters can carry a large amount of drug, nearly five times the amount of drug carried by conventional materials.

Lifestyle Drugs and Risk

I see taking drugs as risky. Certain drug have long histories and seem safe and even seem to have positive side effect like Aspirin (though even it is not without risks – see below). Even if a drug has a good chance of a positive result in treating some medical condition – assuming it is otherwise safe is not wise. I believe you have have a significant positive known benefit to consider taking drugs given the unknown problems that are likely to be lurking. I find the pop a pill culture for anything that might be a minor annoyance to be foolish – taking risks without consideration. Taking drugs entails taking a risk and the more you take the risks of interactions and cumulative effects increase the risks to you. Business Week (somewhat surprising given the huge amount drug makers pay to advertise lifestyle drugs) has a decent article pointing out some of the foolishness involved in the Lifestyle Drug Binge:

The renewed excitement is most evident in four treatment areas that account for the bulk of lifestyle-drug sales: weight loss, hair loss, sleep, and sexual dysfunction.

This trend is surprising because such treatments can expose patients to risks, sparking criticism of drug companies at a time when patient safety is already under a spotlight. Lifestyle drugs are defined loosely as products used to treat conditions that are not life-threatening. Because people take them over long periods of time, sometimes on a daily basis, they may be more dangerous than they first appear.

We have found amazingly helpful and useful drugs. This is great. But people need to remember these drugs are not without potential negative consequences. Take advantage of them when appropriate but don’t forget the risks each instance has for negative side effects. Related: health care improvement articleshealth care blog posts
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Bird Flu Resistant to Main Drug

Bird Flu ‘Resistant to Main Drug’ (site removed content so link to them removed)

While the H5N1 virus is now mostly passed directly from bird to human, health experts have warned that it is just a matter of time before it mutates into a form that is easily transmissible between people. When that happens, it may result in as many as 150 million human deaths.

Obviously the 1918 flu pandemic should stand as a recent example of the danger posed by flu epidemics. I don’t have any ability to judge how likely these threats of “bird flu” are but it seems like we could very easily be failing to invest sufficient resources in fighting such a possibility.

Have bird flu warnings affected you?, BBC

It also is a reminder that we should be careful not to overuse anti-biotics.