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GLG News by this Author

More Uses than Diagnosis

June 15, 2009

Analysis of:Bayer completes Phase II Study on BAY 94-9172 in Alzheimer’s Disease Imaging | www.pipelinereview.com

There is a larger potential benefit from the use of amyloid imaging.  Of course refining diagnosis is important.  But research involving drugs in development, particularly vaccines, relies on the measurement of amyloid in the brain.  To some degree this can be done by looking at spinal fluid, but brain imaging is much less invasive and better tolerated.

Failure is not an option

March 23, 2009

Analysis of:New Alzheimer's disease drugs available with five years | www.nursingtimes.net

The bottom line is that there are many, many drugs in development for the treatment of Alzheimer's (more than the speaker quoted in the article estimates) and, therefore, it is likely that some will be on the market in 5-10 years.  However, they are not necessarily going to be cures or totally preventive.  Some will alleviate symptoms, like the drugs currently on the market.  Others may be more---or less--effective in people who carry certain genes related to Alzheimer's.  The concept of a vaccine captures the public's hopes but is currently in testing in people who already have Alzheimer's.  The testing, or possible approvable use, in people who have not developed Alzheimer's is more in the future.  But we will get there.  This is a scientifically very active field.

Efficacy isn't everything

November 24, 2008

Analysis of:2nd Generation Antidepressants Prove Effective | health.usnews.com

This article tells you only that the drugs are equally effective, but not what that really means in real life.

Just because they say so, it ain't necessarily so.....

October 13, 2008

Analysis of:St John's Wort 'as good as Prozac' | ukpress.google.com

This "report" tells you nothing that you need to know in order to assess the validity of these studies.  We have always known that St. John's Wort has some effectiveness---but it certainly does not come without side-effects.  Where is the information about the length of the studies, the relative doses used, the numbers of people in the studies, the methodology?  Without that, you don't know if they were using comparable doses, for reasonable lengths of time.  You don't know effect size.  Did they use LOCF?  We know that St. John's Wort has drug interactions (it is similar to MAOI's), can cause severe photosensitivity, and has other side effects as well.  Was the study long enough for the participants to experience any of this?  Were the study participants so "selected" that it was unlikely that they would experience any of this.

Interesting, but be cautious

October 8, 2008

Analysis of:Lilly Announces Initiation of Second Global Phase III Trial of Investigational Alzheimer's Disease Compound | newsroom.lilly.com

Gamma secretase inhibitors are one of several kinds of drugs being studied for the prevention/amelioration of Alzheimer's.  In concept they make sense.

Be very careful

July 31, 2008

Analysis of:Blood pressure drugs may protect against Alzheimer's | www.washingtonpost.com

All is not as it seems when reported in the press, especially the non-scientific press.

If you've done everything else, there is nothing else

June 30, 2008

Analysis of:Doctors Say Medication Is Overused in Dementia | www.nytimes.com

We need to look to the cause of why we prescribe antipsychotics to patients with dementia.  We have very few tools to use and sometimes these drugs are a necessity.

We can't afford to practice the "best" medicine

June 23, 2008

Analysis of:Most Doctors Aren’t Using Electronic Health Records | www.nytimes.com

This article clearly describes the Catch-22 in which most doctors, except for those employed by the large institutions, find themselves.  We cannot afford to practice the "best" medicine, and yet, if we could, we might well make fewer errors and make medical care for our patients more seamless.  There would be better communication between caregivers and less--expensive--time wasted. 

Possible wave of the future---or the present

May 12, 2008

Analysis of:Abbott Scientists Present A New Approach for Treating Attention-Deficit Hyperactivity Disorder | biz.yahoo.com

NNR's are being heavily studied for several uses and are looking promising.

The pros and cons of Strattera driving marketing

May 12, 2008

Analysis of:FDA Approves Strattera® for Maintenance of ADHD in Children and Adolescents | newsroom.lilly.com

Eli Lilly needs to find a compelling niche for Strattera since, in the treatment of ADHD, it is viewed as a less effective, though safer (because it cannot be abused), alternative to stimulants.

Eli Lilly is on the right track with gamma secretase inhibiors

April 8, 2008

Analysis of:Lilly Launches Its First Phase III Trial for Treatment of Alzheimer's Disease | www.fiercebiotech.com

Disease modification is the desired direction for drugs to treat Alzheimer's and gamma secretase inhibitors have really just begun to be studied.  The field is very promising.

How do we like our drug reps? Nothing new here but the reps' problems are increasing.

January 29, 2008

Analysis of:19 Percent of Office-Based Physicians Refuse to See Pharmaceutical, Biotech and Medical Device Sales Reps | www.drugs.com

This article is important primarily to those companies and reps who do not pay attention.  Doctors are human and will be most pleased to see those reps who comply with the physician's stated needs.  If the days or hours are limited or an appointment required, the reps need to stay within those limits.  But these are not the issues that will have the greatest impact on drug rep visits and the willingness of doctors to see them. 

Delivery of nerve growth factor to the brain is in infant stage of research

December 17, 2007

Analysis of:Gene A/S begins Phase Ib clinical trial with NsG0202 for the treatment of Alzheimer's disease | www.pipelinereview.com

Nerve growth factor has some connection to Alzheimer's but the mechanism is not clear.  In Alzheimer's, nerve growth factor is actually increased in the brain, EXCEPT, in the nucleus basalis, and this may be crucial.  Will this delivery system get it there?  And then, will it work?

FDA approval, if obtained, for use of Lexapro in adolescents will matter to Lexapro/Forest

December 3, 2007

Analysis of:Forest Laboratories and Lundbeck announces positive results of Lexapro(R) phase III study in adolescents with major depression | www.pipelinereview.com

If this study leads to FDA approval of Lexapro for use in adolescents it should lead to an increase in its use overall, by psychiatrists and by primary care physicians, including pediatricians.

The future impact of this approval is unclear

November 19, 2007

Analysis of:Seroquel XR Receives Approval From FDA for Maintenance Treatment of Schizophrenia | pharmalive.com

Because the studies did not compare Seroquel XR to Seroquel, the true impact of the approval of the XR formulation is unclear.

Correlation is not cause and effect.

October 4, 2007

Analysis of:Conscientious people are less prone to Alzheimer's | www.reuters.com

The apparent connection of one event and another (in this case being conscientious and having a delayed onset of Alzheimer's) may not be what it seems.

Lipodissolve is very frightening.

September 21, 2007

Analysis of:Feel Pudgy? There’s a Shot for That | www.nytimes.com

As a physician and researcher, although not an expert in bariatrics, I find this untested and illogical procedure very frightening.  It has tremendous potential for harm and no logical reason why it should work.

Pfizer and patients should benefit from the results of this study of Aricept

September 19, 2007

Analysis of:Donepezil Effective, Safe in Late-Stage Alzheimer's Disease | www.medscape.com

The results of this study come as no surprise to those of us who  engage in Alzheimer's research and who actively evaluate and treat patients with Alzheimer's.  The real "surprise" is that there are so many patients with severe Alzheimer's who, unfortunately, have not already been placed on a cholinesterase inhibitor.  As the article states, the hope, with these results, is that doctors will not discontinue these medications based on the severity of the patient's condition.  Those of us who do this work know that patients deteriorate rapidly if the medication is discontinued----you often don't realize how much good the drug is doing until it's gone. My only real criticism of the study--or perhaps of the report--is that there is no breakdown of the numbers of patients by initial MMSE score.  It says the MMSE's ranged from 1-12.  12 is closer to moderate Alzheimer's and, if the preponderance of subjects had an MMSE around 12 this would be more a study of moderate than severe disease. 

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