Medicine and Pharmaceuticals

There is an arms race apace, a war of attrition between humans and bacteria that has lasted millennia. However, with the discovery of penicillin in 1928 the scale was tipped. Pneumonia, tuberculosis, and diarrhea – the 3 leading causes of U.S. deaths in 1900 – were greatly reduced. We were winning.

But the story did not end. Indiscriminate antibiotic use coupled with microbial ingenuity ushered in a major setback – drug resistance. Bacteria treated with an antibiotic eventually developed gene mutations, rendering them impervious to that drug; bacteria exchanged/traded these genes like playing cards, creating multi-drug resistant organisms, so-called “superbugs.”

Clostridium difficile, is one of those superbugs.  According to CDC data from 2015, approximately 453,...

Based on the recent demise of experimental vaccines from Genocea and Vical the prospects for a therapeutic vaccine for genital herpes look mighty bleak at this time. So, for most patients who need treatment valacyclovir (Valtrex) is the only choice (1,2). It works well for most people, but not for everyone.

DRUGS VS. VACCINES FOR TREATMENT OF INFECTIOUS DISEASES

There has never been a therapeutic vaccine for any infectious disease, and there isn't one on the horizon. But there are plenty of drugs that work quite well for infections - antibiotics, antifungals, and antivirals. Since herpes is a viral infection is it not unrealistic to predict that an antiviral drug that works better than Valtrex could be discovered. Based on the stunning success of...

More than six percent of surgical patients who received opioid painkillers – but had never taken them previously – developed a "persistent habit" or addiction after the normal recovery period for taking them ended.

That's a key finding from a newly-published paper that reviewed insurance claim data for a recent six-year period. This nationwide retrospective study focused on adults in the United States between the ages of 18 and 64 who underwent surgery and filled post-operative opioid prescriptions. Both major and minor surgeries were included in the project.

The study, entitled "Transitions of Care for Postoperative Opioid Prescribing in Previously Opioid-Naïve Patients in the USA: a Retrospective Review," was conducted by researchers at the University of Michigan and...

Co-payments serve two purposes; first, they offset costs, well actually they add costs to you and reduce them for your insurer who never really "pays" for your care; and second, they make you think twice before you access your care. But drugs are, after all, prescribed for you; they are not necessarily a voluntary purchase, so that second argument about thinking twice is not germane. 

Even though you hand your co-payments to a pharmacist, they are not actually receiving them; they are returned to the pharmacy benefits managers (PBMs an oft-mentioned intermediary in drug pricing), the pharmacists receive their negotiated payments (the drug cost, dispensing fees, and...

Once again, the news is bad for the millions of people who are suffering from herpes simplex virus type 2 (HSV-2), much the same as I reported in September 2017, when Genocea's experimental herpes vaccine GEN-001 was dropped after Phase II clinical trials.

Today, less than a month after I interviewed Larry R. Smith, Ph.D., Vical’s Senior Vice President of Research about the prospects for VCL-HB01, the company's experimental therapeutic herpes vaccine, Vical announced that in randomized controlled Phase II clinical trials VCL-HB01 was ineffective in reducing outbreaks in people who were infected with HSV-2. This is just one more example of a vaccine failing in humans after...

If lowering the LDL cholesterol (bad cholesterol) helps your cardiovascular health than medications that lower LDL to a greater degree should afford your “better health.” That is certainly the thinking behind Repatha and an older study of the combination of drugs acting to both block the absorption of cholesterol from the GI tract (ezetimibe) and lower the blood levels of LDL (simvastatin). The IMPROVE-IT study found that the combination “resulted in a significantly lower risk of cardiovascular events,” quantitatively a 2% reduction or 6.3% relative reduction.  Despite these published results, the FDA denied market-approval for the combination, and it is the reasoning behind the denial that is the subject of a short commentary in the Journal of General Internal Medicine.

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"Synthetic marijuana" or "synthetic cannabinoids" are the worst possible names for these types of drugs. The reason is because their effects on the body are nothing like marijuana or cannabis, which is why we should change the name to something else.

Originally designed by scientists to study the nervous system, these drugs have made their way into the black market for recreational use. However, there are far better ways to spend one's recreational time. As we wrote previously:

According to the CDC, a person...

Reviewing statistics relating to all deaths in the United States during a recent 16-year period, researchers determined that fatalities of young adults from opioid abuse have increased nearly 300 percent over that time.

They also found that in 2016, the last year studied, 20 percent of all deaths in this age group were opioid related.  

Using data from an online data base from the Centers for Disease Control and Prevention, Canadian researchers focused on adult deaths aged 24 to 35. As a point of comparison, in 2001, only 4 percent of fatalities in this age group were connected to opioid use.

"We are increasingly seeing the devastating impact that early loss of life from opioids is having across the United States," stated Dr. Tara Gomes from St. Michael's Hospital...

Anyone who watches television has seen the ads for Opdivo, Lyrica and countless other drugs directed to consumers (physicians still call these people patients). Direct to consumer pharmaceutical ads (DTCPA) are regulated by the FDA and have grown from $12 million in annual marketing spending when initially approved to $3.45 billion last year, eclipsing marketing directed to prescribing physicians. 

DTCPA was initially approved in 1980, Merck placing the first print ad in Reader’s Digest for its then-new pneumococcal vaccine, Pneumovax. Several years later, the FDA adjusted regulations for the limited time of television ads, and DTCPA quickly focused on this medium where consumers are more specifically targeted. It was money well spent as Big Pharma return on their advertising...

Did you notice this week the media reporting that the Supreme Court is allowing a class action suit involving eyedrops to go forward? My colleague, Eric Leif has written on the case previously. Briefly, the patients, now plaintiffs contend that eye drop manufacturers deliberately make eye drops too large resulting in wasted drugs and expenses running down their cheeks. Four of these suits have been dismissed, but this current one is moving forward. The recent legal wrangling has more to do with jurisdiction than the merits of the case and concerns my attorney friends more than you or I.   

Eye drop Science

Eye drops are difficult...