Expert opinion on emerging drugs
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Expert Opin Emerg Drugs · Nov 2005
ReviewEpidermal growth factor receptor inhibitors in the treatment of non-small cell lung cancer.
Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death in both men and women. Despite the introduction of the newer cytotoxic agents in NSCLC treatment during the last decade the survival rates of patients have reached a plateau. New strategies are clearly needed to improve treatment outcomes. ⋯ However, four large Phase III randomised, placebo-controlled trials of gefitinib and erlotinib in combination with standard platinum-based first-line chemotherapy failed to show any survival benefit in patients receiving the study drugs. Possible reasons include patient selection, drug scheduling, trial design or other factors. Active research is ongoing to improve the efficacy of EGFR inhibitors as monotherapy or in combination with other treatment modalities.
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Expert Opin Emerg Drugs · Aug 2005
ReviewEmerging drugs for obesity: linking novel biological mechanisms to pharmaceutical pipelines.
Obesity is associated with hypertension, diabetes, dyslipidaemias and metabolic syndrome, and causes substantial morbidity and mortality from cardiovascular and other diseases. The cost to treat obesity and its complications in the US has increased steeply and is currently estimated to be USD 100 billion. Current therapy for obesity is mainly based on changes in lifestyle that often fail. ⋯ Despite intense investigation, the pipelines for antiobesity drugs in late stages of development are relatively empty. Breakthrough treatments for obesity may take some years to emerge. Clinical trials will be necessary to clarify the impact of new antiobesity drugs on hard cardiovascular and metabolic end points.
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Expert Opin Emerg Drugs · May 2005
ReviewDevelopment of medications for alcohol use disorders: recent advances and ongoing challenges.
During the past decade, efforts to develop medications for alcoholism have burgeoned. Three agents, disulfiram, naltrexone and acamprosate, are now approved in a large number of countries. Although many patients have benefited from existing medications, their effects are moderate, and some alcoholics fail to respond to them. ⋯ Critical barriers must be overcome to ensure that future efforts in the development of medications for alcohol use disorders reach full fruition. These challenges include: establishing key targets for drug discovery; validating animal and human screening models; and developing biomarkers to help predict treatment success. In addition, it is important to formulate methodological and statistical strategies to efficiently conduct alcohol pharmacotherapy trials; to specify genetic and phenotypic patient characteristics associated with efficacy and safety for lead compounds; to forge productive alliances among governmental agencies, the pharmaceutical industry and academic researchers to further drug development; and, ultimately and perhaps most difficult, to engage the practitioner community to incorporate medications into the alcohol treatment process.
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Cancer pain is one of the most frequent symptoms in malignant disease, severely impairing the patients' quality of life. The recommendations of the World Health Organization will provide adequate pain relief for the vast majority of cancer patients. ⋯ NSAIDs with nitric oxide-releasing moieties are an interesting addition, as this new class of analgesics combines improved analgesic efficacy with higher tolerability. Conotoxins and other drugs such as nicotinic acetylcholinergic receptor agonists will be advantageous only for a few patients in the near future, as side-effect profile and risk of complications, as well as the burden on the patient, often are not worth the additional analgesic benefit.
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Neuropathic pain develops as a result of damage to either the peripheral or central nervous system. It is characterised by spontaneous burning pain and/or ongoing pain with accompanying hyperalgesia and allodynia. Neuropathic pain is difficult to treat as it is often refractory to conventional analgesic treatments, with most patients obtaining only partial relief. ⋯ The efficacy of these treatments in neuropathic pain, excepting opioids, has been discovered serendipitously. However, responder rates and overall efficacy is poor with these agents and tolerability or side effects are often limiting. This update will review existing treatment options for neuropathic pain, and highlight more recent advances in the development of novel analgesics to treat this chronic disorder.