Expert opinion on emerging drugs
-
Expert Opin Emerg Drugs · Sep 2012
ReviewEmerging treatment for chronic migraine and refractory chronic migraine.
Chronic migraine (CM), the suffering of 15 or more headache days with at least 8 of these migraine days, afflicts 1.3% - 5.1% of the global population. CM is the most common disorder faced by experts in tertiary headache centers. When resistant to conventional medical treatment and prophylactic medication this condition is known as refractory chronic migraine (RCM). RCM is one of the greatest challenges in headache medicine. ⋯ Medication overuse headache (MOH) is now recognized to be a major factor in many cases of both chronic and refractory chronic migraine. MOH must be addressed prior to evaluating the effectiveness of new preventative and prophylactic treatment approaches. Innovative new drugs and electrical neuromodulation are promising CM treatments. Future studies must carefully screen patients and acquire data that can lead to personalized, tailored treatment strategies.
-
Brain tumors are a unique class of cancers since they are anatomically shielded from normal immunosurveillance by the blood-brain barrier, lack a normal lymphatic drainage system and reside in a potently immunosuppressive environment. Of the primary brain cancers, glioblastoma multiforme (GBM) is the most common and aggressive in adults. Although treatment options include surgery, radiation and chemotherapy, the average lifespan of GBM patients remains at only 14.6 months post-diagnosis. ⋯ Current drugs that improve the quality of life and overall survival in patients with brain tumors, especially for GBM, are poorly effective. This disease requires a reanalysis of currently accepted treatment strategies, as well as newly designed approaches. Here, we review the fundamental aspects of immunosuppression in brain tumors, new and promising immunotherapeutic drugs as well as combinatorial strategies that focus on the simultaneous inhibition of immunosuppressive hubs, both in immune and brain tumor cells, which is critical to consider for achieving future success for the treatment of this devastating disease.
-
Pain affects between 40 and 85% of Parkinson's disease (PD) patients. It is a frequently disabling and overlooked feature, which can significantly reduce health-related quality of life. Unfortunately, there are no universally recommended treatments for this condition. ⋯ Preliminary results indicate that duloxetine, cranial electrotherapy stimulation, rotigotine, subthalamic or pallidum nuclei stimulation or lesion or levodopa could be effective for treating pain in PD. Similarly, some case reports indicate that repetitive transcranial magnetic stimulation (rTMS) or apomorphine could be effective for relieving painful off-period dystonia. Clinical trials with rTMS or oxycodone/naloxone prolonged-release tablets for neuropathic pain or botulinum toxin for off-period dystonia are underway. Success of clinical trials about analgesic strategies in PD will depend on the selection of the right PD population to be treated, according to the type of pain, and the proper selection of study outcomes and follow-up of international recommendations.
-
Expert Opin Emerg Drugs · Mar 2012
EditorialEditorial update on emerging drugs for cancer cachexia.
Cancer cachexia is a multifactorial syndrome characterized by progressive skeletal muscle wasting and weakness. It affects most patients with advanced cancers, reduces quality of life and accounts for more than 20% of all cancer-related deaths. ⋯ However, the multifactorial pathogenesis indicates strongly that the most effective treatments will come from drug combination approaches. Drug treatments should ideally be combined with exercise training to maximize efficacy and ultimately reduce mortality and enhance the quality of life of patients with cancer cachexia.
-
Expert Opin Emerg Drugs · Mar 2012
Editorial CommentEmerging therapies for treatment of acute lung injury and acute respiratory distress syndrome.
In 2007, Bosma et. al provided a comprehensive review of emerging therapies for the acute respiratory distress syndrome (ARDS), a condition which continues to carry a mortality rate of greater than 30%. Over the past several years, the development of novel and effective therapeutic agents for ARDS remains disappointing, and unfortunately, no recent therapeutic interventions have demonstrated a clear benefit. Herein, the results of several of these early and late phase clinical trials are reviewed, the majority of which address known maladaptive processes that have been deemed critical in ARDS pathophysiology. Based on the ongoing futility of current therapeutic models to yield effective therapies, it is speculated whether or not novel treatment paradigms, which address distinctly different aspects of this disease paradigm, may be warranted.