December 2010 Issues

Radiological Society of North America (RSNA)
Summary:Radiology departments are seeing a slight loosening of hospital purse strings, generally for end-of-life items and new MRIs. ♦ The key factors that will affect imaging volume over the next five years will be the aging population, reimbursement, screening exams, molecular imaging, and international sales. ♦ Dose reduction remains a hot topic, and all the companies have some type of offering in this regard. ♦ Mammography is off ~10% due to negative publicity, but that appears to have stabilized. The uptake of 3-D mammography (tomosynthesis) is likely to be even slower than the adoption of digital mammography, especially if there is no additional reimbursement for it, but radiologists also want more data, and new mammography devices are not high on many wish lists. ♦ The initial enthusiasm about imaging of beta-amyloid to detect Alzheimer’s disease early has faded, at least until the role of beta-amyloid is better understood. ♦ Although screening smokers for lung cancer with CT reduces mortality better than x-ray screening, radiologists are uncertain how to translate the findings into clinical practice.

FDA Panel Recommends Approval of Orexigen's Obesity Drug Contrave -- Quick Pulse
Summary:The FDA’s Endocrinologic and Metabolic Drugs Advisory Committee voted 13-7 that the benefits of Orexigen Therapeutics’ new diet pill Contrave (naltrexone + bupropion) outweigh its risks. The panel was divided on whether a larger safety study should be done before (8 votes) or after (11 votes) approval. Contrave is the third new diet drug to come before the panel this year, and the first two were rejected, both by the panel and by the FDA. If approved, Contrave would be the first new prescription drug for obesity in more than a decade.

American College of Rheumatology (ACR)
Summary:Patients but not rheumatologists are feeling the economic pinch. ♦ Gout: Rheumatologists are interested in Savient’s Krystexxa, particularly as induction therapy for patients with tophi, but use will be limited by price. And Ardea’s RDEA-594, when approved, may be used first. ♦ Lupus: There will be strong patient demand for Human Genome Science’s Benlysta, and rheumatologists expect to use it, though most are not wildly optimistic or enthusiastic about it. ♦ Rheumatoid Arthritis: Approved – Use of Johnson & Johnson’s Simponi, Roche’s Actemra, and UCB Pharma’s Cimzia is growing slowly, while Bristol-Myers Squibb’s Orencia is holding steady and unlikely to get much boost from the subcutaneous formulation in development. In development – Oral JAK inhibitors are exciting, but safety questions have arisen about Pfizer’s tasocitinib, particularly ALT/AST and creatinine elevations, that do not appear to be an issue with Incyte’s INCB-028050.