Trends-in-MedicineLynne Peterson,
Senior Writer
Trends-in-Medicine has no financial connections with any pharmaceutical or medical device company. The information and opinions expressed have been compiled or arrived at from sources believed to be reliable and in good faith, but no liability is assumed for information contained in this newsletter.
Copyright© 2004
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European Congress of Rheumatology
Summary: The TEMPO trial showed Amgen’s Enbrel+MTX is more effective than either drug alone. An interim subgroup analysis of the European ReAct trial found Abbott’s Humira is effective in patients who took a prior biologic. Novartis’s Zometa failed to show a statistically significant structural benefit (on bone and joints). The 24-week results of the IMPACT-2 trial confirmed the positive 12- week results of Johnson & Johnson’s Remicade in psoriatic arthritis. Bristol- Myers Squibb’s abatacept (CTLA4Ig) is starting to generate interest, but there is not much data yet. Only an average of 6% of RA patients in Europe are getting a TNF inhibitor, but that number is expected to nearly double by next year. Remicade is losing market share, and that trend is expected to continue, with most of the gains likely to be made by Humira.
Paris Course on Revascularization (PCR)
Summary: This was a news-filled PCR, and drug-eluting stents (DES) dominated the meeting. A ream of positive new drug-eluting stent trial data, particularly for Johnson & Johnson’s Cypher and Boston Scientific’s Taxus stents, was overwhelmed by Guidant’s announcement of a delay in its bioerodable drug-eluting stent program and the high in-stent late loss in a key trial of Medtronic’s Endeavor drug-eluting stent. In fact, the Endeavor late loss data caused some sources to predict that the whole Endeavor program is now in jeopardy, at least in the U.S. There could be negative implications for Abbott’s ZoMaxx drug-eluting stent program as well.
New Clinical Drug Evaluation Unit (NCDEU)
Summary: The hot drug topics at this meeting appeared to be: Expanded use of AstraZeneca’s antipsychotic Seroquel (quetiapine) – but at higher doses. Weight gain with Pfizer’s pregabalin. Expected increases in use of both Bristol-Myers Squibb’s Abilify (aripiprazole) and, to a lesser extent, Pfizer’s Geodon (ziprasidone). These are both more activating (or less calming) than other atypical antipsychotics, but psychiatrists are finding them effective with less weight gain or metabolic syndrome. The potential of Corcept’s Corlux (RU- 486, mifepristone) in treating psychotic major depression, Aventis’s Rilutek (riluzole) for major depression and bipolar depression, and Titan’s Probuphine (depot buprenorphine) for opioid addiction (provided usage restrictions on buprenorphine are modified). Growing interest in other uses for GlaxoSmithKline’s anticonvulsant Lamictal (lamotrigine).
American Urologic Association (AUA)
Summary: Stress incontinence: Doctors are excited about Lilly’s Yentreve (duloxetine), but it is unlikely to find much off-label use for overactive bladder since there are several new therapies on the near horizon for that. Urge incontinence: It may not seem possible but the marketing wars are heating up – and that’s about all the difference doctors see among the various agents. Vaginal slings: The transobturator approach is gaining popularity, though Johnson & Johnson’s TVT remains the market leader. Cancer: Doctors have little interest in cryotherapy for prostate cancer or RF therapy for renal cell cancer, and vaccines are viewed as futuristic. ED: Doctors are not sure GlaxoSmithKline’s Levitra will survive, but Lilly’s Cialis has become a strong competitor to Pfizer’s Viagra. However, the market is growing very slowly, and Pfizer has begun to fight back.
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