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© 2002
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May 2002 issues (click links below for full story)
American Society of Hypertension
Summary: Edema may not be a serious problem with CCBs, but it is bothersome, and that should make Forest Laboratories' lercanidipine a winner since edema is significantly less with lercanidipine than with Pfizer's Norvasc. There's no excitement about Forest's Benicar, and doctors see it primarily as a me-too drug in a crowded ARB market. There also is no enthusiasm for either Pharmacia's Covera HS or Biovail's Cardizem XL. Doctors either consider chronotherapy a gimmick, or they already are prescribing other antihypertensive medications at bedtime and see no need for these agents. Pharmacia's eplerenone is expected to appeal mostly to heart failure patients, diabetics and African-Americans. Half the doctors questioned are very concerned about the hyper-kalemia side effect with eplerenone. A cheaper, generic lisinopril is likely to appeal to managed care, but King's Altace is predicted to gain further market share.
American Psychiatric Association
Summary: It was a positive meeting for:Bristol-Myers Squibb's new antipsychotic, Abilitat (aripiprazole), Forest Labs' new SSRI Lexapro (escitalopram), and Johnson & Johnson's Risperdal, which has seen a resurgence in use due to the problems that have arisen with Lilly's Zyprexa. Doctors also are excited about the new IM version of risperidone (Consta) that is expected to be approved by the FDA later this year. Lilly appears to have several winners in develop-ment, including atomoxetine for ADHD, duloxetine for depression and the anxiolytic mGLuR, but the outlook for Zyprexa and OFC (combination Zyprexa+Prozac) is more iffy. Merck continues to have the lead in NK-1s with its Substance P for anxiety, pain and depression. Questions still remain about the oncogenicity of Pfizer's pregabalin. CRF antidepressants are a promising area of research, but it is not clear which company has the lead.
EuroPCR: Paris Course on Revascularization
Summary: The news was mostly good for Johnson & Johnson and Guidant, mixed for Boston Scientific, and too-early-to-tell for Medtronic and Abbott. The preliminary nine-month SIRIUS data showed a 2% in-stent restenosis rate, and a 9.5% in-segment restenosis rate. European cardiologists are anxious to use Cypher stents, but there is little or no reimbursement and that is hampering usage. In the TAXUS trials, restenosis appears to be low, but aneurysms were found, though they are not included in MACE reports due to a lack of clinical effect - yet. Medtronic and Abbott may be trying to convince the FDA to let them skip Phase I and II trials and go directly to a pivotal Phase III trial of ABT-578. The 30-day MACE rate in Guidant's Deliver paclitaxel trial was low, but sources continue to be dubious that this product will be successful.
Association For Research in Vision and Ophthalmology
Summary: Numerous new therapies are under investigation, but the most promising - and closest to market - are Alcon's anecortave and Bausch & Lomb's Envision TD. Anecortave looks as if it could give QLT's Visudyne a run-for-its money in AMD treatment, though there are still questions about efficacy and side effects. There was little new information at this meeting on Envision, a back-of-the eye therapy for diabetic macular edema and posterior uveitis. The prostaglandin marketing wars continue, and the hyperemia issue with Allergan's Lumigan is causing doctors to look harder at Alcon's Travatan, with use of both Lumigan and Travatan increasing at the expense of Pharmacia's Xalatan. No pickup is in sight this year for refractive surgery.