August 2010 posts
Acute stroke is the third leading cause of mortality and the major cause of long-term disability in the developed world. Ischemic strokes account for about 85 percent of all acute strokes and are caused by clots that block blood vessels in the brain, stopping the flow of blood to crucial brain areas.
The main approach to treating acute ischemic stroke is thrombolysis, which degrades the clot causing the stroke and provides significant clinical improvements. The only thrombolytic intervention for acute ischemic stroke that is currently approved by the U.S. Food and Drug Administration (FDA) is alteplase. However, alteplase must be administered within three hours after symptom onset to avoid the risk of inducing a hemorrhage in the brain. (More recent evidence supports delivering alteplase up to 4.5 hours.) Because of this time limitation, it is estimated that alteplase is currently administered to less than five percent of acute stroke patients. While this time limitation is a large factor, a high proportion of patients arriving within the appropriate time window still do not receive alteplase due to contraindications (e.g. age, severity, hypertension etc.) or due to the unfavorable risk-benefit ratio.
Recently a new thrombolytic agent, desmoteplase, has been developed that is based upon a protein found in the saliva of the Desmodus rotundus, better known as the common vampire bat.
The study of acetazolamide for idiopathic intracranial hypertension described on page 9 of the Spring issue of BrainWaves raises an important question about a neglected aspect of clinical trials: How do investigators obtain funding to study the efficacy of a drug that has no commercial potential?
Only 300 of the approximately 7,000 known human diseases are of interest to the biopharmaceutical industry from the standpoint of prevalence or commercial potential, according to the Office of Rare Diseases Research (ORDR) at the National Institutes of Health (NIH). The Orphan Drug Act of 1983 sought to use patent protection and tax incentives to promote development of drugs for diseases with a small market. In this context, the word “orphan” refers to a condition or drug that has not been “adopted” by the pharmaceutical industry because of limited commercial potential and a rare disease is one that affects 200,000 or fewer Americans. In the twenty years following enactment of the ODA, 249 orphan drugs received marketing authoriza¬tion, compared to 10 in the preceding decade, with the most notable being Amgen’s erythropoietin.
Commercial potential alone does not determine value
Low prevalence does not equate to limited commercial potential, of course, because pricing must also be considered.
The last steel beam for Swedish’s new Issaquah hospital and outpatient center was lifted into place Aug. 6 in a special topping-off ceremony. The beam was signed by construction workers and hospital officials before being lifted into place atop the structure. The topping-off completes a construction milestone en route to the facility’s phase-one opening in July 2011 in the Issaquah Highlands. Once completed, it will be the first new hospital built in King County in 25 years and will include an ambulatory care center, five-story medical office building and acute-care community hospital.
Over 2,000 people arrived at the Seattle Center’s Mural Amphitheatre on Saturday, June 26th to show their support in raising awareness and finding a cure for brain cancer. There has been over $426,000 raised and the numbers continue to climb.
The walk was hosted by Accelerate Brain Cancer Cure and proceeds from the Seattle Brain Cancer Walk will benefit organizations focusing on brain cancer research and patient care in the Pacific Northwest, including the Ben and Catherine Ivy Center for Advanced Brain Tumor Treatment at the Swedish Neuroscience Institute.
These organizations are now working together using groundbreaking research and integrative patient care, to find a cure. This progress brings hope to families, friends, and the 22,000 Americans - 1,200 in the Pacific Northwest - who are diagnosed with a malignant tumor each year. If you would like more information on how to donate, please contact Davida Pennington at 206-320-3629.