A Pain-Drug Champion Has Second Thoughts

from WSJ.com

It has been his life's work. Now, Russell Portenoy appears to be having second thoughts.

Two decades ago, the prominent New York pain-care specialist drove a movement to help people with chronic pain. He campaigned to rehabilitate a group of painkillers derived from the opium poppy that were long shunned by physicians because of their addictiveness.

Dr. Portenoy's message was wildly successful. Today, drugs containing opioids like Vicodin, OxyContin and Percocet are among the most widely prescribed pharmaceuticals in America.

Opioids are also behind the country's deadliest drug epidemic. More than 16,500 people die of overdoses annually, more than all illegal drugs combined.

Now, Dr. Portenoy and other pain doctors who promoted the drugs say they erred by overstating the drugs' benefits and glossing over risks.

"Did I teach about pain management, specifically about opioid therapy, in a way that reflects misinformation? Well, against the standards of 2012, I guess I did," Dr. Portenoy said in an interview with The Wall Street Journal. "We didn't know then what we know now."

Recent research suggests a significantly higher risk of addiction than previously thought, and questions whether opioids are effective against long-term chronic pain.

Dr. Russell Portenoy talks to The Wall Street Journal.

Read the rest of the story at WSJ.com

Less Painful Shots May Come Courtesy of the Porcupine

From FierceDrugDelivery.com

The clever thing about North American porcupine quills is that they slip through the skin easily but they are really tough to get out. This is useful for the porcupine, not so good for the victim. But this defense mechanism could also have a use in drug delivery, for example, by leading to less painful or more robust needles that do less damage as they slip through the skin.The barbs on a porcupine quill act like a serrated knife, requiring about half the pressure to penetrate a surface than a quill without barbs.

Porcupines have about 30,000 quills of up to 10 cm long, and they have tiny backward-facing barbs on the last 4 mm of the quills. These barbs not only mean that the quills snag on the way out, but also make them slide into the skin more easily, needing around half the pressure needed for quills with no barbs. The barbs act like the serrations on a sharp kitchen knife, cutting cleanly and easily through a tomato.

Creating a needle that penetrates as easily as a porcupine quill but isn't as difficult to remove could mean a shot that is much less painful.

"For needles, we envision we could use 'swell-able' or degradable barbs, to enable easy penetration and easy removal," Jeffrey Karp of Harvard Medical School and Brigham and Women's Hospital told BBC News.

Read the story at FierceDrugDelivery

In Girl’s Last Hope, Altered Immune Cells Beat Leukemia

from nytimes.com

PHILIPSBURG, Pa. — Emma Whitehead has been bounding around the house lately, practicing somersaults and rugby-style tumbles that make her parents wince.

It is hard to believe, but last spring Emma, then 6, was near death from leukemia. She had relapsed twice after chemotherapy, and doctors had run out of options.

Desperate to save her, her parents sought an experimental treatment at the Children’s Hospital of Philadelphia, one that had never before been tried in a child, or in anyone with the type of leukemia Emma had. The experiment, in April, used a disabled form of the virus that causes AIDS to reprogram Emma’s immune system genetically to kill cancer cells.

Read the rest of the story at nytimes.com

Drug Used to Treat Psoriasis (and Crohn's) Shows Promise for Alzheimer's

From NHS Choices

BBC News reports that, "drugs used to calm inflammation in psoriasis [and recently found to improve moderate to severe Crohn's Disease] may also help to combat the effects of Alzheimer's disease, a study on mice suggests." The psoriasis treatment, ustekinumab (brand name Stelera), blocks the effects of proteins released by the immune system known as IL-12 and IL-23 that are associated with the inflammation that causes psoriasis.Ustkinumab, with the brand name Stelera, may treat Alzheimer's

Alzheimer's disease is a type of dementia, a condition characterised by the loss of healthy brain cells and the formation of abnormal deposits of proteins ('plaques') and fibres inside the brain.

The news is based on a study published in the journal Nature Medicine that found that proteins released by the immune system (IL-12 and IL-23) that are associated with inflammation were found in high levels in the brains of mice genetically programmed to develop a disease similar to Alzheimer's (a 'mouse model' of Alzheimer's). 

They used two methods to lower the levels of IL-12 and IL-23 in the mouse model of Alzheimer's:

• deleting the genes that carry the instructions for making IL-12 and IL-23
• treating the mice with an antibody that blocks the effects of IL-12 and IL-23

Both methods were found to reduce the formation of plaques, and the antibody treatment could reverse some of the behavioural problems seen in the mouse model of Alzheimer's.

This finding has generated particular interest because ustekinumab, a drug which blocks the effects of IL-12 and IL-23, is already used to treat psoriasis in humans. 

Because safety data already exists for the use of this drug treating people with psoriasis, it may mean that human trials using it to treat Alzheimer's disease could happen sooner than for a completely new drug. 

However, it is likely that this is still a way off, with more animal research needed first to support the possible effectiveness and safety of the treatment for Alzheimer's.

Read the rest of the story at NHS Choices.

FDA Approves New Flu Vaccine Produced Without Eggs

from fiercebiotech.com

The FDA approved Novartis' novel flu vaccine produced using cultured animal cells instead of the traditional manufacturing process that uses fertilized chicken eggs. Novartis will use a process to manufacture its seasonal flu vaccine at its new plant in Holly Springs, NC, that is based on animal cell cultures and so will cut weeks off production times.

The FDA approved the approach for Novartis Flucelvax a few days ago, saying it provides "the potential for a faster startup of the vaccine manufacturing process in the event of a pandemic." The method is used to make other kinds of vaccines. Novartis has received about $500 million in support from the U.S. government for the Holly Springs plant as part of a program that gives the government say over production in the event of a pandemic. Novartis says the joint investment in the technology and plant is about $1 billion.

The Swiss company will use a cell-culture system derived from the kidney of a dog, The Wall Street Journal said. Using mammal cells will shave about four weeks off the process compared with using eggs and eliminates the need to keep a stock of eggs. Novartis uses the same process at a plant in Germany. Novartis says the North Carolina plant will be the first of its kind in the U.S.

Read the rest of the story at fiercebiotech.com