Arab Today, arab today the quest for less addictive drugs
Last Updated : GMT 21:52:43
Arab Today, arab today
Arab Today, arab today

Overcoming Opioids

The Quest for Less Addictive Drugs

Arab Today, arab today

Arab Today, arab today The Quest for Less Addictive Drugs

Doctors carve from hip to hip
London - Arab Today

Tummy tucks really hurt. Doctors carve from hip to hip, slicing off skin, tightening muscles, tugging at innards. Patients often need strong painkillers for days or even weeks, but Mary Hernandez went home on just over-the-counter ibuprofen.

The reason may be the yellowish goo smeared on her 18-inch wound as she lay on the operating table. The Houston woman was helping test a novel medicine aimed at avoiding opioids, potent pain relievers fueling an epidemic of overuse and addiction.

Vicodin, OxyContin and similar drugs are widely used for bad backs, severe arthritis, damaged nerves and other woes. They work powerfully in brain areas that control pleasure and pain, but the body adapts to them quickly, so people need higher and higher doses to get relief.

This growing dependence on opioids has mushroomed into a national health crisis, ripping apart communities and straining police and health departments. Every day, an overdose of prescription opioids or heroin kills 91 people, and legions more are brought back from the brink of death. With some 2 million Americans hooked on these pills, evidence is growing that they're not as good a choice for treating chronic pain as once thought.

Drug companies are working on alternatives, but have had little success.

Twenty or so years ago, they invested heavily and "failed miserably," said Dr. Nora Volkow, director of the National Institute on Drug Abuse.

Pain is a pain to research. Some people bear more than others, and success can't be measured as objectively as it can be with medicines that shrink a tumor or clear an infection. Some new pain drugs that worked well were doomed by side effects — Vioxx, for instance, helped arthritis but hurt hearts.

Some fresh approaches are giving hope:

—"Bespoke" drugs, as Volkow calls them. These target specific pathways and types of pain rather than acting broadly in the brain. One is Enbrel, which treats a key feature of rheumatoid arthritis and, in the process, eases pain.

—Drugs to prevent the need for opioids. One that Hernandez was helping test numbs a wound for a few days and curbs inflammation. If people don't have big pain after surgery, their nerves don't go on high alert and there's less chance of developing chronic pain that might require opioids.

—Funky new sources for medicines. In testing: Drugs from silk, hot chili peppers and the venom of snakes, snails and other critters.

—Novel uses for existing drugs. Some seizure and depression medicines, for example, can help some types of pain.

The biggest need, however, is for completely new medicines that can be used by lots of people for lots of problems. These also pose the most risk — for companies and patients alike.

ONE DRUG'S BUMPY ROAD

In the early 2000s, a small biotech company had a big idea: blocking nerve growth factor, a protein made in response to pain. The company's drug, now called tanezumab (tah-NAZE-uh-mab), works on outlying nerves, helping to keep pain signals from muscles, skin and organs from reaching the spinal cord and brain — good for treating arthritis and bad backs.

Pfizer Inc. bought the firm in 2006 and expanded testing. But in 2010, some people on tanezumab and similar drugs being tested by rivals needed joint replacements. Besides dulling pain, nerve growth factor may affect joint repair and regeneration, so a possible safety issue needed full investigation in a medicine that would be the first of its type ever sold, said one independent expert, Dr. Jianguo Cheng, a Cleveland Clinic pain specialist and science chief for the American Academy of Pain Medicine.

Regulators put some of the studies on hold. Suddenly, some people who had been doing well on tanezumab lost access to it. Phyllis Leis in Waterfall, a small town in south-central Pennsylvania, was one.

"I was so angry," she said. "That was like a miracle drug. It really was. Unless you have arthritis in your knees and have trouble walking, you'll never understand how much relief and what a godsend it was."

Her doctor, Alan Kivitz of Altoona Center for Clinical Research, has helped run hundreds of pain studies and consults for Pfizer and many other companies. "You rarely get people to feel that good" as many of them did on the nerve growth factor drugs, he said.

A drug with that much early promise is unusual, said Ken Verburg, who has led Pfizer's pain research for several decades.

"When you do see one, you fight hard to try to bring one to the market," he said.

An independent review ultimately tied just a few serious joint problems to tanezumab and the suspension on testing was lifted in August 2012. But a new issue — nervous system effects in some animal studies — prompted a second hold later that year, and that wasn't lifted until 2015.

Now Eli Lilly & Co. has joined Pfizer in testing tanezumab in late-stage studies with 7,000 patients. Results are expected late next year — about 17 years after the drug's conception.

AVOIDING PAIN TO AVOID DRUGS

What if a drug could keep people from needing long-term pain relief in the first place? Heron Therapeutics Inc. is testing a novel, long-acting version of two drugs — the anesthetic bupivacaine and the anti-inflammatory meloxicam — for notoriously painful operations like tummy tucks, bunion removal and hernia repair.

Company studies suggest it can numb wounds for about three days and cut patients' need for opioids by 30 to 50 percent.

There's a good chance of preventing brain responses that lead to chronic pain if patients can get through that "initially very rough period," said Dr. Harold Minkowitz, a Houston anesthesiologist who consults for Heron and treated Hernandez in the tummy tuck study.

Hernandez was part of an experiment testing the drug versus a placebo and doesn't know whether she got the drug or a dummy medicine. But she hurt less than she expected to and never filled a prescription for pain pills.

"The goal would be to have half or more of patients not requiring an opiate after they go home," said Heron's chief executive, Barry Quart. "You have far fewer opiates going out into society, far fewer opiates sitting in medicine cabinets that make their way to a high school."

Studies so far are mid-stage — too small to prove safety and effectiveness — but Heron plans more aimed at winning approval.

ON THE HORIZON

Many companies have their eyes on sodium channel blockers, which affect how nerves talk to each other and thus might help various types of pain. Others are testing cell therapies for nerve pain. Stem cells can modulate immune responses and inflammation, and may "overcome a raft of problems," said Cheng of the pain medicine academy.

Some companies, including Samumed, Centrexion Therapeutics and Flexion Therapeutics, are testing long-acting medicines to inject in knees to relieve arthritis pain. Samumed's aims to regenerate cartilage.

And then there's marijuana. A cannabis extract is sold as a mouth spray in Britain for nerve pain and other problems from multiple sclerosis. But cannabinoid research in the U.S. has been hampered by marijuana's legal status. A special license is needed and most researchers don't even try to obtain one, said Susan Ingram, a neurosurgery scientist at Oregon Health & Science University.

She is studying cannabinoid receptors in the brain, looking at how pain affects one type but not another. Such work might someday lead to drugs that relieve pain but don't produce a high or addiction.

Source: Naharnet

arabstoday
arabstoday

GMT 09:11 2017 Wednesday ,19 April

Cholesterol, the good, bad, and the ugly

GMT 11:12 2017 Tuesday ,18 April

The Quest for Less Addictive Drugs

GMT 08:11 2017 Saturday ,15 April

2bn people drinking contaminated water

GMT 07:44 2017 Friday ,14 April

US doctor charged with genital mutilation

GMT 12:24 2017 Wednesday ,12 April

Global depression numbers surge

GMT 11:09 2017 Tuesday ,11 April

El Nino can warn on cholera outbreaks

GMT 11:34 2017 Monday ,10 April

Swiss Test Wireless Cameras
View News in Arabic - Health: رئيسي ثان
Arab Today, arab today
Arab Today, arab today

Name *

E-mail *

Comment Title*

Comment *

: Characters Left

Mandatory *

Terms of use

Publishing Terms: Not to offend the author, or to persons or sanctities or attacking religions or divine self. And stay away from sectarian and racial incitement and insults.

I agree with the Terms of Use

Security Code*

Arab Today, arab today the quest for less addictive drugs Arab Today, arab today the quest for less addictive drugs

 



Arab Today, arab today

Name *

E-mail *

Comment Title*

Comment *

: Characters Left

Mandatory *

Terms of use

Publishing Terms: Not to offend the author, or to persons or sanctities or attacking religions or divine self. And stay away from sectarian and racial incitement and insults.

I agree with the Terms of Use

Security Code*

Arab Today, arab today the quest for less addictive drugs Arab Today, arab today the quest for less addictive drugs

 



Arab Today, arab today Sumaya Abu Shadi reveals her 2017 collection

GMT 13:37 2017 Friday ,21 April

Sumaya Abu Shadi reveals her 2017 collection
Arab Today, arab today New Zealand considering extra security

GMT 11:56 2017 Wednesday ,26 April

New Zealand considering extra security
Arab Today, arab today Egyptian designer revives Easter Day in her designs
Arab Today, arab today Assad's future 'not a deal breaker' on Syria

GMT 09:15 2017 Wednesday ,26 April

Assad's future 'not a deal breaker' on Syria
Arab Today, arab today A chaotic discovery of power

GMT 09:59 2017 Tuesday ,25 April

A chaotic discovery of power
Arab Today, arab today Ben Ayad Raja prepares to launch new collection

GMT 14:23 2017 Thursday ,20 April

Ben Ayad Raja prepares to launch new collection
Arab Today, arab today Bathtub in Dubai costs $ 1 million

GMT 12:37 2017 Tuesday ,25 April

Bathtub in Dubai costs $ 1 million
Arab Today, arab today Sophisticated Classic Dining Room Design Ideas

GMT 13:23 2017 Tuesday ,18 April

Sophisticated Classic Dining Room Design Ideas
Arab Today, arab today American OSCE monitor killed

GMT 09:52 2017 Monday ,24 April

American OSCE monitor killed
Arab Today, arab today Umma Party Interviews President Al-Bashir

GMT 06:36 2017 Monday ,24 April

Umma Party Interviews President Al-Bashir

GMT 09:11 2017 Wednesday ,19 April

Cholesterol, the good, bad, and the ugly

GMT 11:12 2017 Tuesday ,18 April

The Quest for Less Addictive Drugs

GMT 08:11 2017 Saturday ,15 April

2bn people drinking contaminated water

GMT 07:44 2017 Friday ,14 April

US doctor charged with genital mutilation

GMT 12:24 2017 Wednesday ,12 April

Global depression numbers surge

GMT 11:09 2017 Tuesday ,11 April

El Nino can warn on cholera outbreaks

GMT 11:34 2017 Monday ,10 April

Swiss Test Wireless Cameras
View News in Arabic - Health: رئيسي ثان
Arab Today, arab today
Arab Today, arab today
Arab Today, arab today Meziane Meryan ruled out leaking of coming exams

GMT 16:53 2017 Thursday ,20 April

Meziane Meryan ruled out leaking of coming exams
Arab Today, arab today Oprah Winfrey conquers acting fears

GMT 16:35 2017 Monday ,24 April

Oprah Winfrey conquers acting fears
Arab Today, arab today More Antarctic protections urged

GMT 09:29 2017 Tuesday ,25 April

More Antarctic protections urged
Arab Today, arab today Prepares to give stargazers an eyeful

GMT 13:38 2017 Monday ,06 March

Prepares to give stargazers an eyeful
Arab Today, arab today Hyundai Motor posts 21% drop

GMT 08:22 2017 Wednesday ,26 April

Hyundai Motor posts 21% drop
Arab Today, arab today Volvo profits lifted by strong lorry demand

GMT 11:31 2017 Tuesday ,25 April

Volvo profits lifted by strong lorry demand
Arab Today, arab today Dolli Shahin denies participation in Ramadan

GMT 09:27 2017 Monday ,24 April

Dolli Shahin denies participation in Ramadan
Arab Today, arab today Cold snap threatens French vines

GMT 09:25 2017 Saturday ,22 April

Cold snap threatens French vines

GMT 07:35 2017 Monday ,24 April

Poussy happy for success of “Yegalo Amer”

GMT 07:47 2017 Sunday ,23 April

Actress Reham Abdel Ghaffour reveals her role

GMT 15:44 2017 Saturday ,15 April

Yemeni women live tragic situations

GMT 11:48 2017 Friday ,14 April

Pressure on Japan's swimming champ Hagino

GMT 15:39 2017 Monday ,17 April

Sana Boazzawy reveals her recent designs

GMT 10:15 2017 Friday ,21 April

Degraded coral imperils coastal people

GMT 09:25 2017 Tuesday ,18 April

Second lease of life for abused circus bears

GMT 17:39 2017 Monday ,03 April

Parish Nadia reveals secrets of flowers' drying

GMT 12:35 2017 Monday ,24 April

First Large-Scale Malaria Vaccine Trials

GMT 11:06 2017 Saturday ,22 April

Cases of Hepatitis B and C Hit 325m

GMT 08:45 2017 Monday ,24 April

Syrian refugees are New York tourists

GMT 07:55 2017 Monday ,24 April

Japan National Tourism Organization Exhibits

GMT 06:31 2015 Thursday ,04 June

Pluto's unruly moons

GMT 13:12 2015 Saturday ,09 May

Sheikh Sultan opens Sharjah Centre

GMT 01:30 2017 Saturday ,22 April

Apple unveils updated iPad with lowest-ever price

GMT 10:04 2017 Saturday ,15 April

Baia Susi recycles plastic to shopping bags
Arab Today, arab today
Arab Today, arab today
 
 Arab Today Facebook,arab today facebook  Arab Today Twitter,arab today twitter Arab Today Rss,arab today rss  Arab Today Youtube,arab today youtube  Arab Today Youtube,arab today youtube
arabstoday arabstoday arabstoday arabstoday
arabstoday arabstoday arabstoday
arabstoday
بناية النخيل - رأس النبع _ خلف السفارة الفرنسية _بيروت - لبنان
arabstoday, Arabstoday, Arabstoday