100 MAY 2017
Diabetes drugs^
Almost a decade ago, a new wave of diabetes drugs hit the pharmacies,
with promises to lower blood-sugar levels. Yet they failed to alleviate one
of the biggest concerns for Type 2 diabetes sufferers – their increased risk
of cardiovascular disease (CVD).
Last year, two new drugs showed signs of slashing mortality rates from
diabetes related CVD. Empagliflozin modifies the progression of heart
disease by working with the kidney, while liraglutide has a comprehensive
effect on many organs. In light of these results, a distinguished panel of
doctors and researchers, assembled by the Cleveland Clinic in the US,
predicts that, this year, there will be a total shift in the line-up of drugs
prescribed for diabetes – as well as a wave of research into new avenues
targeting Type 2 diabetes and its related diseases.“^
There
will be a
total shift
in the
line-up of
drugs for
diabetes.
”
programmes, such as in cancer. Beyond 2017,
it will become more common for doctors to
use genomic information as a first-line
approach to the diagnosis of diseases.
Doctors should then be able to determine
how best to treat patients. By reading the
clues in individual genome sequences, they
will be able to advise which drugs patients
are most likely to respond to.
Big Data perspectives
The past decade has seen huge advances in
the amount of data we routinely generate,
as well as our ability to integrate, curate,
analyse, understand, store and share it. The
intersection of these trends is what we call
“Big Data” and the healthcare sector (and so
all of us) will be one of its main beneficiaries.
Until recently, the huge amount of data
collected by the medical industry has been
siloed in archives controlled by different
hospitals, surgeries, clinics and universities.
Now, using advanced computing techniques,
doctors can share all types of data – from
symptoms and medications to test results and
responses to medicine – to improve care.
Big Data approaches, such as computer
algorithms, can also detect patterns and
trends to predict epidemics, improve quality
of life, avoid preventable deaths and even
cure disease. Data-sharing arrangements
between the pharmaceutical giants, for
example, led to the discovery that a little used
antidepressant might be able to cure some
types of lung cancer. By using algorithms to
analyse extremely large genetic and biological
databases in this way, we should be able to
find fresh uses for known drugs, accelerating
the development of new treatments.
Experts say it usually takes a decade and
about $1.3 billion to turn a laboratory
finding into a successful drug treatment –
Big Data breakthroughs could cut this to
two years and about $130,000.Blood tests for cancer
Experts say it’s only a matter of time before
diagnosing and treating cancer will be as
routine as an annual check-up, thanks to
so-called “liquid biopsies”. These simple blood
tests look for cell-free circulating tumour DNA
(ctDNA), which is shed from a tumour into
the bloodstream and is more than 100 times
more abundant in the blood than tumour cells.
Studies are still being conducted, but this
technology may do away with invasive tissue
biopsies. Several medical companies are
developing test kits to hit the market next
year and analysts expect huge demand,
tipping annual sales of more than $13 billion.Hope for depression
More than half a million Kiwis have been
diagnosed with depression at some time in
their lives. And for some, traditional anti-
depressants don’t really work. Their only
option is intensive treatments, such as
electroconvulsive therapy.
In 2013, a study to see if ketamine – which
is commonly used for anaesthesia and, less
commonly, as a party drug – could alleviate
treatment-resistant depression (TRD) produced
overwhelmingly positive results: 70 per cent
of TRD patients reported improved symptoms
within 24 hours of being injected with a
low dose of ketamine. As a result, the FDA
expedited the development of new medications
based on the ketamine profile and some, such
as esketamine, are expected to be available
to US patients shortly. There were 579 deaths
by suicide in New Zealand in the 2016
financial year – more than 11 per week – so
the need for an effective treatment for severe
depression is imperative.Self-administered HPV test
In New Zealand, as in other developed
countries, there have been huge strides in the
treatment and prevention of the human
papillomavirus (or HPV), the main cause of
cervical cancer.
Women here are urged to see their doctor
for regular Pap tests, while the free national
HPV vaccination programme has been in
place since 2008 for schoolgirls and began
this year for schoolboys. But the biggest
prevention effort to date is about to take