New advancements

Valve Replacement Forums

Help Support Valve Replacement Forums:

This site may earn a commission from merchant affiliate links, including eBay, Amazon, and others.

LUVMyBirman

Well-known member
Joined
Jun 16, 2001
Messages
3,340
Location
Chicago, IL
By Ben Hirschler, European Pharmaceuticals Correspondent


LONDON, July 5 (Reuters) - With treatments ranging from rat poison to extracts from pig intestines, today's options for dealing with thrombosis are hardly alluring.

But now a new generation of synthetic compounds are on the way which could offer a more predictable dosage and response.

New ways to treat blood coagulation will be under the spotlight at the July 6-12 annual meeting of the International Society on Thrombosis and Haemostatis in Paris -- and investors in three European drugmakers will be watching with interest.

Sanofi-Synthelabo of France and Anglo-Swedish group AstraZeneca Plc both have experimental medicines which could challenge Aventis SA's dominance of the $7-billion-a-year thrombosis market.

Analysts, however, believe the Franco-German group will keep its crown for a few years yet.

Much of the scientific debate at the meeting will rake over clinical studies already in the public domain but the meeting is highly topical with the U.S. Food and Drug Adminstration set to rule on Sanofi's new pentasaccharide drug Arixtra by mid-August.

Arixtra -- being developed with Dutch chemical group Akzo Nobel NV -- is the first in a new class of highly selective indirect inhibitors of Factor Xa, a key component in the biological chain that can cause blood clots.

BNP Paribas forecasts the drug will eventually achieve peak sales of more than $1.5 billion a year, shared between Sanofi and Akzo. But getting there may be a long haul.

HIP AND KNEE

Arixtra will initially be used to prevent blood clot formation during surgery. Sanofi wants approval in both hip and knee surgery but a cautious FDA may opt to limit its use, given relatively high instances of bleeding.

"The data would suggest, from our point of view, that the FDA will either issue an approvable letter and ask for more data in hips or just give it a limited indication in knee surgery," said David Beadle of UBS Warburg.

He thinks the immediate threat to Lovenox is therefore limited -- especially since hip and knee procedures together accounted for only 15 percent of Lovenox sales in 2000, a figure which is likely to fall to 13 percent this year.

With nine approved indications -- or therapeutic uses -- worldwide, Lovenox is currently the "gold standard" among low molecular weight heparins (LMWHs) which block the clotting process and are the mainstay of current thrombosis treatment.

Lovenox is Aventis' second largest product with sales growing 33 percent last year to one billion euros ($842 million), representing eight percent of prescription drug sales.

In the long term, Lovenox -- derived from porcine intestinal mucosa -- and other LMWHs will face competition from newer products, but analysts argue Aventis can offset the damage.

"Aventis have embarked on a very aggressive life-cycle management programme for Lovenox and they are adding indications," said Nigel Barnes of Merrill Lynch.

"So although we are likely to see the pentasaccharide eroding its share of the post-orthopaedic surgery indication, there will be a net improvement in Lovenox sales with new indications coming on-stream."

Sanofi is unlikely to launch its drug to treat arterial thrombosis before 2005, by which time Schroder Salomon Smith Barney expects Lovenox to be raking sales of 2.4 billion euros.

ORAL OPTION

AstraZenecaoffers a different proposition with Exanta, previously known as H376, a novel direct thrombin inhibitor which is given by mouth rather than injection.

Its first use is expected to be for venous thromboembolism, a relatively small market, with launches in arterial indications only expected in 2004, if trials are successful.

Exanta is one of four potential blockbusters which AstraZeneca hopes will revitalise sales following the demise of best-selling ulcer pill Losec, and analysts are looking for peak sales of $1.0-1.5 billion -- though concerns were raised recently about possible liver toxicity.

Its biggest potential, though, lies not in stopping clots after surgery but in preventing strokes in patients with atrial fibrillation -- characterised by fast heart rates in the upper chambers of the heart -- where it will not compete head-on with Lovenox.

The current standard treatment is with the drug warfarin -- originally developed as a rat poison. Warfarin, marketed by DuPont Co as Coumadin, is difficult to use since too much can cause serious bleeding and patients need costly monitoring.

07:48 07-05-01
Copyright 2001 Reuters Limited.
 
Very interesting

Very interesting

This is very interesting, but when trying to decide between rat poison or pig intestine mucosa what a difficult choice............they both sound soooooooooo appealing!!!!!
fdeg
 
Hi Francesca

Hope all is well.

How's the Coumadin regulaton going?

Oh yes, pig mucusa, LOL.

Read the Lovenox box and discoved this. Whatever works I suspose. ;)
 
Humbug---Research to benefit the drug companies. Very informative article and showing a lot of motivation $$$$$

It would seem like they would try to curb the costly maintenance to the patients; but of course the doctors would lose out. Have a heart.:)
 
You bet ya Mike. Keywords "lose out".

That is why some doctors are not accepting home INR testing. They flat out refuse to write the prescriptions and the reason "they don't trust the accuracy"

Ok, then.... why do you use the same testing method on your patients in office??? Been there. Boy if that is not frustrating!

There will be some great advancements.....to patients like us we are probably 10 years away from gaining.
 
Hey Gina, I am the first patient in my Dr.'s office to home test so he and I are sorting it out as we go along. He has no problem with the concept provided he is convinced the person is responsible. As I tend to debate everything with him, he is keenly aware of my attention to the details of my treatment.
I fax him my monthly results so he can have something for his files.

He is thinking of buying the office model of the Coaguchek so he can get immediate results. He said it was pretty labor intensive for his staff to stay on the phones providing the INR test results from the blood draws.
 
DICK

DICK

Hi Dick

Sounds like the lines of communication are wide open with your MD.

The doctor that was regulating me was a hematologist and ran a Coumadin clinic in his office. Big time revenue for his practice. Though he helped me in many ways....felt he was holding me back.

My cardiologist is the one that ended up prescribing the Coaguchek and I stopped seeing the hematologist. He must have complete trust in my self regulation skills. There is no contact with the office. The only scary part is that the lab tech is not very knowledgeable in regulating patients. I tested in his office on Monday and have not received my INR results as of yet. What if there was a real problem? Guess I may have to knock on the door of my hematologist one day down the road if I have major concerns. All said and done I am very happy to be self regulating with the Couguchek. I feel it is very accurate.

Must be doing something correct after 7 months. Still ticking:p

PS. Can you bring your S to Nashville? I will bring mine. Rob or Rain the Protime? We need volunteers, LOL. And oh yes, don't forget the band aides!!
 
Coumadin self management?

Coumadin self management?

Gina et. al.,It came as a slight shock to me when I first realized I
knew more about how to manage my coumadin dosage than did my wonderful cardiologist and/or his nurses. I don't know for sure but I don't think the doctors in his office are even notified of the protimes unless they are way out of wack and then in my own case before I began to self regulate I received some wierd dosage instructions. My cardiologist does a slick cath, does great angioplasty, inserts stents in tiny coronary branches, saves lives
every day in the ER and ICU but you know I wouldn't trust him to mange my coumadin!I think the best run anticoagulation clinics are those supervised by pharmacists. In areas where they are allowed to do it patients seem pleased and they tell me the pharmacist will teach and talk to them as long as the patient wishes. I've had expert internists tell me mangaging blood sugar for diabetics is a snap, managing warfarin is tough. So in summary we must take charge of our own care in this area. If you've got a good MD, RN, or pharmacist -fine, but a prudent patient can't leave it all up to them.Ask questions, learn your own body metabolism. Good sources of information are Dr. Jack Ansell at
jaansell@bmc. org, www.warfarininfo.com, a pharmacist site, and
coumadin. com run by Dupont.
 
Thanks Marty. And agree on all points. My cardiologist spends more time (4 days a week) in the hospital performing procedures. He's great at that! He even has admitted that he is not the person to speak to about the regulation of Coumadin doses. But he is the presrcibing MD for my Coaguchek!

What type of pharmacies handle Coumadin regulation? Hospital?

Talk to you soon....
 
Pharmacist Coumadin Clinic

Pharmacist Coumadin Clinic

Gina, I do not know if pharmacists are allowed to manage Coumadin clinics in TN. In Virginia they are not based in drug stores. I am most familiar with Kaiser a big HMO in this area where the pharmacists run the show with backup when needed from hematologists and cardiologists. At the AC Forum in DC last May I met many pharmacists who manage clinics including Dr. Lodwick who has the website www.warfarinfo.com It is state medical politics that determines what a pharmacist can do.
 
Dear Gina,

I am fortunate that I changed my cardiologists after a year and went with a cardiologist affiliated with the hospital I had my surgery. I was having a lot of trouble getting results and he never knew what I was taking as far as the levels. It was phone tag....we played.

My new cardio works with an internist, who handles my coumadin. It is wonderful because his office uses the coaguchek! I get instant response and at the same time he will review and recommend if it is too low or too high. I can go in anytime to do this and he is very close to my house.

As you all say, this doctor is right on target and understands what is going on. I don't even have to get the home tester now like I thought of doing when I heard Rob got one.

Your idea of comparing of the testers at the reunion sounds like a great idea. Hope I can be there to see it. :)

I haven't checked my coumadin at a lab yet to "check" on the coaguchek... I am running at 2.6 and recommended at 2.5-3.5. Should I eat less greens LoL
 
Protime unit, band-aids & my camera!

Protime unit, band-aids & my camera!

I?m the second patient in my cardio?s office to have a home testing unit. The other person is an older lady who lives in the mountains and gets totally snowed in, in the winter.

My cardio has the coaguchek in his office too. He didn?t have a problem writing me a prescription for the unit.... but he wanted me to be regulated first. That was never going to happen! He wants me to call the results in as I do the tests.. but I don?t. I fax them to him about once a month. He holds a big stick you know... He won?t renew my coumadin prescription unless he has current testing results in front of him. lol

Sure Gina, I?ll bring the protime monitor... with extra cuvettes, band-Aids & my camera!! Now that you have your own unit.. Do you see how much easier it is to do it on yourself, than on someone else?! LOL But I?m ready and willing to try it again if you are!! That was so comical in SAT we probably could have sold tickets! Or maybe I should bring the video camera this time. lol

Talk to you later,
Rain
 

Latest posts

Back
Top