p***o
发帖数: 714 | 1 by pennbrook@168
好久没有正经写点东西了, 今天说说rheumatoid arthritis.
Inappropriate inflammatory cell response is associated with autoimmune
diseases, a spectrum of disorders in which the immune system malfunctions
and causes the body to attack its own organs, tissues, and cells.
The body's own immune system attacks a joint's synovial membrane, which
becomes inflamed, secretes fluid, and the cartilage becomes rough and pitted.
Rheumatoid arthritis大家应该都知道, 基本上每个药出来都是blockbuster.
现在的几种主要治疗方法是:
1. NSAID: 象Pfizer的Celebrex, Merck的Vioxx, generic的ibuprofen等等. 但
NSADI只减轻病痛, 并不治疗病变本身.
2. Steroid, 不多说, 有效, 但副作用极大.
3. Methotrexate is the current standard of care for patients with
rheumatoid arthritis.
4. Injectable Biologicals. The currently dominant TNF-alpha inhibitor
drugs -- mainly Johnson & Johnson's Remicade; Enbrel, which is sold by Amgen
and Wyeth; and Abbott Labs' Humira.现在是市场主导, 但要注射, 而且生物制品很
贵.
现在研发主要是新一代kinase inhibitor, especially oral small molecule drug.
Currently, RIGL’s SYK inhibitors, PFE’s JAK3 inhibitors and INCY’s JAK2
inhibitors are all in advanced clinical trials.
Here is an article from thestreet.com:
New RA Data Could Be Magic Pill for Rigel
Rigel Pharmaceuticals(RIGL) will release new clinical data next month on an
experimental pill for rheumatoid arthritis that could alleviate concerns
about the drug's safety and help the company sign a lucrative partnership
deal later this year.
The Rigel drug, known as R788, is one of two oral medicines in mid- and late
-stage clinical trials as a treatment for rheumatoid arthritis (RA), a
progressive disease in which a patient's immune system attacks the bones and
cartilage in the body's joints.
The current RA treatment market totals about $14 billion in sales worldwide,
with the bulk of that coming from a class of injectable drugs known as "TNF
-alpha inhibitors."
Rigel and Pfizer(PFE ) are locked in a race to develop the first oral pill
for RA that could compete with, and perhaps even supplant, the currently
dominant TNF-alpha inhibitor drugs -- mainly Johnson & Johnson's(JNJ)
Remicade; Enbrel, which is sold by Amgen(AMGN) and Wyeth(WYE ); and Abbott
Labs'(ABT) Humira.
Rigel, a small drugmaker based in South San Francisco, is conducting two
phase II studies of R788 that have enrolled a total of about 650 patients
with RA. The company expects to release the first results from these studies
in July, followed by another data release in August.
Rigel shares have already begun moving higher as investors anticipate the
new R788 data. Rigel shares trading at $8 in late May closed Friday at $11.
89. The stock was up 2.7% to $12.21 in recent trading.
A previous and smaller phase II study of R788 released last year showed the
drug to be effective at alleviating the pain and joint inflammation suffered
by RA patients, but the study was too small to adequately assess R788's
safety. RA is a chronic disease requiring patients to take drugs for the
rest of their lives, so long-term safety is critical.
In particular, R788 caused an increase in blood pressure that raised
concerns about a potential increase in cardiovascular risk for patients. The
two ongoing phase IIb studies were designed, in part, to provide more
detailed safety data on blood pressure effects tied to R788.
If the two studies are positive, Rigel plans to meet with the U.S. Food and
Drug Administration in the fall to get the agency's sign off on a phase III
study program for R788 in RA. The company will also use the new safety and
efficacy data to negotiate a partnership and development deal for R788 with
a larger drug company.
Pfizer's oral RA drug, known as CP-690,550, is already in phase III studies.
Additional phase II data were presented last week at a European meeting of
rheumatologists. Like R788, Pfizer's drug has shown effectiveness at
treating RA, but it also comes with concerning side effects -- in this case,
increases in cholesterol levels.
R788 belong to a new class of experimental oral drugs known as SYK
inhibitors. These drugs work by inhibiting an enzyme found only on immune
cells that prevents the autoimmune process that leads to inflammation and
destruction of joints.
从股票市场来说, INCY, 现在仍在市场低位, 潜力更大些.
Janus Kinase Inhibitors: Compelling Approach to Treat Inflammation,
Myeloproliferative Disorders and Cancer
Potential Benefits
* Convenient oral and topical dosing - current best-of-care anti-
inflammatory therapies are injectable.
* Expected to be effective in patients refractory to anti-TNF therapies.
* Rapid onset of action based on data from Phase IIa clinical studies in
RA and psoriasis.
* Potential to be first targeted therapy for MPDs.
* Broad applicability in a number of autoimmune diseases, malignant
hematologic conditions and solid cancers.
当然还有一些更早期的, 象LXRX的S1P inhibitor等等, 随着progress我们可以慢慢留
意. |
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