Sunday, January 31, 2010

Levoleucovorin's supplemental New Drug Application (sNDA) for colorectal cancer...

We know that  Levoleucovorin (see structure; source : chemspider) is  used to treat or prevent toxic effects of methotrexate in people who have received methotrexate to treat bone cancer.

Recently, Spectrum Pharmaceuticals announced that it has met with the FDA regarding it’s supplemental New Drug Application (sNDA) for FUSILEV® (levoleucovorin) for injection for the treatment of patients with advanced metastatic colorectal cancer. The company is expected to  to submit in the third quarter of 2010. The FDA did not request any additional efficacy studies. Hope the FDA will  approve the drug  for advanced metastatic colorectal cancer...

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Rapamycin as a potential treatment for kidney disease (ADPKD).........

I did  mention about the use of Rapamycin (see structure)  to improve the  efficacy of tuberculosis vaccine in my earlier blog. This drug has been already  used as an immunosuppressant drug to prevent rejection in organ transplantation,  especially useful in kidney transplants.

 Rapamycin, was originally developed as an antifungal agent. However, this was abandoned when it was discovered that it had potent immunosuppressive and antiproliferative properties. Some researchers have  also reported that  the drug prolong the life of mice and might also be useful in the treatment of certain cancers.

Researchers from UC Santa Barbara  earlier claimed that, rapamycin has  a potential to treat  kidney disease,  however  concluded  that the  mice had different genes affected than human patients. Interestingly, the same researchers recently found that  "rapamycin is also highly effective in a new mouse model in which the same gene is affected as in most human patients".

As claimed by the lead researcher, Thomas Weimbs currently, no treatment exists to prevent or slow cyst formation and most ADPKD patients require kidney transplants or lifelong dialysis for survival. I think this will boost the confidence of the several international groups,  who are undertaking the  clinical trials  to test the safety and efficacy of rapamycin and related drugs in polycystic kidney disease. Though the  researchers are hopeful of positive results  they caution that,  it will be critical to balance any benefits against the expected side effects to judge whether these drugs should be recommended for the treatment of polycystic kidney disease. Let us be optimistic.....

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Saturday, January 30, 2010

Positive results from Phase 2 trial of picoplatin for colorectal cancer...

In continuation of my update on picoplatin,.......

Poniard Pharmaceuticals, Inc,  claims that Phase 2 trial  study met its primary objective, that is picoplatin in combination with 5-fluorouracil and leucovorin (FOLPI regimen) was associated with a statistically significant reduction in neurotoxicity (p <0.004) compared to oxaliplatin given in combination with 5-fluorouracil and leucovorin (FOLFOX regimen). More...

Friday, January 29, 2010

FDAs approval of fampridine-SR for multiple sclerosis...

In continuation of my  update on MS, I found this info useful to share with. Multiple sclerosis (MS, also also known as disseminated sclerosis or encephalomyelitis disseminata) is a disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms. Disease onset usually occurs in young adults, and it is more common in females. MS affects the ability of nerve cells in the brain and spinal cord to communicate with each other. Nerve cells communicate by sending electrical signals called action potentials down long fibers called axons, which are wrapped in an insulating substance called myelin.

In MS, the body's own immune system attacks and damages the myelin. When myelin is lost, the axons can no longer effectively conduct signals. The name multiple sclerosis refers to scars (scleroses, better known as plaques or lesions) in the white matter of the brain and spinal cord, which is mainly composed of myelin. (see, picture, source : URMC).

Now FDA has approved fampridine-SR (see structure, source : chemspider),  for the treatment of multiple sclerosis. Most interesting part of the research lies in the fact that Researchers at the University of Rochester Medical Center (URMC) have been evaluating the effects of the drug in MS for more than 10 years- it is the first medication shown to enhance some neurological functions in people with the disease and I think their efforts helped pave the way for action by the FDA.

Researchers at URMC helped develop the study protocols and lead the clinical trials  that demonstrated consistently improved mobility - timed walking speed- in more than a third of patients with MS. This is the first instance in which a drug for multiple sclerosis was found to improve function lost as a result of the disease. Goodman and his colleagues published the results of a Phase 3 clinical trial of the drug in the journal Lancet. Fampridine-SR is being developed by Acorda Therapeutics and marketed under the name Ampyra. The company submitted a new drug application to the FDA in February 2009. An expert advisory panel recommended approval of the drug in October and that recommendation was adopted by the FDA on 23. January 2010.

As per the claim by the researchers, fampridine improves the transmission of signals in the central nervous system of some multiple sclerosis patients by blocking potassium ion channels in nerve cells and restoring signal conduction( have covered an article in the same lines).

The authors claim that, 35% of patients taking the drug were responders who consistently improved their walking speed by an average of about 25%. While walking was the primary measure, patients also reported that they could walk farther distances, climb stairs better, and stay on their feet longer. Except for the mild seizure, at the FDA approved dosage, the drug is safe. Hope, people with MS will have some sort of relief......

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Thursday, January 28, 2010

Naproxcinod a better NSAID.....

I knew  about Naproxen, because my first job was with Rallis India  Limited and the pharma division (sold to Shreya Group) was selling it as  a gel. It works by inhibiting both the COX-1 and COX-2 enzymes and that is the reason, why it has side effects. It has  been established already that the selective inhibitors of  COX-2 & 5 -LO will be the best drugs with least or no ulcerogenecity. We have  some drug like Celecoxib with selective inhibition of COX-2 (cyclo oxygenase enzyme), still we need to have selective inhibitors of both COX-2 & 5 -LO, so that  there will not be any cases like Rofecoxib withdrawal.

Naproxcinod, is a nitroxybutyl ester of naproxen. The ester group allow it to also act as a nitric oxide donor. Interestingly, this second mechanism of action makes naproxcinod the first of a new class of drugs, the cyclooxygenase inhibiting nitric oxide donators (CINODs), that are expected to produce similar analgesic efficacy to traditional NSAIDs, but with less gastrointestinal and cardiovascular side effects.  Now NicOx S.A announced that European Medicines Agency (EMEA) has validated the Marketing Authorization Application (MAA) for naproxcinod. NicOx is seeking approval for an indication for the relief of the signs and symptoms of primary osteoarthritis. This follows the acceptance for filing of a New Drug Application (NDA) by the US Food and Drug Administration (FDA) in November 2009.

More interestingly, in addition to naproxcinod, NicOx's pipeline includes several nitric oxide- donating NCEs, which are in development internally and with partners, including Merck & Co., Inc., for the treatment of widespread eye diseases, cardiometabolic diseases, hypertension and dermatological disease.

Details of the press release, one can read at the link....

Wednesday, January 27, 2010

LOAD - a better combination therapy against Helicobater pylori....

In continuation of my update on Helicobater pylori infection and its treatment, I found this info interesting to share with. Dr. Patrick Basu and his colleagues at Columbia University College of Physicians and Surgeons found that,  a shorter course of the four-drug combination (LOAD), seven days vs. a ten-day treatment, is equally effective. As per the claim by the researchers  Helicobater pylori, a bacteria implicated in peptic ulcers and gastritis, was eradicated in 95 percent patients who took a 7-day course of combination therapy with  levofloxacin (L), omeprazole (O), nitazoxanide (Alinia®) (A) and doxycycline  (D) (LOAD) compared to eradication in only 80.9 percent of patients on lansoprazole, amoxicillin and clarithromycin (LAC) for seven days.

The study included 135 patients with treatment naïve Helicobacter pylori infection, who were randomized to LOAD (7 or 10 days) vs. LAC (10 days). There was a total wash out period of six weeks from any prior antibiotic and PPI use prior to the initiation of therapy.

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Tuesday, January 26, 2010

SPC3649 ( LNA- locked nucleic acid) - a new hope for hepatitis C.....

When  I was working with Innovasynth Technologies, Khopoli, I had an opportunity to do literature survey about  Lock Nucleic Acids (LNAs) and Peptide Nucleic Acids (PNAs) (we were supposed to work on the preparation of  some of the LNAs & PNAs for US based companies). In my opinion though these class of compounds (including oligonucleotides) are  still emerging,  I think in the days to come there will be more and more drugs from oligonucleotides, Locked Nucleic Acids (LNAs) and Peptide Nucleic Acids, (PNAs) class of compounds.

LNAs : A locked nucleic acid (LNA) (see the right side general structure), is a modified RNA nucleotide. Ribose moiety of an LNA nucleotide is modified with an extra bridge

connecting the 2' oxygen and 4' carbon. The bridge "locks" the ribose  in the 3'-endo (North) conformation, which is often found in the A-form of DNA or RNA. LNA nucleotides can be mixed with DNA or RNA bases in the oligonucleotide whenever desired. This locking  significantly increases the thermal stability (mp) of oligonucleotide.

LNA nucleotides are used to increase the sensitivity and specificity of expression in DNA microarrays, FISH probes, real-time PCR probes and other molecular biology techniques based on oligonucleotides. For the in situ detection of miRNA the use of LNA is currently the only efficient method. A triplet of LNA nucleotides surrounding a single-base mismatch site maximizes LNA probe specificity unless the probe contains the  G-T mismatch. We have already seen some antisense drugs (oligonucleotides from Geron & Isis) and some are into clinical trials.

Now its interesting to see that Santaris Pharma   is currently advancing LNA based compounds within infectious diseases, metabolic disorders, oncology, inflammatory and rare genetic disorders.

Santaris Pharama, has developed a LNA,  SPC3649 - which captures a small RNA molecule in the liver, called microRNA122, that is required for HCV replication.

As per the claim by the company, SPC3649 works by altering the environment in the host liver cell to inhibit viral replication rather than inhibiting the virus itself. This subtle difference (in comparison  with other therapies) may have significant implications, as it may reduce the risk of the virus becoming resistant to therapy – a major concern with current therapies.

As per the claim by Dr. Robert Lanford,  (who has collaboration with Santaris Pharma), that in a preclinical study  SPC3649 successfully inhibited miR-122, a liver-expressed microRNA important for Hepatitis C viral replication. By inhibiting miR-122, SPC3649 dramatically reduced Hepatitis C virus in the liver and in the bloodstream in chimpanzees chronically infected with the Hepatitis C virus. Four HCV chronically infected chimpanzees were treated weekly with 5 or 1 mg/kg of SPC3649 for 12 weeks followed by a treatment free period of 17 weeks. The two animals that received the 5 mg/kg dose had a significant decline in viral levels in the blood and liver of approximately 2.5 orders of magnitude or approximately 350 fold. Hope the new therapy could potentially replace interferon (interferon and ribavirin is  approved by FDA for hepatitis C and this treatment is very toxic, requires 48 weeks with 50% success) in future cocktails, since it provides a high barrier to resistance. This antiviral could be used alone to treat disease progression and there are indications that it can convert interferon non-responders to responders, so that non-responders to the current therapy could be treated with the combination of this drug with interferon.   More....

Those interested  can see the video demo with the link

Monday, January 25, 2010

Apple pectin as a novel prebiotic substance, that helps the intestinal microbiota....

We know the proverb "An apple a day keeps the doctor away" because of the fact that apple has been  addressing the health effects of the fruit, dates from 19th century. Interestingly apples have shown reduce the risk of  colon cancer, prostate cancer and lung cancer.Compared to many other fruits and vegetables, apples contain relatively low amounts of Vitamin C, but are rich source of other antioxidants.  The fiber content, while less than in most other fruits, helps regulate bowel movements and may thus reduce the risk of colon cancer. They may also help with heart disease, weight loss,  and controlling cholesterol, as they do not have any cholesterol, have fiber, which reduces cholesterol by preventing re absorption, and are bulky for their caloric content like most fruits and vegetables . There is  in vitro evidence that  phenolic compounds in apples (quercetin, epicatechin, and procyanidin B2) are  cancer-protective and  also demonstrate antioxidant activity.

Apples can be canned or juiced and the juice can be fermented to make apple cider (non-alcoholic, sweet cider) and cider (alcoholic, hard cider), ciderkin, and vinegar. Alcoholic beverages are produced such as applejack (beverage) and Calvados.  Apple wine can also be made. Pectin is also produced. 

Now microbiologists at the University of Denmark's National Food Institute,  tested the effect of apple consumption by feeding rats a diet of whole apples as well as apple-derived products such as apple juice and puree. The researchers then checked the bacteria in the guts of the rats to see if consuming apples affected levels of "friendly" bacteria, which are beneficial for digestive health and may reduce the risk of some diseases. Researchers found that rats eating a diet high in pectin, a component of dietary fiber in apples, had increased amounts of certain bacteria that may improve intestinal health.

As per the claim by the researchers, consuming apples affected levels of "friendly" bacteria, (bacteria that are beneficial for digestive health) and there by  reduce the risk of some diseases. And bacteria help produce short-chain fatty acids that provide ideal pH conditions for ensuring a beneficial balance of microorganisms. They also produce butyrate, which is an important fuel for the cells of the intestinal wall. Interestingly, consumption of apple pectin (7% in the diet) increases the population of butyrate and beta-glucuronidase producing Clostridiales, and decreases the population of specific species within the Bacteroidetes group in the rat gut. Similar changes were not caused by consumption of whole apples, apple juice, puree or pomace....

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Sunday, January 24, 2010

New class of drugs for hepatitis C .....

Eiger BioPharmaceuticals, Inc., has come up with a novel class of compounds as HCV Inhibitors. The  research validates a domain, termed 4BAH2, within the non-structural protein (NS4B) of the HCV genome, as essential for HCV replication and describes the development of a high-throughput screen leading to the identification of small molecule inhibitors of 4BAH2.

 Interestingly, the researchers claims that 4BAH2 is the second new domain within NS4B now proven necessary and essential for HCV replication, and which has been shown to be susceptible to pharmacologic inhibition.  Eiger is developing small molecule inhibitors of both NS4B-RNA binding and small molecule inhibitors of NS4B-AH2, each of which has significant activity alone and significant synergy when combined. The researchers have tried the following two compounds (a pyrazolopyrimidine derivative and an amiloride derivative see the below structures). Mechanistic studies reveal that the inhibitors target 4BAH2 function by preventing either 4BAH2 oligomerization or 4BAH2 membrane association. 4BAH2 inhibitors represent an additional class of compounds with potential to effectively treat HCV.

The researchers  claims that like AIDS and tuberculosis, future effective therapy for HCV is expected to require a cocktail of several independent classes of drugs, each designed against a different viral target.
Eiger is focused on the discovery and development of new antiviral agents  against novel targets for the treatment of hepatitis virus infections. Eiger's pipeline includes repurposed clinical stage therapeutic agents as well as preclinical NCEs from discovery that exhibit antiviral activity against Hepatitis C, Hepatitis D, and other viruses.

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Saturday, January 23, 2010

Alternative therapy ?

This is my off the  subject topic, but some how felt interested to share with. As a chemist and science student  still,  I have  many doubts about this  therapy i.e., "past-life therapy".

Now a days, many  Indian TV channels [as for as my knowledge goes NDTv (Hindi),  Kasturi and TV9 (both in Kannada)] have started programs  about this therapy. Most of the persons having been treated by this therapy claimed that,   they have been able to get solutions to the problems they have faced for many months/years.  Out of curiosity, I tried to know about Reiki and other alternative therapies, but  to  my surprise there is no scientific evidence  (1 & 2) for reiki (a systematic review of randomized clinical trials conducted in 2008 did not support the efficacy of reiki or its recommendation for use in the treatment of any condition).

Recently, TV9 has an interview with a doctor (a neurosurgeon), a psychologist and Sri. Balakrishna Guruji of SOMBO. Though the discussion was inconclusive, Guruji, referred to a book by Dr. Brian Weiss titled  "Many Lives, Many Masters: The True Story of a Prominent Psychiatrist, His Young Patient and the Past-life Therapy That Changed Both Their Lives.

This book is all about Dr. Brian Weiss's (traditional psychotherapist - presently Chairman Emeritus of Psychiatry at the Mount Sinai Medical Center in Miami) experience in treating his patient Catherine. For 18 months, Dr. Weiss used conventional methods of treatment to help Catherine overcome her traumas. When nothing seemed to work, he tried hypnosis, which, he explains, “is an excellent tool to help a patient remember long-forgotten incidents" As per the claim by Dr.Weiss, it is just a state of focused concentration. Under the instruction of a trained hypnotist, the patient’s body relaxes, causing the memory to sharpen eliciting memories of long-forgotten traumas that were disrupting their lives.”

As a reviewer says "Dr. Weiss’s experience and Catherine’s transcendental knowledge might be awe inspiring to the Occidental, but to a Hindu, a Buddhist  these methods were followed traditionally and still being followed.

One reviewer  concludes like this : Many Lives, Many Masters makes for an unstoppable read and, like Dr. Weiss, we too realize that "life is more than meets the eye. Life goes beyond our five senses. Be receptive to new knowledge and to new experiences. Our task is to learn, to become God-like through knowledge."... ..............

In fact,  I was in dilemma whether or not publish this article, but read an article titled "Medical Students Supportive of Alternative Medicine" am publishing this...

Those interested reading his other books can visit the link  


Friday, January 22, 2010

Encouraging results from first phase III clinical trials of Balaglitazone (an anti-diabetic drug)......

Balaglitazone (CAS-199113-98-9),5-[[4-[3-methyl-4-oxo-3,4-dihydro-2-quinazolinyl] methoxy]phenyl-methyl]thiazolidine-2,4-dione, (see structure) is a novel partial agonist of PPAR-gamma, which elicits only 52% of the PPAR-gamma activation observed with both pio- and rosiglitazone.
Pre-clinical studies have indicated that besides robust glucose lowering ability, balaglitazone results in lower body fluid accumulation, lower fat accumulation, less heart enlargement and no reduction of bone formation, indicating that Balaglitazone may be able to displace the balance between desired and side effects, and thus show a better safety profile than full agonists of PPAR-gamma.

 Now Reddy's Lab, has come up with interesting results from its  Phase III clinical trial programme.The study explored the impact of adding placebo, Balaglitazone 10mg, Balaglitazone 20mg or Pioglitazone 45mg to a background treatment regimen of stable insulin therapy for a period of 26 weeks. The primary endpoint was HbA1c reduction, while several secondary endpoints including fasting plasma glucose, oedema, weight gain, and body composition were considered.

In all, 409 patients were randomized in roughly equal proportions across the four arms of the study. All three active arms (Balaglitazone 10mg, 20mg and Pioglitazone 45mg) showed similar levels of efficacy with respect to both HbA1c and fasting plasma glucose.

All three active arms showed good tolerability and adverse event profile, with Balaglitazone 10mg demonstrating less water retention, less fat accumulation, lower weight/BMI gain and less bone loss when compared to the Pioglitazone arm.

Encourged by these results both companies (Dr. Reddy's & Rheoscience) are planning for detailed studies required for registration of  Balaglitazone.

Type 2 diabetes is a major cause of morbidity and mortality in the industrialized world, with cardiovascular disease as the leading cause of death, accounting for almost 50% of all T2D deaths. Furthermore, the number of T2D patients is increasing rapidly, and the number of patients is expected to reach between 300 and 380 million by 2025, thereby placing an enormous economical burden on global healthcare. Hope new drugs will take care of this problem.

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Thursday, January 21, 2010

Brilinta (Ticagrelor) better than Plavix. ?.......

W knew that, Astra-Zeneca,  in its PLATO clinical trial in mid-2009,  found that ticagrelor had better mortality rates than clopidogrel (9.8% vs. 11.7%, p<0.001) in treating patients with acute coronary syndrome. Patients given ticagrelor were less likely to die from vascular causes, heart attack, or stroke but had slightly greater chances of major bleeding which was non-significant (11.6 vs. 11.2, p=0.4). Like clopidogrel and ticlopidine, ticagrelor blocks ADP receptors of subtype P2Y12. In contrast to the other antiplatelet drugs, the blockage is reversible. Moreover, it does not need hepatic activation, which could reduce the risk of drug interactions-which makes it special.

Now this has been further substantiated by Dr. Chris. Cannon, who claims that  clot-busting drug Ticagrelor (Brilinta), may soon take the place of Clopidogrel (Plavix) in treating patients with acute coronary syndrome, which includes angina and heart attack.

In a new trial (by Dr. Christopher Cannon, a cardiologist with Brigham and Women's Hospital and an associate professor of medicine at Harvard Medical School, both in Boston), the upstart drug ticagrelor (Brilinta) reduced the risk of second heart attacks and death without raising the risk of bleeding, as clopidogrel (Plavix) can do and the authors claim  that this is pretty compelling evidence from this trial that ticagrelor is better without any increased risk of bleeding. 

In this study (funded by AstraZeneca) of more than 13,000 patients with acute coronary syndrome, Brilinta, appears to be more potent than Plavix and has  emerged with several advantages over the old standby  claims the researchers.

Brilinta is s processed as soon as it's swallowed (meaning it doesn't have to go through the liver), and kicks in faster than Plavix, where as Plavix (usually in combination with aspirin) has its share of problems, namely a lag time between when it is administered and when it takes effect, and variability in how different individuals respond to it. And because of an increased risk of bleeding, Plavix must be discontinued before surgery. Overall the researchers, claim that Brilinta has a more reliable level of anti-clotting effect. There's less variability. At the dose, it has about twice the level of anti-clotting effect and hence the  benefit in preventing heart attacks and stent thrombosis. The authors attribute the reason for the superiority of the drug to its quicker reversblity (than Plavix) and patients could have surgery with a lower risk of bleeding. FDA is expected to approve the drug late this year and  hope the patients with thrombosis, angina and acute coronary syndrome will breathe a sigh of relief...

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Wednesday, January 20, 2010

BQCA improves symptoms of Alzheimer’s disease in rodents.....

The compound  benzylquinolone carboxylic acid (BQCA)  has been shown in earlier studies (rodent)  to lessen the occurrence and severity of the behavioral disturbances often symptomatic of Alzheimer's, such as hallucinations, delusions, paranoia and outbursts. But the important feature of this research lies in the fact that the compound, was able to change the way the brain works and whether or not it improved memory in our 'Alzheimer's mice,' which are experiencing progressive cognitive decline much like a person with Alzheimer's does.

Other attempts to identify such a specific treatment for Alzheimer's have failed, according to Dr.Michelle  Nicolle, the lead researcher. As per her claim "current treatments only treat the symptoms while the underlying disease is still progressing and  so recent research efforts are focusing on stopping disease progression instead of symptomatic treatment".

The researchers' findings suggest that  the compound BQCA,  could alter the progression of disease in mice and  ultimately  hold importance for humans as well.

BQCA activates a specific neurotransmitter receptor in the brain called the M1 muscarinic acetylcholine receptor. M1 receptors have been the focus of research into treatment of Alzheimer's disease because they affect the part of the brain that stimulates the memory and learning functions the disease inhibits. Until now, scientists have not found a treatment selective enough to activate the receptors without producing side effects such as nausea, vomiting and increased frequency of urination. As per the claim, BCQA is specific and BQCA also seemed to inhibit production of amyloid beta, one of the markers of Alzheimer's disease in the brain - perhaps key to the compound's potential for slowing the progression of the disease. Though detailed studies are still to be established its an interesting research. I found an interesting article in the same lines, those interested can read.

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Tuesday, January 19, 2010

Quercetin blocks Hepatitis C infection....

The conventional treatments for hepatitis C are interferon and ribavirin, which can cause major side effects and aren't effective in all patients. But something interesting and unique has been achieved  by UCLA researchers.

As per the claim by the lead researcher Samuel French Assistant Professor, Pathology of UCLA, they have  identified major two cellular proteins (HSPs, heat shock proteins 40 and 70) that play an important role in hepatitis C infection, and they say the finding may point to new and less toxic treatments for the disease, which can lead to cirrhosis and liver cancer. The researchers also found that Quercetin,  blocks the synthesis of two heat shock proteins 40 and 70proteins  and significantly inhibited viral infection in tissue culture.

Quercetin (see the structure) :  

Is a plant-derived flavonoid, specifically a flavonol, used as a nutritional supplement. Laboratory studies show it may have anti-inflammatory and antioxidant properties,  and it is being investigated for a wide range of potential health benefits.Interestingly American cancer society, says that while quercetin has been promoted as being effective against a wide variety of diseases, including cancer, There is current early-stage clinical research on quercetin addressing safety and efficacy against sarcoidosis, asthma and glucose absorption in obesity and diabetes. Food riches in Quercetin includes, capers, lovage, apples, tea (Camellia sinensis), onion, especially red onion (higher concentrations of quercetin occur in the outermost rings), red grapes, citrus fruit, tomato, broccoli and other leafy green vegetables, cherries and berries.

Significant claims by the researchers are ;

a. quercetin targets cellular proteins rather than viral proteins, there is less likelihood of developing viral
    resistance (cellular proteins cannot change like viral proteins can);
b. quercetin may allow for the dissection of the viral life cycle and has potential therapeutic use to reduce
    virus  production with low associated toxicity.

Hope the researcher will have positive results from the phase 1 clinical trial.....

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Monday, January 18, 2010

Metformin - safe for patients with advanced heart failure and diabetes mellitus

In continuation of my update on Metformin,   I am sharing herewith  something interesting info,  about the same drug. Now researchers from David Geffen School of Medicine at UCLA,  have found that metformin, a drug often used in the treatment of diabetes mellitus, is safe for use in treating patients who have both diabetes and advanced heart failure. 

Diabetes increases not only the risk of developing heart failure, but also the risk of death among heart failure patients. This is due in large part to the fact that diabetes, because it increases the amounts of sugar and fat circulating in the bloodstream, accelerates the onset of coronary atherosclerosis. This hardening and thickening of blood vessels is the hallmark of atherosclerotic heart disease, the most common cause of death. The optimal treatment for high glucose and fat blood levels among heart failure patients has not been demonstrated.

The new study involved 401 patients of an average age of 56, with type II diabetes and advanced systolic heart failure. This patient cohort was followed for 14 years in a comprehensive heart failure management program.

The study results suggest that, in patients with both advanced heart failure and diabetes, use of metformin is safe, and may be associated with better heart failure survival.

Interestingly, the diabetes drug metformin previously carried a "black box warning" from the FDA against its use in treating diabetes in heart failure patients and that is why most many physicians have been reluctant to use metformin and other similar medications to treat this patient group. However, analysis by the researchars, shows that using metformin to treat diabetes in patients with advanced, systolic heart failure is not only safe, but may also play a role in improving outcomes compared to conventional diabetes care. As per the claim by Dr Gregg Fonarow, coresearcher,  metformin improves myocardial function via activation of a signaling mechanism (AMP-activated protein kinase) independent of antihyperglycemic effects. Together, these studies suggest that metformin may be cardioprotective by augmenting heart function at the molecular level, and should be further investigated as a treatment for heart failure, irrespective of diabetes....

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Sunday, January 17, 2010

DBZ an Alzheimer drug in clinical trails - a new hope for oesophageal cancer ?

Though there are some drugs for other cancers, but there is no good treatment, and sufferers for the cancer of  oesophagus  or gullet  and the patients  frequently face a short, painful battle which ends all too quickly in death. Many of the cancers diagnosed are in people with a long history of heartburn.

About Oesophagus cancer :

Chronic heartburn leads to the lower parts of the gullet being bathed in a toxic acid solution, and the lining of the gullet defends itself against this by changing itself into something which looks a lot like the lining of the lower intestines. Although the damaged tissue, called Barrett's oesophagus, is not cancerous in itself, its presence warns doctors that the patient has taken the first step towards cancer, and triggers a rigorous programme of monitoring, coupled with therapy to prevent further damage.

Patients with Barrett's oesophagus can be stabilised, and most do not go on to develop cancer, but once it is there, the mutated tissue is almost impossible to eradicate, so the risk always remains. Researchers have long been searching for new drugs able to revert Barrett's oesophagus to the healthy, normal lining of the gullet, and now, a team led by Hans Clevers of the Hubrecht Institute, Utrecht, have come up with a drug DBZ (see structure : source : Paul J. Ciaccio)  a drug already in clinical trails for the Alzheimer's disease.

The interesting part of this research is the basis for testing the drug. Clevers' team, whose research into colon cancer is world-renowned, reasoned that as Barrett's oesophagus cells are very similar to the cells which line the colon, they might share vital control pathways.

Clevers and his team then put this together with the fact that  the anti-Alzheimer's drug DBZ, currently in clinical trials, is known to have side effects on the lower gut lining. Researchers used a rat model of oesophageal cancer to observe the effects of DBZ on Barrett's oesophagus tissue, and found that DBZ could halt the growth of Barrett's oesophagus, and in some cases completely destroyed the mutant tissue. Whilst the treatment is still a long way from being trialled in humans, it is an exciting step forward in the fight for a cure for oesophageal cancer.

New hope for therapy in heartburn-related cancer is presented in the Research Article entitled 'Conversion of metaplastic Barrett's epithelium into post-mitotic goblet cells by gamma-secretase inhibition',
Hans Clevers et. al., Disease Models & Mechanisms (DMM), Vol3, Issue 1/2,

I found an interesting article in the similar lines, those interested can read at the link...

Saturday, January 16, 2010

Pomegranates May Prevent Growth of Breast cancer cells.....

We know that Pomegranate aril juice provides about 16% of an adult's daily vitamin C requirement per 100 ml serving, and is a good source of vitamin B5 (pantothenic acid), potassium and antioxidant polyphenols.  The most abundant polyphenols in pomegranate juice are the hydrolyzable tannins called punicalagins which have free-radical scavenging properties in laboratory experiments. Punicalagins are absorbed into the human body and may have dietary value as antioxidants. Other phytochemicals include polyphenols catechins, gallocatechins, and anthocyanins such as prodelphinidins, delphinidin, cyanidin, and pelargonidin.   Many food and dietary supplement makers have found advantages of using pomegranate phenolic extracts as ingredients in their products instead of the juice. One of these extracts is ellagic acid which may become bioavailable only after parent molecule punicalagins are metabolized. However, ingested ellagic acid from pomegranate juice does not accumulate in the blood in significant quantities and is rapidly excreted. Accordingly, ellagic acid from pomegranate juice does not appear to be biologically important in vivo.

Now researchers lead by Dr Shiuan Chen, director of the Division of Tumour Cell Biology, and Dr Lynn Adams, a research fellow at the centre's Beckman Research Institute have found that Pomegranates contain a group of compounds called ellagitannins ( glucosidesof elligacic acid) may prevent the growth of breast cancer cells. Researchers tried to determine whether chemicals in pomegranates could block the action of an enzyme called aromatase. Aromatase plays a key role in driving the growth of some forms of breast cancer by helping the body produce the female sex hormone oestrogen. Breast cancer drugs like anastrozole are designed to block its action.

The researchers screened ten ellagitannin-like compounds and found that one in particular, Urolithin B, (see above structure) significantly inhibited breast cancer cell growth in the laboratory. Its interesting to note that phytochemicals in pomegranates to exhibit this property (earlier the same authors have reported the inhibition of aromatase by grapes (phytochemicals).

Though further studies like in vivo are essential to further substantiate the in vitro studies (relatively high levels of ellagitannin compounds were required to demonstrate an anti-proliferative effect on cultured breast cancer cells) are essential (because of the fact that  the ellagitannins are not well absorbed into blood when provided in the diet), still in my opinion its a good finding......

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Friday, January 15, 2010

Benefits of calcium and vitamin D in preventing fractures confirmed

Benefits of calcium and vitamin D in preventing fractures confirmed

Phentermine & Topiramate combination (Qnexa®) for obstructive sleep apnea (OSA)....

In continuation of my update on Qnexa® (combination of Phentermine & Topiramate), a drug by VIVUS, Inc., I found this info really interesting  to share with.

VIVUS, Inc on 7. January 201, announced positive results from a phase 2 study evaluating the safety and efficacy of Qnexa®, an investigational drug, for the treatment of obstructive sleep apnea (OSA). VIVUS recently completed phase 3 development of Qnexa for the treatment of obesity and submitted a New Drug Application (NDA) to the FDA for that indication. The OSA- study announced  demonstrated statistically significant improvement in the apnea/hypopnea index ("AHI" - a measure of the severity of sleep apnea) in patients with OSA treated with Qnexa for 28 weeks.

OSA is a sleep-related breathing disorder that involves a decrease or complete halt in airflow despite an ongoing effort to breathe. OSA is associated with an increased risk of hypertension, diabetes, stroke, sudden cardiac death and all-cause mortality. Currently, there are no approved pharmacologic treatments for OSA and current treatment approaches are limited to devices or surgery, so if approved by the FDA, Qnexa®  not only reduce the weight  but also significantly improve sleep apnea.

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Thursday, January 14, 2010

NDA of Lurasidone for Schizophrenia...

In continuation of my update on  Lurasidone, ........

Dainippon Sumitomo Pharma America, Inc. (DSPA), a U.S. subsidiary of Dainippon Sumitomo Pharma Co., Ltd. (DSP), submitted a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA) for lurasidone, an investigational atypical antipsychotic agent for the treatment of schizophrenia. The application, submitted on December 30, 2009, includes data from more than 40 clinical studies involving more than 2,500 lurasidone-treated patients.The efficacy of once-daily lurasidone was demonstrated in four six-week, placebo-controlled studies, involving hospitalized patients with schizophrenia. These studies included the global PEARL 1 and PEARL 2 clinical trials....

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Wednesday, January 13, 2010

Clorgyline an old antidepressant may reverse heart failure....

We know that Clorgyline is an irreversible and selective  inhibitor of monoamine oxidase A (MAO-A) . It is structurally related to pargyline (which is a preferential inhibitor of MAO type B) and when compared the antidepressant activity clorgyline is superior over Pargyline. However the drug is no longer in use in humans

Interestingly, now researchers from Johns Hopkins and other researchers have found in animal experiments that this  antidepressant developed over 40 years ago,  can blunt and even reverse the muscle enlargement and weakened pumping function associated with heart failure. Italian heart experts describes in a dozen key laboratory experiments in rodents how the  clorgyline,  blocks the action of enzyme monoamine oxidase-A (MAO-A) and stops its breakdown of a key neurohormone. Norepinephrine, as it is called, controls the pace of blood pumping and makes the heart pump harder and faster in response to stress.

This result is of great significance because of the fact that this is the first evidence showing how elevated MAO-A activity biochemically drives heart failure and that its dangerous downstream effects can be stalled by drug therapy. Hope this vicious chemical circle of stimulant norepinephrine overload and breakdown, might  offer  a disease blueprint with monoamine oxidase-A as the target for drugs similar to clorgyline to rein in the disease.

As claimed by the lead researcher Dr.Nazareno Paolocci, norepinephrine is not properly stored and released from the nerves directed to the heart, monoamine oxidase-A breaks it down, generating dangerous chemical species in the nerves and the heart muscle. and these toxic free radicals produce the same deleterious effects on heart muscle size and pumping function long observed in heart failure. Though further studies with similar class of compounds is essential  for this initial proof of an important principle, its a good achievement..

More details...

Tuesday, January 12, 2010

Celecoxib reduces the risk of common skin cancer in humans.....

We know that Celecoxib   is a non-steroidal anti-inflammatory drug (NSAID)  used in the treatment of osteoarthritis, rheumatoid arthritis, acute pain, painful menstruation and menstrual symptoms, and to reduce numbers of colon and rectum polyps in patients with familial adenomatous polyposis. It is marketed by Pfizer. It is known under the brand name Celebrex or Celebra for arthritis and Onsenal for polyps. Celecoxib is available by prescription in capsule form.

Researchers from UC-San Francisco and Children's Hospital Oakland,  (Dr. Tang was was an assistant professor at UC-San Francisco and Children’s Hospital Oakland  when the trial was conducted) have come up with very interesting results for the same drug. The drug can reduce the risk of a common skin cancer in humans. Though celecoxib, is associated with an increased risk of heart attack and stroke in some people, it's possible that topical application could have a safer, protective effect for people prone to developing the cancers, called basal cell carcinomas, the researcher believes.

For the current research, Tang and her colleagues capitalized on a previous finding suggesting that celecoxib, a NSAID, can inhibit the development of a different kind of skin cancer, squamous cell carcinoma, in mice. They wondered if the drug, sold by the pharmaceutical company Pfizer under the brand names Celebrex and Onsenal, would have a similar effect on the more common basal cell carcinoma.

Celecoxib is thought to work to prevent or slow cancer growth by interfering with the action of an enzyme called Cox-2, which causes tissue inflammation (pro inflammator). Celecoxib has both pain-killing (analgesic) and anti-inflammatory properties. Chronic inflammation has long been associated with the development of many types of cancer, and celecoxib has been shown in clinical trials to reduce the incidence of colon cancer in people with a genetic predisposition to the disease.

Interestingly, researchers stopped the clinical trials in 2003 (from 2001) when the study lead to high risk  of heart attack and stroke in patients taking a different NSAID. (RofecoxibVioxx by  Merck & Co. was withdrawn from the market by Merck in 2004  and Tang's trial was discontinued that year in response to ongoing concerns about long-term treatment with Cox-2 inhibitors). At that time, most participants had received about two years of drug treatment. No patient died or suffered adverse cardiovascular events due to their participation in the trial. Although drug treatment had been discontinued, the researchers continued to monitor basal cell carcinoma formation in people who had received the drug or placebo for an additional year to complete the three-year study. They found that, although both groups continued to develop new cancers during the study, oral celecoxib treatment decreased the growth of skin tumors by about 50 percent as compared to placebo in participants who entered the trial with 15 or fewer basal cell carcinomas. Celecoxib treatment also reduced the overall tumor burden in the  group of patients (where in the carcinomas are removed upon diagnosis in most people).

Now the lead researcher Dr. Tang is continuing her focus on skin cancer prevention at Stanford. She's currently investigating whether it's possible to develop a topical formulation of the drug that can be applied directly to the skin to achieve a similar protective effect without associated cardiovascular risk. Hope she will get positive results via topical formulation .....

In my opinion  its really a great achievement.We know that compounds with selective inhibitors of 5-LO (Lipoxygenase) and COX (Cyclooxegenase, that too COX-II) will be  the best NSAIDs without any ulcerogenecity, its good see that the  same compounds can be used to treat skin cancer....

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Monday, January 11, 2010

Talampanel has potential to slow the muscle weakening that comes with amyotrophic lateral sclerosis (ALS)...

Talampanel (strutcure, source:ChemSpider), (8R)-7-Acetyl-5-  (4-aminophenyl)-8,9-dihydro-8-methyl-7H-1,3-dioxolo[4,5-h][2,3]benzodiazepine  is a drug used to treat epilepsy. Now researchers from Johns Hopkins and Indiana University, have found interesting activity of the same anticonvulsant drug, i.e., the drug has potential to slow the muscle weakening that comes with amyotrophic lateral sclerosis (ALS)  . The researchers after completing a Phase II clinical trial-an early, small-scale test to show if the drug works and continues to be safe. As per the claim by the researchers,  the drug talampanel showed some ability to slow the loss of major daily life activities such as speaking, walking and dressing that typically slip away as the disease progresses. Interestingly the drug  has the anti-anxiety and  muscle relaxing activity too (work in the brain and spinal cord).

The trial in 59 volunteers with ALS - also called Lou Gehrig's disease - showed that talampanel can be safe for patients with the disease and that any recorded side effects are tolerable.  Phase II trials are designed to show on a small scale if a drug is safe and if it works. So the present trial included ways to measure the drug's benefits, which came across as clear, if not statistically significant. The research demonstrates that talampanel appears able to slow the progression of disabling ALS symptoms. Though the effect isn't overwhelming at the dosage of medicine used in this early, very small trial and the researchers claims that  having promising human data is reason enough to keep it in the drug pipeline where they can really find out where it stands for patient.

With the exception of riluzole, the single FDA-approved drug for the disease, there's no other treatment to slow or stop it. Riluzole can extend life only modestly and hasn't been shown to slow ALS symptoms. so the need for better therapy is real. Hope in the days to come people with ALS symptoms will have a better drug...

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Sunday, January 10, 2010

Scientists determine how RNAi, a biological response to RNA, can regulate gene expression

Scientists determine how RNAi, a biological response to RNA, can regulate gene expression

New key factor (ßCTF, a small protein found in APP) identified in the development of Alzheimer's disease...

Inheritance of an extra copy of the gene- β -amyloid precursor protein, APP, in individuals with Down syndrome leads to the inevitable development of early onset Alzheimer's disease, known to be linked to the deposition of Amyloid β peptide or Aβ in the brain. However, a new study published online by Proceedings of the National Academy of Sciences identifies βCTF, a small protein found in APP, as a novel factor for the development of Alzheimer's disease related endosome abnormalities, which have also been tied previously to the loss of brain cells in Alzheimer's disease.

In their study, using the cells from individuals with Down syndrome that are genetically predisposed to developing Alzheimer's disease, the researchers showed that elevated levels of ßCTF, independent of Aß, cause a specific pattern of endosome defects with similar pathology of brain cells in Alzheimer's disease. As per the claim by Dr. Ying Jiang, (Department of Psychiatry at NYU Langone Medical Center. they were successfully able to pinpoint that ßCTF causes Alzheimer's disease-related endosome defects and successfully reverse these endosome defects by lowering ßCTF levels in the cells. Hope this study demonstrating an alternative protein factor, ßCTF, derived from the gene APP, is also unequivocally involved in Alzheimer's disease and may be of additional importance for the development of future effective therapies in the days to come...

Saturday, January 9, 2010

Cladribine-the first oral disease-modifying multiple sclerosis therapy ?

In my earlier blog, I have mentioned about the NDA (new drug application) of this drug Cladribine as drug to treat Multiple SclerosisNow as per the report by Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that a recent "refuse to file" (RTF) letter issued by the FDA regarding Merck Serono's oral cladribine has heightened the competition between oral cladribine and its primary competitor, Novartis/Mitsubishi Tanabe's FTY-720 (fingolimod), to be the first oral disease-modifying multiple sclerosis therapy to reach the market in the United States.

Although oral cladribine's first-to-market advantage over FTY-720 will be reduced as a result of a likely delay to market caused by the FDA's action, oral cladribine is still expected to launch in the U.S. in 2010 while FTY-720 remains on track to launch in early 2011. .....

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Friday, January 8, 2010

Imetelstat (GRN 163L) shows promising results against brain cancer glioblastoma and prostate cancer...

In continuation of my update on Telomerase inhibitors, I find this info really interesting and hence sharing here with. As mentioned in my earlier blog about imetelstat (GRN163L )  has been undergoing Phase I clinical trials designed to examine the safety, tolerability, pharmacokinetics and pharmacodynamics of the drug, alone or in combination, in solid tumors, chronic lymphoproliferative disease, multiple myeloma, lung and breast cancers and the company claims that Phase I objectives for imetelstat  (structure) have been achieved. Now  Dr. Jerry Shay, professor of cell biology of  The University of Texas Southwestern Medical Center at Dallas, claims that the same drug shows promise in fighting the brain cancer glioblastoma and prostate cancer.

Glioblastomas are the most common malignant brain tumors in adults, according to the American Cancer Society. They are difficult to treat with drugs because blood vessels in the brain have tightly constructed walls that allow only a few substances to pass through.

The researcher focused on cells called tumor-initiating cells. Some researchers believe that tumors contain a small subset of initiating cells – or cancer stem cells – that are able to initiate and drive tumors and that are often resistant to radiation therapy and chemotherapy.

In the glioblastoma study, Dr. Shay and his colleagues found that imetelstat blocked the action of telomerase in isolated tumor-initiating cells as well as the bulk of the tumor cells, eventually killing the cells. Combining imetelstat with radiation and a standard chemotherapy drug made imetelstat even more effective. When the researchers implanted human tumor-initiating cells into rodents, they found that imetelstat was able to enter brain tissue and inhibit telomerase activity.

In the prostate cancer study, the researchers isolated tumor-initiating cells from human prostate cancer cells. The cells showed significant telomerase activity. Imetelstat blocked the enzyme’s activity, and telomeres shortened greatly. As per Dr.Shay, since the drug attacks a mechanism that is active in most cancers, it might prove to be widely useful, especially when combined with other therapies.

Hope  Geron people must be really happy for these results  and conclusions.....

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Thursday, January 7, 2010

Liquorice root for antibiotic-resistant infections resulting from severe burns...

Liquorice root candy, or properly Glycyrrhiza glabra, is the dried root  of the liquorice plant (see pictures - credit : wikipedia), which is eaten as a candy. It is also used in traditional Chinese medicine, as well as in the traditional medicines of Japan, Korea, Vietnam, and other Asian nations (In India ಯಷ್ಠಿಮಧು/ಅತಿಮಧುರ (in kannada & मुलहठी in hindi). The extract of the liquorice root is one of the main ingredients in liquorice confectionery. Liquorice root can be shredded and added to boiling water to create liquorice root tea. Liquorice root has been traditionally used as a herbal remedy against different symptoms, such as cough and catarrh. People with heart conditions or high blood pressure should avoid ingesting extensive amounts of liquorice, as it can further heighten blood pressure and lead to stroke.

Though liquorice root has also been reported to speed the healing of canker sores, now researchers from University of Texas Medical Branch and Shriners Hospitals for Children have come up with more interesting findings, that is root can be used to treat antibiotic-resistant infections resulting from severe burns. They found that in burned mice, glycyrrhizin improved the ability of damaged skin to create small proteins that serve as the first line of defense against infection. These proteins, called antimicrobial peptides, work by puncturing the cell membranes of bacteria similar to how pins pop balloons. As per the claim by the researchers lead by Dr. Fujio Suzuki, more research is necessary to determine if this finding would have any implications for people with cystic fibrosis, who can develop Pseudomonas aeruginosa infections in their lungs.

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Wednesday, January 6, 2010

Donepezil hydrochloride for Dementia Related to Alzheimer's Disease...

We know that, ARICEPT® [donepezil hydrochloride, see structure  (source-chemSpider) ] is a reversible inhibitor of the enzyme acetylcholinesterase, known chemically as (±)-2,3-dihydro-5,6-dimethoxy-2 -[[1-(phenylmethyl)-4-piperidinyl]- methyl]-1H-inden-1-one hydrochloride. Donepezil hydrochloride is commonly referred to in the pharmacological literature as E2020.

Acetylcholinesterase is the target of many Alzheimer's Dementia drugs , nerve gases, particularly the organophosphates (e.g. Sarin) and insecticides (e.g. carbaryl). These agents — known as cholinesterase inhibitors — block the function of acetylcholinesterase and thus cause excessive acetylcholine to accumulate in the synaptic cleft. The excess acetylcholine causes neuromuscular paralysis (i.e. interminable muscle contractions) throughout the entire body, leading to death by asphyxiation.

The U.S. Food and Drug Administration approved the first generic versions of Aricept (donepezil hydrochloride) orally disintegrating tablets on Dec. 11. Donepezil hydrochloride is indicated for the treatment of dementia related to Alzheimer's disease. Orally disintegrating tablets dissolve on the tongue, without having to be swallowed whole. This may make it easier to take the medication for older or disabled patients who have difficulty swallowing.

Alzheimer's disease :

Alzheimer's disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks of daily living. In most people with Alzheimer's disease, symptoms first appear after age 60. Alzheimer's disease is the most common cause of dementia among older people, but it is not a normal part of aging...

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Tuesday, January 5, 2010

Quetiapine fumarate (Seroquel XR) for Major Depressive Disorder (MDD)....

Quetiapine fumarate (see structure) is marketed by AstraZeneca as Seroquel or SeroquelXR and by Orion Pharma as Ketipinor, is an atypical antipsychotic schizophrenia used in the management of, bipolar I mania, bipolar II depression, bipolar I depression, and used off-label for a variety of other purposes, including insomnia and anxiety disorders.

It is sometimes used off-label, often as an augmentation agent, to treat such conditions as obsessive-compulsive disorder, post-traumatic stress disorder, restless legs syndrome, autism, alcoholism, depression, Tourette syndrome, and has been used by physicians as a sedative for those with sleep disorders or anxiety disorders.

Astra-Zeneca, recently  announced that the FDA has approved once-daily Seroquel XR (quetiapine fumarate) Extended Release Tablets as adjunctive (add-on) treatment to antidepressants in adults with Major Depressive Disorder (MDD). Seroquel XR is the only medication in its class approved by the FDA to treat both major depressive disorder as adjunctive therapy and acute depressive episodes associated with bipolar disorder as monotherapy. The company claims that this approval for Seroquel XR provides physicians with a new adjunctive treatment option for patients with MDD who have an inadequate response to their current antidepressant. FDAs approval of Seroquel XR is based on a clinical development program in MDD involving 939 patients randomized across two studies that assessed the efficacy and safety of once-daily treatment with Seroquel XR as adjunctive treatment to antidepressants.....

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