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zoom RSS 多発性硬化症の初の経口薬 FDAが認可へ/Gilenia(fingolimod)

<<   作成日時 : 2010/06/14 19:21   >>

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 木曜日、FDAの諮問機関は多発性硬化症MSの初の経口薬ノバルティス社のGilenia(fingolimod FTY720)の認可を勧告した。副作用の懸念があるので低容量での効果テストを実施するようにノバルティスに求めたが、数年かかってしまうので市販後でも可能であるとした。
 バイエルのBetaseronやBiogen IdecのAvonex に比べて30%の再発減少が見られたが、重大な副作用が従来薬の5.8%に比べて約8.5%と高かったことが問題となり、心・肺・眼にみられた。
 MSは神経の髄鞘が障害され、世界中で約250万人がこの疾患に苦しんでおり、繰り返す再発が問題となる。
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多発性硬化症の経口治療薬/cladribine fingolimod 冬虫夏草
http://kurie.at.webry.info/201001/article_24.html
冬虫夏草の抗がん作用
http://kurie.at.webry.info/200912/article_38.html
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FDA Panel Endorses 1st Oral Drug for Multiple Sclerosis
But concerns about side effects led experts to vote for post-market study of lower-dose pill
By Steven ReinbergHealthDay Reporter
http://health.msn.com/medications/articlepage.aspx?cp-documentid=100260197

THURSDAY, June 10 (HealthDay News) -- An expert advisory panel of the U.S. Food and Drug Administration on Thursday recommended that the agency approve an oral drug, Gilenia, as a first-line treatment for multiple sclerosis (MS).

Gilenia appears to be both safe and effective, the panel confirmed in two separate votes.

Approval would mark a major shift in MS therapy since other drugs for the neurodegenerative illness require frequent injections or intravenous infusions.

"This is revolutionary," said Dr. Janice Maldonado, an assistant professor of neurology at the University of Miami Miller School of Medicine. "It's a marvelous achievement of being the first oral drug out for relapsing multiple sclerosis."

Maldonado, who has participated in trials with the drug, said the results have been very encouraging. "All of our patients have done well and have not had any problems, so it's quite promising," she said.

Patricia O'Looney, vice president of biomedical research at the National Multiple Sclerosis Society, went even further, saying that "this is a historic day. The panel recommended the approval of Gilenia as a first-line option for people with MS."

As an oral drug, it opens the door to more MS sufferers accepting treatment, she explained. "Those people who have not been on therapy, for a variety of reasons, because they did not like the injections, didn't like the infusions or they are not on therapy because they didn't respond to the other drugs -- this is another option."

In its first vote of the day, according to the Associated Press, the FDA panel voted 25-0 that the drug was effective in reducing relapses of multiple sclerosis, which causes a host of movement and cognitive problems.

But because side effects of the drug are a concern, the panel voted that Novartis, the maker of Gilenia, conduct tests to see if the drug is effective at lower doses, the AP reported. However, the panel said that these tests could be conducted after the drug reaches the market. Requiring such a study before approval could have kept the drug off the market for years.

Currently, the FDA is reviewing the drug as a priority, which is reserved for groundbreaking therapies. A decision is expected by late September, according to the AP.

A study of 1,200 patients conducted by Novartis showed about a 30 percent reduction in the relapse rate among patients taking Gilenia, compared to older drugs, such as Bayer's Betaseron and Biogen Idec's Avonex, the news service said.

However, the agency is concerned about serious side effects that occurred in about 8.5 percent of patients taking Gilenia, compared with 5.8 percent of patients taking older MS drugs, the AP reported. Those side effects can include heart and lung problems, and eye disorders.

Although the FDA is not required to follow its advisory panels' recommendations, it usually does.

Around the world, about 2.5 million people suffer from MS, which can cause muscle tremors, paralysis and problems with speech, memory and concentration. In the most common form of the nervous system disease, patients experience periods with no symptoms followed by periodic relapses.

MS damages the myelin sheath, the material that surrounds and protects nerve cells. This damage slows down or blocks messages between the brain and the body, according to the U.S. National Institutes of Health.

More information

For more on MS, visit the National Multiple Sclerosis Society.
SOURCES: Janice Maldonado, M.D., assistant professor, neurology, University of Miami Miller School of Medicine; Patricia O'Looney, Ph.D., vice president, biomedical research, National Multiple Sclerosis Society; Associated Press

Copyright @2010 HealthDay. All Rights Reserved.

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