Features

Race for the cures

National | Uncle Sam scrambles for smallpox vaccines as private firms fight old problems with new approaches

Issue: "Elaine Chao: Unlikely star," Nov. 3, 2001

Beyond Anthrax
The threat of bioterrorism has the U.S. government scrambling to prepare to fight a potential smallpox threat. Like anthrax, this old enemy can be dispersed as aerosols or airborne particles or used to contaminate water and food. Unlike anthrax, smallpox is contagious. According to the Centers for Disease Control and Prevention, smallpox has no proven treatment and about 30 percent of victims die from the disease. Routine inoculations ended in 1972 after officials considered the disease defeated. Now the threat is back, but no one knows whether terrorists actually have access to the virus. Experts say that if authorities do not contain an outbreak, emergency services may not be ready for it. An outbreak that begins with just 100 infected people would need 9 million doses of vaccine. Right now the federal government has a stockpile of about 15 million doses of smallpox vaccine, and Washington wants to boost that supply to 300 million by the end of next year. Officials are also scrambling to collect a drug needed to treat the vaccine's potentially fatal side effects. Currently, the National Institutes of Health is financing research on a safer smallpox vaccine. The development of such products faces three obstacles: Vaccines are less profitable for drug companies, so such research has not been a high priority; litigation risks are also enormous if things go wrong; and even in a crisis makers of new vaccines must jump through Food and Drug Administration (FDA) hoops. Thanks for the memories
Can human memory be improved? Numerous researchers and dozens of companies are actively searching for new drugs to boost people's recall. As baby boomers grow older, the race is on to find treatments for memory loss. Eric Kandel, who shared last year's Nobel Prize in medicine, co-founded New Jersey-based Memory Pharmaceuticals to treat common memory loss among the elderly. The company reports that about half of all seniors suffer from the ailment. "This isn't cosmetic," said Dr. Kandel. "This is a real medical problem." Dr. Kandel's work dates back to the 1960s. When working with sea slugs, he discovered that when he hit one cell with a neurotransmitter called serotonin, the growth of new synaptic connections followed. Now he wants to turn his research into useful drugs. Researchers are looking for a breakthrough whose side effects are minimal enough to be used with mild memory loss. Since these proposed therapies would target problems considered normal, such as the ordinary tendency to forget things, they raise big regulatory issues: According to FDA spokeswoman Laura Bradbard, any new drug would have to prove effective on major memory ailments to win approval. "Aging isn't a disease," she said. Memory problems are already a big business in the pharmaceutical industry. Americans spend about $1 billion a year on gingko biloba, an herb many claim improves recall, but with debatable clinical evidence. Another $1 billion is spent each year on four major prescription drugs for Alzheimer's, which is currently incurable. Less extreme
A new device just approved by the FDA may help millions of women stop excessive menstrual bleeding. A treatment called NovaSure uses radio waves to zap the lining of a patient's uterus. The ailment known as menorrhagia affects one in five women, according to the treatment's manufacturer, Palo Alto, Calif.-based Novacept. Symptoms include fatigue, anemia, embarrassing accidents, and restricted activity. While the bleeding is typically benign, menorrhagia is troublesome enough that many women seek hormone treatments and even hysterectomies to end the problem. Doctors say the NovaSure system can alleviate the problem without extreme measures. Novacept plans to have it available to gynecologists this month. Use is limited to women who have not yet begun menopause but do not plan to bear children in the future. NovaSure works as an outpatient treatment, usually with only light anesthesia. Doctors insert a thin catheter in the patient's body up to the uterus. Then the device emits about 90 seconds of radio waves, which attack part of the lining known as the endometrium and muscle tissue called the superficial myometrium. Earlier this year, the FDA approved another anti-menorrhagia treatment called the Hydro ThermAblator. With this procedure, developed by New Jersey-based BEI Medical Systems, a doctor looks at the uterus with a tint telescope, then breaks down the endometrium with heated saline solution. Meanwhile, an Israeli company called Lumenis has another system that attacks tissue with lasers. Currently, about 180,000 women have hysterectomies to stop the ailment's aggravations. The new treatments may mean that most menorrhagia cases will soon be easily cured.

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