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To address this gap in knowledge between the academic and
corporate worlds ,"[Bartfai] offered to give these lectures
as a primer," says Skaggs Institute Director Julius Rebek.
"Since I came here, I have [had] about five colleagues each
week asking me something about drug development," Bartfai
says. "People have asked me questions like, 'Why did they
stop the development of this drug that we have worked on?'"
He has been asked to look at their business plans or to
clear up confusion over a decision by a large company with
which they collaborate, for instance, or to help make sense
of a new request.
The Sociological Imperative
Another perspective Bartfai hopes to address during the upcoming
lectures is how the pharmaceutical industry is highly sensitive
to the social context in which it exists.
Drug development follows trends and these trends are informed
by the public's actual and perceived wants and needs. In America
today, that does not simply mean demands from patients and
from doctors tending to their patients' needs, but also pressure
from patients' interest groups and health maintenance organizations
and other large demographic forces.
We are an aging society. The CDC estimates that by the year
2030, there will be 70 million elderly Americansmore
than twice the current number. And the United Nations recently
estimated that population of people in the world over the
age of 60 will reach two billion within 50 years.
This aging of America and the rest of the world means an
increased demand for better compounds to combat those diseases
and indications specific to the elderly, and the pharmaceutical
companies are a weathervane of this demand.
For instance Alzheimer's disease, which is believed to afflict
four million Americans, is now a major area of research. Our
aging society has recognized and understood the need to confront
the problem of Alzheimer's disease, and today, according to
Bartfai, there is no self-respecting pharmaceutical company
that does not have 5-15 Alzheimer's programs. Yet this has
not always been the case.
"If somebody stood up in 1970 and said, 'I want to make
an Alzheimer's drug,' he would not only have not got any support
within a drug company, but he would also not have gotten a
grant from the NIH [National Institutes of Health]," says
Similarly, other targets of pharmaceutical research are
aimed at an aging America.
Osteoporosis drugs are needed to combat the deterioration
of bones in the elderly, one of the leading causes of loss
of quality of life in later years. Some 44 million Americansmost
of whom are womenhave already developed osteoporosis
or the early signs of bone density loss that lead to it. As
our population ages, this number will only increase, and osteoporosis
blockers are a major target for pharmaceutical companies.
Many companies are also taking aim at other age-related ailments
like arthritis, Parkinson's disease, and urinary incontinence.
Besides being an aging society, we are a society that is
increasingly aware of mental illness and increasingly more
willing to medicate it. Antidepressants already make up one
of the largest markets in the United States, amounting for
around $15 billion annually. However, there is still a great
need for a fast acting antidepressant. Normal antidepressants
take two or three weeks to take effect, and as many as a third
of patients do not respond to the drugs. This is problematic
because the core symptom of serious depression is suicidal
tendencies. In 1997, for instance, 30,535 Americans committed
suicide, making it the eighth leading cause of death in the
United States that year. One of Bartfai's own longstanding
goals is to develop a quick-acting compound for the treatment
of depression. "We just don't know how to make such a tablet
yet," he says.
Some of the other drug targets today are high-profile diseases,
like AIDS and various types of cancer. From a global perspective,
there is a need for vaccines for tuberculosis and malaria,
both major health problems worldwide.
"People would like to have vaccines [against TB and malaria]
without a shadow of a doubt," says Bartfai, "Even the rich
countries have come to realize that helping to eradicated
these diseases would be a formidable form of aid, not only
to third world, but also to countries such as Russia with
26 million tuberculosis cases."
Other drug targets are not so obvious to those outside the
field, such as drugs to control asthma and other respiratory
infections and constrictions, preventative migraine medicine,
or a decent (safe, less side-effect prone, but efficacious)
acne drugthe market for which, Bartfai insists, should
not be underestimated.
"If someone came up with [a decent acne drug], it would
sell for billions," says Bartfai.
TARGET-BASED DRUG DISCOVERY, on Thursday, May 2. Topics
to be discussed include validated drug targets: what they
are and for whom, a determination of their value, and comparison
of targets for the same clinical indication.
SELECTION OF CLINICAL CANDIDATES: MULTIPLE PRESSURES, on
Thursday, May 9. The presentation will focus on the key milestones
of preclinical drug developmenttiming, expenditures,
backup strategies, outside validations, and orphan drugsas
these factors play out in big Pharma decision making.
Lectures will be held from 5 to 6:30 PM in the Neurosciences
Institute Auditorium, 10640 John Jay Hopkins Drive.
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