News

16 November 2009

Obstacles to Effective Treatment: Poll Results

The question was asked of our visitors: What do you feel is your biggest challenge when it comes to getting effective treatment?

You can see the responses to the right.

First, I was glad to see that Lack of support from family and friends only got 2%. That doesn’t mean it isn’t an issue – clearly it is. But it’s good to know that’s not the biggest obstacle most people face, because it really is a difficult one to overcome.

Finances tops the list, not surprisingly, considering the cost of many treatments. Finances of course come into play with other obstacles mentioned as well. What if insurance won’t cover you? Many excellent non-traditional treatments are not covered. And what if a good specialist or treatment is too far away?

A lack of local help was a big issue – combining lack of local specialists and lack of local treatment, 29% considered this their biggest obstacle. Part of this probably relates to the lack of knowledge out there about headache and migraine conditions – a good doctor may be close, but she may not be up to date on the best treatments available.

Frustration with the medical system was another big factor, at 26%. Though related to finances, this can take on added dimensions, as patients try to go through the proper channels to get the proper treatment – only to find dead ends.

Finally, 7% said that the biggest obstacle was myself – I need to decide to take action. Though certainly there are some who have put off getting treatment when they shouldn’t have, there are many issues here as well. What about the person who has been ignored or put down by doctors, and who is reluctant to go back? And what if you’ve tried treatment after treatment – it can be hard to keep going.

There are no easy answers to these issues. Continuing research and education will go a long way in getting the right treatment to the right people at a reasonable cost. More understanding and knowledge for doctors, specialists, and even those family and friends, will make a big difference.

There are answers, there is hope, and now is not the time to give up. It’s time to fight back.

10 November 2009

Easy injections and needle-free injections

James Medications, News 5

Progress is being made to make needle-free injections widely available. The DosePro needle free system is one of these. Zogenix plans to launch SUMAVEL DosePro in January (2010), a needle free sumatriptan injection.

Certain studies have suggested that taking your abortive medication earlier during your migraine attack is critical. But the fact remains, if you’re going to take the medicine, the sooner it gets into your system the better.

An injection allows you to get the relief that the medicine offers within minutes. And the DosePro system is very easy and quick.

You may notice, however, that whatever the inference may be, this system is not being marketed as "pain-free". Yes, it still hurts. Though it may have advantages over a needle injection, being painless isn’t one of those advantages.

Some patients aren’t aware that there are now very easy needle injections out there as well. Even needle injections have come a long way since the days of one big needle, careful handling, and all the other horrors you may imagine.

Patients can use a simple pen like device to give themselves a quick injection, and they may find faster, more effective relief over the oral medicine.

More on the upcoming release of SUMAVEL DosePro
Thoughts from Dr. Alexander Mauskop on injections

6 November 2009

Feature Length Movie in the works…

James News 0

I recently received a nice email from Dr. Edmund Messina. You may remember him – he is the neurologist who was involved in the production of the documentary Life and Migraine, which I reviewed in September.

Dr Messina has a passion about helping patients become their own advocates. He agreed with my assessment that the documentary was harsh – and that, he says, is exactly what he hears from his patients. They are struggling with lives which are incredibly harsh.

Dr. Messina also told me a secret – he’s involved in a full length feature film. As he described it, it’s about a woman who finally becomes her own advocate for controlling headaches and fixing a very dysfunctional life. He’s hoping it will be released in the spring.

So stay tuned for that. It’s great to see others recognizing the harsh reality of headaches and migraine – and the need to take action to fight back.

14 October 2009

By the Way – Botox Lawsuit one to Watch…

James News 0

Botox is going through some interesting times these days. And though Botox users should be interested, the news is really of interest to everyone.

For one thing, the company (Allergan) is being probed by federal investigators in the USA for "past practices". This has to do with the sales and marketing of Botox. Has Allergan really followed the rules when marketing its product?

You see, there are strict rules in place when it comes to marketing a product. If it’s approved, you can promote it for that use, but not for "off-label" uses. For example, using Botox for migraine treatment is an off-label use. Commonly practised and legal, but not officially approved.

But Allergan is taking action itself (action which, it says, is unrelated to this investigation). It has filed a free-speech lawsuit against the federal government.

"Wait a second" the argument goes, "We need to be able to talk about off-label uses too. After all, we need to share safety information with doctors for these uses, and how the medication can best be used! After all, we have all this information…."

Well, that sounds great. But it would mean that, all of a sudden, drug companies could get their drug approved for one thing, and then promote it for everything… but of course, they wouldn’t do that.

This is a huge issue, because it involves a major philosophy of how drug marketing works in the United States. And as you know, big money is at stake.

Oh yes, and patients are important too.

It’s unlikely that regulations in the USA will suddenly and drastically change here, but everyone is watching for a change of direction – will this set a precedent? Or will this lawsuit simply give Allergan a little leverage in its other case?

Meanwhile, the news is out about positive Botox for migraine trials, and the news is also out about how much Allergan is spending wining and dining doctors and nurses in Australia, for example. Yes, big money. I hope in all the rhetoric the patients aren’t left behind.

13 October 2009

New Migraine Drug Telcagepant – Not Dead Yet

James Discoveries & Stats, Medications, News 4

The pharmaceutical company Merck & Co., Inc was at the 14th International Headache Congress in September, talking again about the migraine drug Telcagepant. And hopes that Telcagepant will see the light of day aren’t dead yet.

After concerns about using Telcagepant as a migraine preventative, Merck has moved ahead with trials using the new drug as an abortive. Researchers were originally concerned when some patients developed high levels of liver enzymes (transaminases). (more on the background of Telcagepant here)

In one of the new trials, none of the patients had high levels of liver enzymes apparently caused by the drug (you caught that, right? Some did have the problem, but investigators felt it was not drug related.).

Two trials were reported on. First, compared with rizatriptan (Maxalt, Rizaliv, Rizalt), how many "adverse events" would patients experience?

Investigators didn’t look for any side effect here, they only measured events from a predetermined list. The adverse events were not too serious with either group, and there tended to be fewer with Telcagepant.

The problems more common with Telcagepant included nasopharyngitis, upper abdominal pain, and nausea and vomiting. In the other study, patients on telcagepant were more likely to feel sleepy (than those on a placebo). In an earlier study, Telcagepant was less likely to cause nausea than zolmitriptan, so we’ll see how it continues to compare with the triptans on this one.

But did Telcagepant fight symptoms of migraine? Yes, the results still look positive. In a large trial of 1,677 patients, researchers used doses of 140mg or 280mg and measured symptoms after 2 hours. They were interested in pain freedom or pain relief (reduction to mild or none). These charts show the percentage of patients helped at either dose, compared to a placebo:

Merck is preparing to have some major discussions regarding Telcagepant later this year with regulatory agencies. It remains to be seen if this drug will be the next big one for Merck and migraine, though it’s still showing promise.

The bad news is that Merck has shelved MK-3207, it’s other possible oral calcitonin gene-related peptide (CGRP) receptor antagonist for migraine treatment. So research on this type of drug continues to be stop and go for Merck.

However, Dr. David Michelson, vice president of clinical neurosciences, said Merck is still committed to this type of research: "Merck believes that the blocking of CGRP receptors remains an exciting pathway to address the underlying pathophysiology of migraine. We are continuing our efforts to offer patients a new treatment approach."

via: Merck Updates Status of Clinical Development Programs for Investigational CGRP Receptor Antagonist Treatments for Acute Migraine; MK-3207 Clinical Development Discontinued