From sepsis to depression
SummaryDailyUpdates 26th May, 2006: As our daily trip around the drug discovery world continues we hit Friday with some revealing information on sepsis and new phase 3 data on Wyeth's antidepressant desvenlafaxine. Read on for more about these highlight on visit today's edition of DailyUpdates for more on these advances or any of the other 50+ items featured today
Defining the problem of sepsis: Sepsis, a complex and rapidly progressing disease with high levels of mortality, presents major challenges with regard to its epidemiology, definition and management. Rising disease incidence has been fuelled by the growing number of surgical interventions and an increase in immunocompromization. Disease management is predominantly non-specific, relying on a range of interventions. Sepsis is widely regarded as the most challenging problem in intensive care (see Sepsis our new feature for an in depth look at this field). Today’s featured research article focuses on SOAP, a multiple-center, observational study of 198 intensive care units in 24 European countries designed to better define the incidence of sepsis and the characteristics of critically ill patients in European intensive care units. The study identifies the lung as the most common site of infection in patients with sepsis, while Staphylococcus aureus, Pseudomonas species, and Escherichia coli were most commonly the causative pathogen. Patients with sepsis had more severe organ dysfunction, longer intensive care unit and hospital lengths of stay, and higher mortality rate than patients without sepsis.
Phase 3 data on Wyeth's SNRI, desvenlafaxine: Major Depressive Disorder is estimated to affect over 34 million individuals yearly across the seven major markets. Only a fraction of this patient population is treated adequately, resulting in lost productivity, unnecessary patient suffering and unfulfilled revenue potential for manufacturers (see our recent feature Major Depressive Disorder). Most of the leading antidepressants are selective serotonin reuptake inhibitors. In addition the class of serotonin and norepinephrine reuptake inhibitors (SNRIs) now occupies a significant portion the antidepressant market. Lilly’s Cymbalta (duloxetine), launched in the Q3 2004 for the treatment of major depressive disorder and diabetic peripheral neuropathic pain, generated $233.3 million in sales in Q1 2006. This compared to $945 million in sales for Wyeth’s Effexor (venlafaxine) over the same time period. While long-term, head-to-head studies comparing SNRIs with SSRIs are rare, evidence suggests that Effexor is comparable to the SSRIs in terms of remission rates, and venlafaxine may bring patients to remission earlier than SSRIs. Today’s lead news item highlights phase 3 data presented for the first time on desvenlafaxine succinate (DVS-233), a metabolite of Effexor. Overall, the phase 3 data results showed desvenlafaxine succinate significantly improved depressive symptoms in adult patients compared to placebo. An NDA was submitted to the FDA in December 2005.