Clinical Research

I just came back from Boston and the annual meeting of BAARN – the Boston Area Antibiotic Resistance Network symposium held at the Broad Institute.  The meeting was interesting but the atmosphere was funereal. Many of those losing their jobs with the closure of Cubist’s research center in Lexington, Mass were there as were many whose jobs are threatened at AZ’s facility in Waltham, Mass.

One major topic of discussion during the breaks was – where will all the antibiotic research go?
An examination of clinical trials covering more than 95,000 patients has found that glucose or sugar-lowering medications prescribed to patients with diabetes may pose an increased risk for the development of heart failure in these patients.

Heart failure is a common occurrence for patients with type 2 diabetes and has a major impact on one's life expectancy and quality of life as well as representing a major driver of health care costs. Overall, the study found that for every one kilogram of weight gain attributed to a sugar-lowering diabetes medication or strategy, there was an associated seven percent increased risk of heart failure directly linked to that medication or strategy.  
Academics have written a lot of articles claiming their competitors in the private sector selectively publish trials that favor their own interests don't care as much about transparency as academia, but is that really true? 

When it comes to investigational drugs, devices and biologic therapies, the data is available and it shows that industry was actually 3X more likely to comply with legal requirements than academic studies after disclosure was mandated. 

Leaky blood vessels in the lung can lead to acute respiratory distress. Shutterstock

By Jalees Rehman, University of Illinois at Chicago

Okay, but that's not the way to extract it. fabriceh_com, CC BY-NC-SA

By Benjamin Burke, University of Hull

In the development of new drugs, taking something from nature and modifying it has been a successful tactic employed by medicinal chemists for years.

Now, with the help of nanotechnology, researchers are turning once-discarded drug candidates into usable drugs.

Overcoming gaps in medical funding. nakrnsm, CC BY

By Stephanie Swift, University of Ottawa

Disease can affect any person, rich or poor. While your bank balance can’t really protect you from getting sick, it could potentially buy you – and many other patients – access to a better treatment for your disease. A new “plutocratic proposal” put forward by Alexander Masters enlists wealthy patients to both fund and participate in clinical trials alongside other patients who could benefit from an otherwise untested new treatment.

Up to 50 percent of patients with heart failure have normal or near-normal ejection fraction, termed heart failure with preserved ejection fraction (HFPEF).

The risk of death in HFPEF may be as high as in heart failure with reduced ejection fraction (HFREF), but there is no proven therapy.

Beta-blockers improve outcomes in HFREF and may be beneficial in HFPEF, but data are sparse and inconclusive, and beta-blockers are currently not indicated for treating HFPEF, according to background information in the article.

A recent study compared two of the most commonly performed bariatric surgery procedures.

There are tradeoffs between the two surgical approaches in potential risks and benefits and so there has been an ongoing debate about which can achieve weight loss, with conflicting results in systematic reviews. 

The two procedures were laparoscopic Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (AGB). The result was that RYGB resulted in much greater weight loss than AGB but had a higher risk of short-term complications and long-term subsequent hospitalizations. 

Each year, nearly 600,000 children die from severe, dehydrating diarrhea and millions more are hospitalized. Enterotoxigenic Escherichia coli (ETEC)
may be the first enteric illness encountered by many infants, and it causes several hundred million cases of diarrhea each year, mainly in children.

The idea of using stem cells to treat Type I Diabetes is very promising and could have huge practical impact. Real progress has been achieved toward this goal over the last decade. In perhaps another decade there might be a validated treatment.