By Sumathi Reddy
A new year could bring new treatments for migraines and breast cancer, greater access to a powerful cholesterol drug, advances in gene editing and more
Don’t be surprised if 2018 proves to be a big year for health in good ways and bad.
While experts foresee trouble ahead for influenza and potential measles outbreaks, the areas of targeted breast cancer therapies, gene editing and migraine medicines offer new promise. The high price tag of some of the new therapies and technology will remain a concern for U.S. consumers. Here are some of the most intriguing health stories to watch for in 2018:
Targeted Breast Cancer Treatments
Targeted therapies to treat breast cancer are evolving to provide additional and less toxic treatment options. These drugs attack specific pathways in cancer cells. PARP inhibitors have been found to show promise in patients with mutations in the BRCA1 and BRCA2 genes.
These drugs are already on the market for ovarian cancer. The hope is the U.S. Food and Drug Administration will approve them for use in breast cancer in 2018. A class of drugs called CDK 4/6 inhibitors has already been shown to significantly improve the length of time postmenopausal women live without their breast cancer worsening, when used in combination with anti-estrogen therapy. With new data showing they also work in premenopausal women, they will likely be used to treat more such women.
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Advances in Genetics-Based Medicine
Drug companies and researchers will continue their quest to get gene-editing tech from clinical trials into practice. The use of Crispr/Cas9 gene editing—a technology that acts like molecular scissors to cut and edit DNA—to treat individuals with life-threatening illnesses is expected to move forward, with a number of clinical trials in the works, including one by Crispr Therapeutics ,which is planning to start a clinical trial for an inherited blood disorder in Europe in 2018.
Other gene-editing technologies are also taking off. Sangamo Therapeutics announced in November that its scientists had edited a gene inside the body of a man with Hunter syndrome, a genetic disorder. Sangamo has two other clinical trials under way looking at genome editing for patients with two other genetic diseases. News in December that Spark Therapeutics got approval for a therapy to replace a faulty gene in people with retinal dystrophy, a rare form of vision loss, will fuel further consumer interest in genetics-based medicine. And expect plenty of headlines when Spark announces the therapy’s price early in 2018. Experts expect it to be very expensive.
Meanwhile, the more controversial use of Crispr-Cas9 gene editing in altering the genetic makeup of embryos—which poses many ethical questions—will also likely be a topic of great debate.
A Possible Cholesterol Breakthrough
All eyes in the cardiology world will be on the results of a clinical trial expected to be announced in early 2018. ODYSSEY is the longest clinical cardiovascular outcomes trial done of heart patients on PCSK9 inhibitors, powerful new drugs that can dramatically lower LDL, or bad cholesterol levels, when drugs like statins can’t do the job. The drugs have been hampered by their price tag—around $14,000 a year—and insurance companies’ high rates of refusal to pay for them.
The trial is of alirocumab (Praluent), a drug made by Sanofi and Regeneron Pharmaceuticals, and follows 18,000 high-risk patients for up to five years. Patients hope strong trial results will make insurance companies more apt to approve them.
Antibiotic Overuse and Resistance
The emergence of superbugs—antibiotic-resistant infections—will continue to pose a problem. Agencies, including the Centers for Disease Control and Prevention and the World Health Organization, will continue to focus on them in 2018. More than a dozen infections—including MRSA and a strain of gonorrhea—are resistant to antibiotics.
The CDC estimates that at least two million people in the U.S. get an antibiotic-resistant infection every year. Such infections cause 23,000 deaths a year. The CDC is slated to offer a new containment approach in April, with plans to detect and respond to emerging cases of resistance.
The more than 35 million Americans who suffer from migraines may have some headache-reducing news in 2018. A new class of migraine drugs is in development that would help prevent attacks. Teva Pharmaceutical Industries and Amgen, in conjunction with Novartis, reported positive data in November.
Most medications now on the market are for attacks already under way. The prevention drugs that sufferers take are approved for other uses and don’t always work or cause side effects, such as rebound headaches, fatigue and weight gain.
The experimental drugs are part of a class of mostly injectable treatments that target a chemical known as CGRP, which is involved in the brain’s pain signaling during migraines. Alder BioPharmaceuticals, Allergan and Eli Lilly are also working on new migraine drugs.
Focus on Flu and Measles
Influenza season, which is just starting and not expected to peak until early 2018, will likely be a bad one. Based on the Southern Hemisphere’s brutal season and the fact that this year’s vaccine was likely not a good match for the circulating strain, some experts are saying protection could be inadequate.
Meanwhile, infectious disease experts are also fearful about the possibility of more measles outbreaks, particularly in Texas.
This may be due in part to the number of parents exempting their children from vaccines in the Lone Star State. There has been a 19-fold increase between 2003 and 2016. Peter Hotez, a pediatrician at Baylor College of Medicine in Houston, says at some private schools in the Austin area exemption rates are as high as 40%