Thursday, April 24, 2008

Drug news: Resolvyx / RX10045

According to a recent news report, Resolvyx Pharmaceutical (Bedford MA) is planning some dry eye drug trials for later this year.

Resolvyx are a little off the beaten track but on a track that many dry eye patients (especially auto-immune types) might find interesting, as it's all based on research into Omega 3s. They are apparently aspiring to develop drugs for a host of inflammatory auto-immune conditions.

Bedford biotech gains steam and attention
April 22, 2008

Resolvyx Pharmaceuticals Inc., based in Bedford, hopes to use recent scientific research on how omega-3 fatty acids work to develop a powerful new class of drugs to treat inflammatory diseases, ranging from asthma to cardiovascular problems....

Cofounder Charles Serhan, a scientist at Brigham and Women's Hospital in Boston, found evidence that omega-3s are important because the body uses them as raw materials to create another set of compounds, called resolvins, which help regulate the immune system. Without enough resolvins, the body has trouble stopping inflammation - a key way it fights off disease - after the threat has passed, contributing to an array of diseases, including arthritis....

So far, the company has only tested its drugs in rodents, such as asthmatic mice. But Resolvyx plans to test one compound, RX-10045, in humans this year to treat dry eye. And within the next year, it plans to launch clinical trials for another compound, RX-10001, to treat asthma. Resolvyx eventually hopes to determine whether the drugs can effectively treat more conditions, including rheumatoid arthritis, inflammatory bowel disease, cardiovascular diseases, and other eye problems.

Wednesday, April 23, 2008

Study: RA, bad genes and dry eye

This is one of those numbers-heavy studies relating dryness in rheumatoid arthritis patients to genes... of interest perhaps to the research diehards if not to me personally....

[The presence of dry eye syndrome and corneal complications in patients with rheumatoid arthritis and its association with -174 gene polymorphism for interleukin 6]
Polanská V, Serý O, Fojtík Z, Hlinomazová Z.
Cesk Slov Oftalmol. 2008 Mar;64(2):77-80

The aim of this study was to evaluate the presence of the dry eye syndrome and corneal complications in patients with rheumatoid arthritis and to assess its association with the -174 gene polymorphism for interleukin 6. The group consisted of 123 patients treated for rheumatoid arthritis (20 men, 103 women); the mean age was 53 years (+/- 13.6). Every patient had completely ophthalmologic examination and special attention was paid to the amount of tears. The presence of corneal complications was detected in the medical history and evaluated during the slit lamp examination. In all patients the polymorphism-174 IL-6 examinations were performed. For the statistical data processing, the chi square (chi2) test for nominal variable was used. The dry eye syndrome (DES) was found in 98 eyes (79.7%), severe dry eye syndrome was detected in 53 patients (43.1%). Corneal complications appeared in 9 patients (7.3%). DES was present in 32 patients with the GG genotype (91.4%, n1 = 35), in 49 patients with the CG genotype (71.0%, n2 = 69), and in 8 patients with the CC genotype (42.1%, n3 = 19). After the statistical evaluation we have found the association between the dry eye syndrome and the GG genotype (chi2 = 8.9) and the association between less common dry eye syndrome appearance and the presence of the CC genotype (chi2 = 10.3). Severe dry eye syndrome we proved in 18 patients with GG genotype (51.4%, n1 = 35), in 31 patients with CG genotype (44.9%, n2 = 69), and in 4 patients with CC genotype CC (21.1%, n3 = 19). We proved statistically significant association between CC genotype and less often appearance of the severe dry eye syndrome (chi2 = 4.45). Corneal complications we noticed in one patient with GG genotype (2.8%, n1 = 35), in 5 patients with CG genotype (7.2%, n2 = 69), and in 3 patients with CC genotype (15.8%, n3 = 19). We did not prove statistically significant association between the 174 IL-6 polymorphism and corneal complications appearance. The 174 IL-6 polymorphism influences the appearance of the dry eye syndrome. In patients with GG genotype of the -174 gene polymorphism for IL-6 is its appearance more common. Patients with the rheumatoid arthritis and with CC genotype of the -174 gene IL-6 polymorphism have lower frequency of the dry eye syndrome presence.

Study: Autologous serum (again). Everybody listening?

This time from Czechoslovakia, but the message is the same and I hope all you MDs who have never tried serum are listening! Next time you have a patient who is still miserable with burning despite all your best efforts, please, consider taking the plunge.

[The application of the autologous serum eye drops results in significant improvement of the conjunctival status in patients with the dry eye syndrome]
Jirsová K, Hrdlicková E, Alfakih A, Juklová K, Filipec M, Faltus V, Veselá V.
Cesk Slov Oftalmol. 2008 Mar;64(2):52-6.

AIM: To detect the changes on the conjunctiva surface before and after the application of the autologous serum (AS) eye drops in patients with dry eye syndrome, using both clinical and laboratory approaches, supplemented with subjective assessing the discomfort status. MATERIALS AND METHODS: The AS eye drops were applied during the period of 3 months in 8 patients with dry eye syndrome (Schirmer test < 5 mm and break-up time < 5 seconds), with the highest (maximum) frequency 8 times a day. The clinical (Schirmer test, break-up time, rose Bengal staining, examination of the tear meniscus, detritus and superficial punctate keratitis) and laboratory examinations (morphological assessment of the conjunctiva, detection of apoptotic cells) were performed at the start and at the end of the 3 months treatment period. Each day, patients reported their ocular status (dryness, discomfort, foreign body sensation, light sensitivity). RESULTS: The AS eye drops application improved significantly the values of the Schirmer test, detritus and superficial punctate keratitis as well. The goblet cells density on the conjunctival surface increased and the number of apoptotic cells decreased. The intensity of unpleasant feelings reported by the patients decreased significantly in all of the assessed categories. CONCLUSION: Because the application of AS eye drops caused the improvement of conjunctival status as well as the decrease of the severity of difficulties reported by the patients, the AS eye drops application should become common therapeutic practice in patients with dry eye syndrome.

Study: Stevens-Johnson Syndrome.

Paints a grim picture. I'm puzzled as to why there is no mention of either bandage contacts or Boston sclerals. I'm not too knowledgeable about the former but the latter at least have well documented benefits for SJS. Why resort to surgery if you don't have to?

The ophthalmologic management of acute stevens-johnson syndrome.
Gregory DG.
Ocul Surf. 2008 Apr;6(2):87-95.

ABSTRACT Stevens-Johnson syndrome (SJS) and its more severe variant, toxic epidermal necrolysis (TEN), cause significant ocular surface damage. The majority of affected patients develop conjunctival inflammation during the acute phase of the disease. If intense, this inflammation yields permanent destruction of the normal mucosal tissue of the ocular surface and eyelids. Loss of the normal glandular structures leads to severe dry eye problems and vision loss. Medical treatments do little to arrest these problems, and repairing the damage after the acute phase is difficult, if not impossible. Recently, the application of cryopreserved amniotic membrane to the ocular surface during the acute phase of the disease has shown great promise in limiting the destructive inflammation and its long-term sequelae. A rationale for this treatment and a detailed description of the application procedure are provided, along with practical guidelines for the managing surgeon.

Newsblurb: AMO, tears and lasers

Weird. I don't see why a not-very-exciting not-really-new artificial tear forecast to do $12million in sales would even make the news for AMO much less be used to offset concerns about the outlook for refractive equipment. Whatever.

Analysts Look to FDA Lasik Panel Outcome

NEW YORK - Analysts said Monday Advanced Medical Optics Inc. is executing well on its new contact lens and dry eye product offerings, but expressed concern about the outcome of the Food and Drug Administration's panel meeting on Lasik surgery later this month.

Wachovia (nyse: WB - news - people ) Capital Markets LLC analyst Larry Biegelsen said Advanced Medical's launch of its Tecnis multifocal contact lens, Blink Tears dry eye treatment and iFS IntraLase laser upgrade will go a long way toward building investor confidence in the company's ability to execute.

In a note to clients, Biegelsen said Tecnis has the potential to be a significant contributor to the company's growth, given that it is Advanced Medical's initial foray into the largest market for implantable lenses. And with the lack of dry eye treatment options, he thinks his $12 million 2008 sales forecast for Blink Tears may be conservative. Finally, the iFS laser upgrade, which increases safety and precision of the device, will likely help fend off competition.