Drug Therapy

Paris-Basic research in erectile dysfunction therapy is being hamperedby the attitude of some funding bodies that phosphodiesterase type-5 inhibitorsalone have solved all problems, according to a special committee convenedat the 2nd International Consultation on Erectile and Sexual Dysfunctionshere.

Now more than ever before, men suffering from erectile dysfunction havea high likelihood that their condition will be successfully managed. Withtwo efficacious, safe, and easily administered oral medications on the marketand a third coming soon, men with ED are far better off than they were just6 years ago.

The paradigm for the medical management of benign prostatic hyperplasia has undergone a significant change during the past decade. Guided by new research, the approval of novel pharmaceutical and minimally invasive therapies, and the economics of health care financing, physicians have altered their approach to patient care in distinct ways.

Chicago-Resistance to drugs commonly used against uncomplicated urinary tract infections continues to grow, according to the results of a large North American study presented at the 43rd Interscience Conference on Antimicrobials and Chemotherapy.

Scientists at Northwestern University have developed an ultra-sensitivetechnology based on gold nanoparticles and DNA that can detect PSA whenpresent at extremely low levels in the blood sample. The new protein-detectionmethod could be used to monitor prostate cancer patients following surgery,according to the researchers, whose findings are published in the Sept.26 issue of the journal Science (2003; 301:1884-6).

Chicago-Neoadjuvant platinum-based chemotherapy is associatedwith a statistically significant improvement in the overall survival ofpatients with locally advanced bladder cancer, according to the resultsof a recent meta-analysis presented at the AUA annual meeting here. However,the treatment benefit is not strong enough to support a recommendation forusing neoadjuvant chemotherapy in this setting, said Amir Sherif, MD, PhD,speaking on behalf of the Nordic Cooperative Bladder Cancer Group.

A number of urologists have been implicated in two high-profile casesconcerning the illegal sale of drug samples. In this Urology Times SpecialReport, OIG attorneys outline several steps to take-and activities to avoid-tokeep you and your practice compliant with current regulations.

Once-daily quinolone gains new urology indications: West Haven, CT-Bayer Pharmaceuticals has received FDA approval to market its once-daily, extended-release fluoroquinolone, ciprofloxacin (Cipro XR), for two new indications: complicated urinary tract infections and acute uncomplicated pyelonephritis.

The FDA has approved a higher-dose (1,000-mg) formulation of once-daily ciprofloxacin (Cipro XR) for the treatment of complicated urinary infections. The drug is to be taken for 7 to 14 days.

Patients with locally advanced bladder cancer have more than a fighting chance for survival with neoadjuvant chemotherapy, which has been found to provide a longer life in patients compared with the standard treatment of surgery alone, according to an 11-year study published in the New England Journal of Medicine (2003; 349:859-66).

An oral bisphosphonate may slow the development of symptomatic bone metastases and reduce the risk of death from this disease, new data show.

Indianapolis-Integrity Pharmaceutical Corp., announces the reintroduction of its antiseptic agent hyoscyamine sulfate (Urimax). The company recently completed a voluntary recall and review of the product to assure continuing potency of its active ingredient.

Increasing knowledge of the ways in which we differ from each other genetically has the potential to change the way medicine is practiced in the not too distant future.88 One of the most common forms of human genetic diversity is the single nucleotide polymorphism (SNP), a single base-pair position in genomic DNA at which different sequence alternatives (alleles) exist in normal individuals.

Chemoprevention is the use of natural or synthetic agents to avert the induction of, or to inhibit, delay, or suppress the progression of cancers or other diseases. Carcinogenesis is a process that occurs over a period of months to years and is under the influence of a range of genetic and environmental factors.

Urology has always been a fascinating and somewhat hybrid specialty inthe field of medicine. First and foremost, it has been a surgical specialty,requiring many years of intense surgical training to master. Many of ushave been drawn to urology because of the wide assortment of surgical proceduresand the ability to put to use the highest technological advancements inthe course of our work.

Chicago-Real-world clinical practice data provide further evidencethat treatment with a 5-alpha-reductase inhibitor significantly reducesthe risks for progression to acute urinary retention (AUR), catheterization,or surgery in men with BPH, according to a retrospective analysis from theUnited Kingdom.

Raritan, NJ-Ortho-McNeil Pharmaceutical has received FDA approval to market levofloxacin (Levaquin) for the treatment of chronic bacterial prostatitis caused by Escherichia coli, Enterococcus faecalis, or Staphylococcus epidermidis.

Chicago-The selective endothelin receptor antagonist atrasentan significantly attenuates changes in biochemical markers of bone metabolism and disease progression in a group of patients with advanced hormone-refractory prostate cancer that had progressed on placebo, according to the results of a randomized clinical trial.

Chicago-New research on efforts to lower the infection rate among men receiving penile prostheses will likely change how urologists approach this challenging problem, say researchers from three leading Southeastern institutions.

Chicago-Pharmacologic treatment of overactive bladder-once the private domain of only two or three agents-is about to expand significantly, providing urologists with a number of new therapeutic options.

Wilmington, DE-The federal government will likely pursue urologistsin a second round of investigations surrounding the fraudulent marketingand sale of luteinizing hormone-releasing hormone agonists for prostatecancer. Just how far the probe will extend remains a source of debate amonglegal experts familiar with the case.

Seattle-Leading U.S. prostate cancer thought leaders are expressingwidely divergent opinions on the recent announcement of a 25% reductionin prostate cancer incidence in men treated with finasteride (Proscar),according to interviews conducted by Urology Times. Whereas some expertssee the finding as the beginning of a new era in prostate cancer prevention,others say that more data are needed before urologists can confidently applythe finding to clinical practice.

References

Presented by Allen D. Seftel, MD, Case Western Reserve University, Cleveland

Presented by Larry Lipshultz, MD, Baylor College of Medicine, Houston.

Presented by Richard Grady, MD, University of Washington, Seattle.

Presented by Margaret S. Pearle, MD, University of Texas SouthwesternMedical Center, Dallas.

Presented by Kevin M. Slawin, MD, Baylor College of Medicine, Houston.

Presented by Donald A. Elmajian, MD, Lousiiana State University, Shreveport

Chicago-Women with stress urinary incontinence receiving an investigationalagent designed to inhibit two key neurotransmitters significantly showeda reduced number of weekly incontinence episodes and improvements in qualityof life compared with patients receiving placebo. The drug, duloxetine,is dual reuptake inhibitor of serotonin and norepinephrine currently inphase III development.