pharmacology

The European Medicines Agency (EMA) has recommended not granting marketing authorization for Leqembi™ (lecanemab) for the treatment of Alzheimer's disease. The EMA's Committee for Medicinal Products for Human Use (CHMP) considers that its effect in delaying cognitive decline does not outweigh the risk of serious side effects associated with the drug, in particular swelling and possible bleeding in patients' brains. Leqembi™ was approved in 2023 in the United States.

A paper published today in the journal Science explores the potential of glucagon-like peptide-1 (GLP-1)-based drugs such as semaglutide to treat diseases beyond diabetes and obesity. For example, recent studies suggest that they could improve conditions ranging from depression to neurological disorders to cardiovascular and kidney disease.

The use of the antidepressants escitalopram, paroxetine, and duloxetine is associated with greater weight gain than the use of sertraline, according to the results of an analysis comparing data from more than 183,000 adults treated with one of eight types of antidepressants. Among these, bupropion is associated with the least weight gain, concludes the study, which is published in Annals of Internal Medicine.

Ketamine extended-release tablets are effective, safe and well tolerated in patients with depression resistant to other treatments, according to a phase 2 clinical trial. Compared to intranasal or intravenous use of ketamine, these oral tablets are easier to administer and would provide less dissociative intensity, lower risk of abuse and cardiovascular adverse effects, the authors write in Nature Medicine. 

Artemisinins, plant-based antimalarials, may serve as a treatment for polycystic ovary syndrome - which affects millions of women worldwide and can lead to infertility - according to a new study published in Science. The compounds suppressed ovarian androgen production in rodents, as well as in a small cohort of 19 human patients for 12 weeks, leading to more regular menstrual cycles without side effects. 

The Lancet Psychiatry publishes the first meta-analysis of the incidence of antidepressant treatment discontinuation symptoms that includes data from more than 20,000 patients collected from 79 randomised controlled trials and observational studies. The study sought to distinguish between symptoms directly caused by medication discontinuation and other ‘non-specific’ symptoms that may be associated with patient or professional expectations (the nocebo effect). The study concludes that one in six to seven patients will experience one or more symptoms directly caused by stopping medication, and one in 35 are likely to experience severe symptoms.  

According to a study published today by The BMJ, people with dementia who are treated with antipsychotics are at increased risk of serious adverse events such as stroke, blood clots, myocardial infarction, heart failure, fractures, pneumonia, and acute kidney injury, compared with those who do not take them, . These findings extend the harms previously associated with the use of these drugs on these patients. 

A phase 2 clinical trial in France has examined whether taking an oral anti-diabetic drug called lixisenatide - a GLP1 receptor analogue, similar to those also used for weight loss - also has an effect on the progression of Parkinson's disease. The results indicate that there is a modest but significant decrease in the progression of motor symptoms of the disease, although side effects were also observed. The results are published in the journal NEJM. 

The European Medicines Agency (EMA) has recommended granting marketing authorisation in the European Union for a new therapy for the treatment of adult patients with amyotrophic lateral sclerosis (ALS), a rare and frequently fatal disease that causes muscle weakness and leads to paralysis. Qalsody (tofersen) is indicated for the treatment of adults with ALS who have a mutation in the SOD1 gene. There is currently only one treatment for ALS authorised in the EU (riluzole).

For the treatment of many diseases it is necessary to use large molecules that do not resist the digestion process and must be injected. Now, a group of scientists at the Institute of Chemical Sciences and Engineering in Lausanne (Switzerland) has developed a method for synthesizing a type of protein called cyclic peptides, capable of binding to varied and complex targets, and they have done so in a way that makes them capable of being administered orally. According to the press release accompanying the publication, this opens "a new era in drug development".