News (Media Awareness Project) - US: Drug Warrior |
| Title: | US: Drug Warrior |
| Published On: | 2001-03-05 |
| Source: | Forbes Magazine (US) |
| Fetched On: | 2008-01-26 23:47:10 |
DRUG WARRIOR
When immunologist Philippe Pouletty was a resident at a hospital emergency
room in Paris in the early 1980s, he was struck by the fact that, although
20% of patients admitted were drunks or drug addicts, doctors had no
adequate treatment for them. Occasionally he would quiz drug industry
executives on the problem: "Tell me which disease has 30 million chronic
patients worldwide and costs 1% to 3% of the U.S. gross national product."
"No one guessed addiction," Pouletty says. He decided to do something about
it. In 1994 Pouletty formed his third biotech startup and named it
DrugAbuse Sciences, basing it in Paris and Los Altos, Calif. and devoting
it solely to developing treatments for alcohol and drug addiction.
Pouletty, 42, now has six drugs in the pipeline, two of them in late-stage
human trialsone for drunks and heroin addicts, the other for cocaine
abusers. DAS has no revenue yet, paying its 25 scientists from the $30
million it has raised from ABNAmro, Edmond de Rothschild Asset Management
and other investors.
But most drug companies continue to shun addiction. Except for pockets of
research in academia, drug companies have devoted almost no funding to
searching for cures for drug and alcohol addiction. Most of their efforts
target the $15 billion market for patches, gums and pills to get smokers
off nicotine, leaving the rough stuff overlooked. "It falls at the top of
unmet medical needs," says Peter Suzdak, research chief at Guilford
Pharmaceuticals, which specializes in drugs for brain disorders such as
Alzheimer's and Parkinson's.
Drug and alcohol abuse costs the U.S. economy $300 billion in medical bills
and lost productivity, according to federal government estimates. Some 14
million Americans are hooked on drugs and booze, outnumbering 8 million
cancer patients almost 2-to-1 and schizophrenia patients 7-to-1. Eli
Lilly's schizophrenia drug, Zyprexa, pulled in $2 billion in sales last
year, yet sales of anti-addiction drugs amount to a mere $170 million a
year, chiefly from naltrexone, for heroin and alcohol, buprenorphine, for
heroin, and acamprosate, for alcohol.
Yet the mechanics of addiction are more or less well understood. "We're
further along in addiction than depression and schizophrenia," says David
Self, a neuroscientist at the University of Texas Southwestern.
To Pouletty, the industry's apathy recalls its attitude toward depression
drugs in the 1980s, when marketers believed the market would amount to no
more than $200 million per year. Prozac's release in 1988 stunned the
skeptics and ignited a frenzy for feel-better pills; that market now tops
$10 billion in annual sales.
Treating addiction through medication, though, presents a tougher set of
challenges. Getting junkies to cooperate with clinical trials can be
tricky. The dropout rate ranges from 15% to 50%, compared with 3% to 4% for
cancer and cardiovascular trials. Addiction carries a potent social stigma,
too. Treating crackheads doesn't quite fit the wholesome image
pharmaceutical companies want to project.
Most past efforts have been incidental and have been abandoned at the
earliest sign of failure. In 1996 Guilford came up with a compound that
successfully blocked cocaine from binding with the brain's dopamine
transporters, but it didn't stop the cravings. The company ended up
scrapping its research.
In the same year Abbott Laboratories had hopes that an experimental
Parkinson's drug, ABT 431, could stabilize levels of dopamine in coke
addicts. By raising depleted levels of dopamine, a feel-good molecule
released in moments of pleasure, Abbott hoped to fend off the craving for
cocaine. But the company struggled with formulations. When it scrapped its
Parkinson's program, out went the cocaine experiments.
DuPont markets a treatment for alcohol and heroin, naltrexone, which blocks
the brain receptors involved in producing the highs from those substances,
but it has been a major disappointment. Patients forget to take their daily
tablet, so doctors don't widely prescribe it. Total naltrexone sales are a
mere $30 million, despite the fact that major insurers often cover it.
Pouletty, aiming to overcome those hurdles, is working with both naltrexone
and Abbott's Parkinson's compound. To get around the problem of addicts
failing to follow a drug regimen, DrugAbuse Sciences is developing a
controlled-release version of naltrexone that requires only a monthly
injection. Naltrel, as it is known, is in the last phase of human trials.
So far one injection eliminated the highs experienced by a group of 15
heroin users for six weeks. And the company hopes to improve the absorption
(and impact) of Abbott's 431 compound by developing it as an inhaler.
DrugAbuse Sciences also is working on a cocaine vaccine, licensed from the
Scripps Research Institute. Scripps scientists used lab rats to prove that
the body's immune system can be prompted into destroying cocaine molecules
before they cross from the blood into the brain. The vaccine is made from
cocaine that has been chemically rendered inactive and attached to a bulky
protein extracted from crabs. Pouletty's goal is to begin human trials by
year-end. A similar vaccine from Cantab Pharmaceuticals in the U.K. is in
midstage human testing.
Pouletty is pursuing some original research, as well. This year he will
start enrolling 6,000 alcoholics in seven European countries in an
ambitiousproject to sequence 150 genes in the brain. By comparing genes of
alcoholics with those who are not, Pouletty hopes to pinpoint any genetic
anomalies that may make suitable drug targets.
One blockbuster from Pouletty would likely set off a wave of anti-addiction
drug development. But even he knows that all the medicine in the world
can't offer a panacea for addicts. Ultimately they have to choose sobriety
on their own.
(SIDEBAR)
Kicking The Habit
Only a handful of anti-addiction drugs are slated to come to market soon.
Drug Application Owner Status
Subutex Heroin Developed Waiting for FDA
addiction by Reckitt approval
Benckiser; marketed by
Schering-Plough.
Campral Alcohol Merck KGaA Filing for
addiction FDA approval
Naltrel Alcohol DrugAbuse Late-stage clinical
addiction Sciences trials
TA-CD Cocaine Cantab Mid-stage
addiction Pharmaceuticals clinical trials
When immunologist Philippe Pouletty was a resident at a hospital emergency
room in Paris in the early 1980s, he was struck by the fact that, although
20% of patients admitted were drunks or drug addicts, doctors had no
adequate treatment for them. Occasionally he would quiz drug industry
executives on the problem: "Tell me which disease has 30 million chronic
patients worldwide and costs 1% to 3% of the U.S. gross national product."
"No one guessed addiction," Pouletty says. He decided to do something about
it. In 1994 Pouletty formed his third biotech startup and named it
DrugAbuse Sciences, basing it in Paris and Los Altos, Calif. and devoting
it solely to developing treatments for alcohol and drug addiction.
Pouletty, 42, now has six drugs in the pipeline, two of them in late-stage
human trialsone for drunks and heroin addicts, the other for cocaine
abusers. DAS has no revenue yet, paying its 25 scientists from the $30
million it has raised from ABNAmro, Edmond de Rothschild Asset Management
and other investors.
But most drug companies continue to shun addiction. Except for pockets of
research in academia, drug companies have devoted almost no funding to
searching for cures for drug and alcohol addiction. Most of their efforts
target the $15 billion market for patches, gums and pills to get smokers
off nicotine, leaving the rough stuff overlooked. "It falls at the top of
unmet medical needs," says Peter Suzdak, research chief at Guilford
Pharmaceuticals, which specializes in drugs for brain disorders such as
Alzheimer's and Parkinson's.
Drug and alcohol abuse costs the U.S. economy $300 billion in medical bills
and lost productivity, according to federal government estimates. Some 14
million Americans are hooked on drugs and booze, outnumbering 8 million
cancer patients almost 2-to-1 and schizophrenia patients 7-to-1. Eli
Lilly's schizophrenia drug, Zyprexa, pulled in $2 billion in sales last
year, yet sales of anti-addiction drugs amount to a mere $170 million a
year, chiefly from naltrexone, for heroin and alcohol, buprenorphine, for
heroin, and acamprosate, for alcohol.
Yet the mechanics of addiction are more or less well understood. "We're
further along in addiction than depression and schizophrenia," says David
Self, a neuroscientist at the University of Texas Southwestern.
To Pouletty, the industry's apathy recalls its attitude toward depression
drugs in the 1980s, when marketers believed the market would amount to no
more than $200 million per year. Prozac's release in 1988 stunned the
skeptics and ignited a frenzy for feel-better pills; that market now tops
$10 billion in annual sales.
Treating addiction through medication, though, presents a tougher set of
challenges. Getting junkies to cooperate with clinical trials can be
tricky. The dropout rate ranges from 15% to 50%, compared with 3% to 4% for
cancer and cardiovascular trials. Addiction carries a potent social stigma,
too. Treating crackheads doesn't quite fit the wholesome image
pharmaceutical companies want to project.
Most past efforts have been incidental and have been abandoned at the
earliest sign of failure. In 1996 Guilford came up with a compound that
successfully blocked cocaine from binding with the brain's dopamine
transporters, but it didn't stop the cravings. The company ended up
scrapping its research.
In the same year Abbott Laboratories had hopes that an experimental
Parkinson's drug, ABT 431, could stabilize levels of dopamine in coke
addicts. By raising depleted levels of dopamine, a feel-good molecule
released in moments of pleasure, Abbott hoped to fend off the craving for
cocaine. But the company struggled with formulations. When it scrapped its
Parkinson's program, out went the cocaine experiments.
DuPont markets a treatment for alcohol and heroin, naltrexone, which blocks
the brain receptors involved in producing the highs from those substances,
but it has been a major disappointment. Patients forget to take their daily
tablet, so doctors don't widely prescribe it. Total naltrexone sales are a
mere $30 million, despite the fact that major insurers often cover it.
Pouletty, aiming to overcome those hurdles, is working with both naltrexone
and Abbott's Parkinson's compound. To get around the problem of addicts
failing to follow a drug regimen, DrugAbuse Sciences is developing a
controlled-release version of naltrexone that requires only a monthly
injection. Naltrel, as it is known, is in the last phase of human trials.
So far one injection eliminated the highs experienced by a group of 15
heroin users for six weeks. And the company hopes to improve the absorption
(and impact) of Abbott's 431 compound by developing it as an inhaler.
DrugAbuse Sciences also is working on a cocaine vaccine, licensed from the
Scripps Research Institute. Scripps scientists used lab rats to prove that
the body's immune system can be prompted into destroying cocaine molecules
before they cross from the blood into the brain. The vaccine is made from
cocaine that has been chemically rendered inactive and attached to a bulky
protein extracted from crabs. Pouletty's goal is to begin human trials by
year-end. A similar vaccine from Cantab Pharmaceuticals in the U.K. is in
midstage human testing.
Pouletty is pursuing some original research, as well. This year he will
start enrolling 6,000 alcoholics in seven European countries in an
ambitiousproject to sequence 150 genes in the brain. By comparing genes of
alcoholics with those who are not, Pouletty hopes to pinpoint any genetic
anomalies that may make suitable drug targets.
One blockbuster from Pouletty would likely set off a wave of anti-addiction
drug development. But even he knows that all the medicine in the world
can't offer a panacea for addicts. Ultimately they have to choose sobriety
on their own.
(SIDEBAR)
Kicking The Habit
Only a handful of anti-addiction drugs are slated to come to market soon.
Drug Application Owner Status
Subutex Heroin Developed Waiting for FDA
addiction by Reckitt approval
Benckiser; marketed by
Schering-Plough.
Campral Alcohol Merck KGaA Filing for
addiction FDA approval
Naltrel Alcohol DrugAbuse Late-stage clinical
addiction Sciences trials
TA-CD Cocaine Cantab Mid-stage
addiction Pharmaceuticals clinical trials
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