Author: Jo Seed

New asthma treatment candidate provides hope to millions

By IGHI guest blogger Chanice Henry, Pharma IQ

Researchers have uncovered a new drug candidate that could relieve millions of people who are under-served by current asthma treatments.  

Asthma is a relatively common disease that hinders the respiration of over 300 million individuals globally, leading to episodes of wheezing, chest tightness and other severe problems.

Limitations

Indeed inhalers and other medications exist to manage the disease. However, many of these manufactured treatments have critical side effects and fail to provide relief for around one-third of asthma suffers. Bronchodilator inhalers are used by the majority of asthma suffers and although effective in treating respiratory conditions there are still some gaps in understanding on how and why these inhalers work.

According to recent reports US prices for biologics that combat asthma are to be reviewed this year.

Read more: Biosimilars grow from strength to strength

New hope

After examining over 6,000 compounds, researchers from Rutgers New Jersey Medical School and Shanghai University in China have identified a new drug that relaxes the muscles and opens airways in egg and dust mite induced asthma sufferers.

Luis Ulloa, a lead author and immunologist at Rutgers New Jersey Medical School notes that the treatment could provide hope for asthma suffers without many options currently.

The study discovered that asthmatic lung tissue had lower levels of the protein metallothionein-2 (MT2). In fact, mice without this protein were twice as vulnerable to asthma. Treatment with MT2 improved breathing troubles.

The treatment the researchers developed from the M2-2 protein (TSG12) was found to relax airway muscle cells, widen pulmonary airways and lower pulmonary resistance.

The next stage for the candidate, which is not toxic to human cells and more successful in reducing pulmonary resistance than other FDA approved medications according to the medical school, is for it to enter clinical trials.

Luis Ulloa said: “We found that the TSG12 used in the study is both non-toxic and more effective in reducing pulmonary resistance and could be a promising therapeutic approach for treating asthma without losing their effectiveness overtime.”

Read more: Artificial Intelligence and The Future of Drug Discovery (more…)

Launching the NHS Digital Academy

By Rachel Dunscombe, CEO, NHS Digital Academy

Standing in the Royal Society on the 16th of April waiting for the participants to arrive was both surreal and exciting. Surreal because of the rapid journey our wonderful team had taken to make the programme happen – this had become a reality so quickly. Exciting because I couldn’t wait to get started – this programme is important for the system and for me something I am hugely committed to.

The Digital Academy operational team, of which I am a part, are all keen to ensure that this programme is as grounded in digital leaders’ practice as much as possible rather than being too high end academic. It is a difficult juggling act given that folk will be coming away with a postgraduate diploma from Imperial College London. We worked hard to strike this balance in the run up to the first three day residential.

I set the tone for day one by conducting a poll of the audience. We found out who was in the room and that out of 104 participants there were 53 doctors – the majority by a long way. I do question why more people from other professional groups didn’t apply for the first programme? It would be great to see more nurses, for example, applying for future cohorts given that they represent the majority of the workforce. That said, we do have six nurses on the current cohort along with four pharmacists, a dentist and a social care digital specialist.

Everyone was super enthusiastic and really got stuck in to the icebreaker session. We immediately started to find common ground and get motivated about being a huge movement of like-minded digital leaders. #digitalleaders soon began trending on Twitter followed later by #cohort1. (more…)

Malaria research: Scientist industry urged to not underestimate CRISPR’s risks

By IGHI guest blogger Chanice Henry, Editor, Pharma IQ & Pharma Logistics IQ

Similar to new Hollywood feature Rampage, a recent study has urged the life sciences industry not to underestimate the dangers that could hide within CRISPR Cas9.

Although the film has been criticised for wildly exaggerating the capabilities of the gene editing technique, it can be recognised for its effort to draw focus from the excitable buzz around CRISPR Cas9 towards the importance of considering the ethics and dangers associated with the tool.

A recent commentary piece also emphasised the importance of methodically debating the potential outcomes of CRISPR within the task of tackling Malaria.

Malaria is spread by the bite of female mosquitos holding the Plasmodium parasite. Plasmodium falciparum causes life threatening malaria.

Advances made so far

In the five years to 2015, 17 countries managed to eradicate malaria –including the likes of Senegal and Bolivia. In this period, mortality fell by 50% and incidences fell by 15% – preventing over 6 million deaths.

The World Health Organisation (WHO) recently launched “the world’s first malaria vaccine that has been shown to provide partial protection against malaria in young children.”  After establishing efficacy in Phase 3 clinical trials a vaccine implementation programme is due to commence within this year’s immunization projects in Ghana, Kenya and Malawi.

A long way to go

Government spend on malaria prevention has seen a dramatic increase over the past decade. Although, experts note that around $6.5 billion of funding by 2020 will be key to hitting the WHO’s 2030 goal to wipe out malaria in 35 countries and shrink incidents and deaths by 90%.

Statistics claim that malaria still kills one child every two minutes.

Sub-Saharan Africa, as noted by Tanvi Nagpal, housed around 80% of the world’s malaria cases in 2016. “Their high infection rates are compounded by insufficient domestic budgets and struggling health systems.”Reports recently emerged stating of one in four blood banks in certain areas of Sub-Saharan Africa host supplies infected with malaria causing parasites.

CRISPR Cas9  

Researchers are now turning to CRISPR Cas9 to stop the disease at the source of transmission – the mosquito.

What is CRISPR?

The genome-editing system based on CRISPR-Cas9 is becoming a valuable tool for different applications in biomedical research, drug discovery and human gene therapy by gene repair and gene disruption, gene disruption of viral sequences and programmable RNA targeting.  The tool permanently manipulates gene expression by using programmable DNA nuclease and can remove faulty genes from a DNA sequence. (more…)

The power of our microbiota

by Lily Roberts, Centre for Health Policy, Institute of Global Health Innovation

Did you know that not only does your gut do an incredible job of nourishing you by digesting your food, but that the composition of your resident gut bacteria also has a profound impact on your quality of life? While some of the specific mechanisms are still to this day unclear, a plethora of significant research is out there, with answers to our burning questions on how our gut bacteria can affect us.

On day one, the human body is exposed to a multitude of bacteria via the birthing canal. These bacterial cells colonise our body at a ratio of 10:1 with our own cells, most of which taking residence in the gut. Those that make themselves at home in our gut are referred to as our ‘microbiota’ (roughly translating to tiny living things). The relationship between the human body and these cells which make up our microbiota is referred to as ‘symbiotic’, which simply means both parties benefit from co-existing. It turns out our microbiota responds directly to the food supply by encouraging growth of either beneficial bacteria or harmful bacteria. This means that if we choose to eat nourishing whole, natural, unprocessed foods, our beneficial gut bacteria will thrive. If we constantly feed ourselves processed foods like hamburgers and chips, harmful bacteria that thrive on these foods will take over the gut and wreak havoc, impeding growth of beneficial bacteria. Ever heard of the phrase ‘you are what you eat’? (more…)

We can, I can, this World Cancer Day

By Caitriona Tyndall, MSc. BSc, Cancer Research UK Imperial Centre, Department of Surgery and Cancer, Imperial College London.

Cancer Research UK (CRUK) introduced the unity bands as a symbol of our united front against cancer and a pledge to help beat cancer sooner.

The 4th of February is World Cancer Day. This is a day to remember and celebrate. Sadly cancer affects us all whether it’s personally or through our friends and family or work colleagues. In fact it’s estimated that 1 in 2 of us will be affected by cancer at some point in our lifetime. But in the face of this depressing statistic there is cause to celebrate. We can celebrate the people we know who have beaten cancer, celebrate the lives of those we have lost and celebrate the ground-breaking research being done by thousands of people across the UK and the world to help beat cancer sooner. I started my career in cancer research in the final year of my undergraduate. As I was starting my final year project in breast cancer research, someone very close to me was diagnosed with breast cancer. Thankfully she fought tooth and nail and came out a survivor but this moment really drove home the importance of the work that cancer researchers, clinicians and volunteers do to find new ways to prevent, diagnose and treat cancer.

The theme of World Cancer Day 2016-2018 is “We can. I can.” It may not seem likely but everyone as an individual can have an impact on cancer as a disease. This is why it’s a great opportunity on World Cancer Day to raise awareness of the different types of cancers and how we as a collective can beat each and every one. Prevention is one of the key ways we can reduce cancer incidence. There are many preventative steps we can all take. Health and lifestyle factors (also known as risk factors) influence the chances of developing cancer. We can reduce this influence by changing small habits, for example reducing our alcohol intake, stopping smoking and adopting more balanced, healthier and active lifestyles. We also want to keep an eye on our bodies, get to know what’s normal for us so we can spot when something isn’t normal. These simple individual changes can add up to a global shift in cancer incidence and mortality. (more…)

The IGHI Big Data Analytical Unit 2017 – year in review

By Joshua Symons, BDAU, Centre for Health Policy, Institute of Global Health Innovation 

2017 has been a very busy year for the Big Data and Analytical Unit (BDAU). High level accomplishments in data security and researcher outreach have led the BDAU to become one of the most secure and recognised analytic platforms for healthcare data at Imperial.

In May of 2017, the BDAU Secure Environment (SE) became the first ISO 27001:2013 (figure 1) and NHS IG Toolkit 100% Level 3 (figure 2) certified research environment in Imperial College. Over the course of 2017, the BDAU SE was successful in completing a further 11 internal and external audits. The 6-month surveillance audit required for retaining ISO 27001 certification was completed with 0 non-conformances. The BDAU now provides advisory to the Imperial College Information Governance Operational Group and the Information Governance Steering Committee for the Department of Surgery and Cancer.

Usage (more…)

Pharmacists – the new guardians of breast cancer care?

By guest blogger Chanice Henry, Editor, Pharma IQ

In the fight against one of the world’s most widespread diseases, new research has found that pharmacists are key in the optimisation of medical treatment for breast cancer patients.

Breast cancer is the most common cancer that occurs in women. In 2012 there were 1.7 million new diagnoses ­– which equated to 12% of all new cancer cases. Less than one per cent of breast cancer develops in males.

Despite its prevalence, death rates from this form of cancer have been consistently declining over the past 25 years due to better awareness and advancing treatment options. Now authors of recent research are advising the involvement of pharmacist as a bridge between physicians and patients to improve therapy outcomes.

A first line of defence

Researchers have suggested that it is productive for pharmacists to address the worries and concerns of the patient.

The study by C. C. Dang et al notes that: “Pharmacist-led pre-chemotherapy counselling improves patient knowledge and understanding of the chemotherapy regimen received.”

In other areas it has been noted that the involvement of the pharmacist in parts of the primary health care system can have positive impacts on drug costs and the length of hospital stays.

Industry understanding of the disease

Like all cancers, breast cancer develops due to a DNA mutation that drives the haphazard reproduction of breast cells into a malignant tumour.

Although there is no definitive cause for the trigger of breast cancer, experts propose that certain life events may increase the risk of its onset.  These include, exposure to radiation from medical treatment, use of hormone therapies and menopause.

North America, Sweden and Japan boast an 80% breast cancer survival rate, however the rate plummets for countries with less financial clout. This is understood to be down to the lower level of early detection programs for breast cancer in these regions.

The World Health Organization (WHO) notes early detection and diagnosis as the “cornerstone of breast cancer control”.  Detection measures include awareness of the signs and symptoms of the condition and screening programs to identify those who may have a susceptibility to the disease. (more…)

Discovering the medicines of tomorrow: Four lessons from failed Alzheimer’s research

By guest blogger Chanice Henry, Editor, Pharma IQ

Even though drug development for Alzheimer’s Disease has a steep failure rate, the lessons learned from failed trials are of great benefit to future research.

Alzheimer’s is the most common form of dementia – the irreversible loss of memory and other cognitive functions which eventually makes daily tasks unmanageable.

As the life expectancy of the world’s population grows, the Alzheimer’s is becoming more common. Estimates suggest that  the number of affected US patients will climb from 5.3 million to almost 14 million by 2050.

In the fight against this disease many have dedicated their careers to revolutionise how the neurodegenerative disease is diagnosed and handled. Recent studies have created artificial intelligence that can identify the presence of Alzheimer’s two years before a doctor.

Progression has been made in the understanding of this progressive brain cell failure with “..promising targets for next-generation drug therapies under investigation in current research studies” according to the Alzheimer’s association.

However, the failure rates are high when it comes to creating new medical treatments to stop, slow or prevent Alzheimer’s. Between 2002 to 2012 there was a reported 99.6% failure rate within drug discovery for this condition.

Jeffrey Cummings notes that researchers have a duty to make sure that both the physical and financial efforts behind these failed trials are not in vain as they have a lot to contribute in the battle against Alzheimer’s.

Some key lessons from failed trials to incorporate into today’s R&D pipelines:

Animal models aren’t reliable indicators of toxicity of efficacy in humans

Animal testing has long played a key role in the development of drugs and the understanding of how diseases function. However, animal models also have critical translation issues when results are compared to human trials. (more…)

Using the value-based approach to overcome challenges facing healthcare systems in the U.K and Rwanda

By IGHI guest blogger, Chris Bird, PG student in the Centre for Health Policy and Project Manager in the System Engagement Programme at the National Institute for Health and Care Excellence (NICE)

Systems under pressure

Rwanda and the developing world face even more acute pressure on frontline healthcare services.

Health systems around the world face the twin pressures of a rising demand for services, coupled with financial pressure on resources to deliver them. For publicly-funded universal health services in developed countries such as the UK’s National Health Service (NHS), new investment is at an all-time low. Funding for the NHS in England has seen a real-terms rise of 4.4% over 6 years, meaning that the average annual rise was just 0.7% per year. Traditionally NHS funding had averaged at 4% per year.[1]

At the same time in the developing world, pressure on frontline services is even more acute from challenges ranging from natural disaster, population displacement, communicable disease and often scarce availability of healthcare resources and skills to respond. Innovation is the best hope for policymakers and clinical leaders to meet and sustain the WHO’s Millennium Development Goals (MDGs) that aim to address the fundamental inequality in health outcomes between the developed and developing world.

Meeting the challenge with a value-based healthcare approach

In the face of these competing pressures on healthcare systems, Michael Porter of Harvard Business School argues that the time has come for a fundamental new strategy, which represents a shift away from the supply-side model of health care organisation towards a more patient-centred system focussing on achieving best outcomes at the lowest cost. It is termed the ‘value-based healthcare’ (VBH) agenda.

Central to delivering VBH is the Integrated Practice Unit (IPU). An IPU brings all related healthcare professionals together, organised around a given condition, in a multidisciplinary setting, having geographic reach and removing the need for the patient to travel around a variety of different services to access appropriate care interventions. The IPU team takes responsibility for the full cycle of care for the condition including inpatient, outpatient and rehab. It measures outcomes, costs and processes for each patient using a common information platform. (more…)

How health and voluntary sector services can work together collaboratively to improve health and wellbeing in later life

By IGHI guest blogger, Chris Bird, PG student in the Centre for Health Policy and Project Manager in the System Engagement Programme at the National Institute for Health and Care Excellence (NICE)

In today’s fast moving world, we need to constantly adapt to keep up. But what about those people in later life who might struggle to do so?

We live in a world where society is ageing. Falling mortality rates, particularly in the over 65-year age group coupled with low fertility rates in the younger population are leading to a society which is growing older[i].It is also true that conventional care delivery is often based around admittance to institutionalised hospital care which is both costly and can be inefficient as professionals, bound by silo working, fail to achieve either best value or best care for patients[ii].

The National Institute for Health and Care Excellence (NICE) has developed a quality standard which addresses the need for the National Health Service (NHS) and other sectors to work together to identify mental health and independence issues in older people. This an important step for those who would benefit from a helping hand but can’t find it themselves.

The integrated care pathway

Working with Age UK’s Integrated Care Team to evaluate their personalised integrated care programme, I have seen first-hand how the essence of this standard can be put into practice locally and improve older people’s wellbeing for the better. Age UK delivers an integrated holistic service for older people. It’s aimed at those with complex and long-term health problems.

Working with GPs to identify those who are eligible for the programme, (typically those who have had 2 or more unplanned hospital admissions and have 2 or more long-term conditions), Age UK is able to set individual’s up with their own “independence coordinator”.

After a series of home visits to get to know the person better, the coordinator helps create some personal goals. These can range from visiting a coffee mornings, to arts and crafts lessons, to a day out at the seaside – it depends on the person and what is important to them.

Over the course of this three-month personal intervention programme, independence coordinators monitor changes in their clients’ wellbeing through use of the Warwick and Edinburgh Mental Wellbeing Scale (WEMBWS). (more…)