Top 10 Medical Innovations according to the Cleveland Clinic (8)
Specialists of the Cleveland Clinic, Ohio, have compiled another annual list of innovations that, in their opinion, will have the greatest impact on the healthcare system in the coming 2015.
No. 8. New drugs for the treatment of idiopathic pulmonary fibrosis
The lungs are vital organs that provide the body with oxygen necessary for vital activity. As the only internal organs directly exposed to the environment, the lungs suffer from a number of diseases.
One of the diseases in which only organ transplantation can save a patient from death is idiopathic pulmonary fibrosis.
This progressive disease leads to scarring, thickening and damage to the tissue around and between the alveoli – tiny air bubbles that form the spongy structure of the lungs. This significantly complicates the penetration of oxygen-containing air into the bloodstream and, accordingly, its spread throughout the body. As a result, patients develop severe shortness of breath, especially during physical exertion, and a strong feeling of fatigue.
The cause of this disease is unknown. Some patients inherit it from their parents, while in others it can be caused by exposure to certain types of quartz dust, asbestos fibers, grain dust, feces of birds and animals, or tobacco smoke. Sometimes idiopathic pulmonary fibrosis develops after undergoing radiotherapy for lung or breast cancer, as well as after chemotherapy, taking antiarrhythmic drugs or certain types of antibiotics. The disease develops between the ages of 40 and 70, with approximately two-thirds of cases occurring in patients over 60 years of age.
To date, there is no therapy that would eliminate scars in the lung tissue, slow down the course of the disease or cure it. As a rule, the life expectancy of patients after diagnosis is 3-5 years, during which their condition progressively worsens, in most cases due to respiratory failure.
However, more recently, patients with idiopathic pulmonary fibrosis have had a "light at the end of the tunnel". Major international clinical studies have demonstrated the ability of two new drugs to significantly slow the progression of the disease.
One of these drugs, pirfenidone, demonstrated the ability to slow the progression of the disease after 13 weeks of use in a placebo–controlled clinical trial lasting one year. It also significantly improved lung function and the distance that patients could walk. In general, compared with placebo, the drug reduced the risk of mortality by almost 2 times – by 48%.
The mechanisms of action of pirfenidone are not completely clear, however, it is known that the drug has anti-inflammatory properties and inhibits the activity of growth factor involved in the formation of fibrous scars. The use of the drug has already been approved in Europe, Japan and Canada. More recently, the United States has joined this list.
During two phase III clinical trials involving more than 1,000 patients, another drug, nintedanib, demonstrated the ability to reduce the severity of lung function decline by about 2 times (by 48-55%) during the year, compared with 5% for the placebo group.
Nintedanib acts by blocking the effects of tyrosine kinases, enzymes that trigger the formation of scar tissue in the lungs. Thanks to the status of "breakthrough therapy" received from the FDA, the drug was recently approved for use in the United States.
Evgeniya Ryabtseva
Portal "Eternal youth" http://vechnayamolodost.ru based on the materials of the Cleveland Clinic: Top 10 Innovations for 2015.
11.12.2014