The importance of innovation: from patents of new molecules to clinical application
ORVOSI HETILAP
Authors: Szabo Sandor
Abstract
The patenting of an invention and innovation is now almost as important as publishing the original experimental result or clinical observation in a good scientific journal. This is mainly important in countries such as Hungary, whose 'innovation index' is far below the EU average. Therefore, research institutes, teaching hospitals and individual researchers are responsible for patenting an innovation or new drug effect before a conference presentation or publication in a scnetific journal. I illustrate this innovation process with five examples of our research laboratory, four of which have been patented. Despite being surprising and novel the anti-duodenal ulcer effect of dopamine agonists (e.g., bromocriptine, L-deprenil), the companies producing these medicines did not patent them because these drugs were previously introduced for other clinical uses. However, we were able to patent the prolonged gastroprotective effect (e.g., 12-24 hours) of pyrazole derivatives as well as the potent ulcer-healing effects of angiogenic growth factors and of novel angiogenic steroids. We also patented the protective effect of somatostatin against the development of septic shock and mortality in animal models, but this effect has not been tested in clinical studies.
Contemporary Management of Clinically Non-functioning Pituitary Adenomas: A Clinical Review
CLINICAL MEDICINE INSIGHTS-ENDOCRINOLOGY AND DIABETES
Authors: AlMalki, Mussa H.; Ahmad, Maswood M.; Brema, Imad; AlDahmani, Khaled M.; Pervez, Nadeem; Al-Dandan, Sadeq; AlObaid, Abdullah; Beshyah, Salem A.
Abstract
Non-functioning pituitary adenomas (NFPAs) are benign pituitary tumours that constitute about one-third of all pituitary adenomas. They typically present with symptoms of mass effects resulting in hypopituitarism, visual symptoms, or headache. Most NFPAs are macroadenomas (>1 cm in diameter) at diagnosis that can occasionally grow quite large and invade the cavernous sinus causing acute nerve compression and some patients may develop acute haemorrhage due to pituitary apoplexy. The progression from benign to malignant pituitary tumours is not fully understood; however, genetic and epigenetic abnormalities may be involved. Non-functioning pituitary carcinoma is extremely rare accounting for only 0.1% to 0.5 % of all pituitary tumours and presents with cerebrospinal, meningeal, or distant metastasis along with the absence of features of hormonal hypersecretion. Pituitary surgery through trans-sphenoidal approach has been the treatment of choice for symptomatic NFPAs; however, total resection of large macroadenomas is not always possible. Recurrence of tumours is frequent and occurs in 51.5% during 10 years of follow-up and negatively affects the overall prognosis. Adjuvant radiotherapy can decrease and prevent tumour growth but at the cost of significant side effects. The presence of somatostatin receptor types 2 and 3 (SSTR3 and SSTR2) and D2-specific dopaminergic receptors (D2R) within NFPAs has opened a new perspective of medical treatment for such tumours. The effect of dopamine agonist from pooled results on patients with NFPAs has emerged as a very promising treatment modality as it has resulted in reduction of tumour size in 30% of patients and stabilization of the disease in about 58%. Despite the lack of long-term studies on the mortality, the available limited evidence indicates that patients with NFPA have higher standardized mortality ratios (SMR) than the general population, with women particularly having higher SMR than men. Older age at diagnosis and higher doses of glucocorticoid replacement therapy are the only known predictors for increased mortality.