Advances in diabetes...combating the menace of HIV/Tuberculosis co-infection

Todays Headlines from across the DailyUpdates network (June 12th, 2006 - access this edition)

• Breaking News (from DailyUpdates-Metabolic Disorders): Metabolex announce phase II/III trial of novel insulin sensitizer Diabetes affects approximately 170 million people worldwide a figure that is increasing with the WHO predicting 300 million diabetics by 2025 (see The World Diabetes Market, 2005-2011). The US alone has 20.8 million people suffering with diabetes. This equates to approximately 6% of the population. It was the 6th most common cause of death as recorded on US death certificates. The global diabetes drugs treatment market was valued at $15 billion in 2005. Oral anti-diabetics were the leading category of drugs. The total sales for insulin were $6.83 billion. The thiazolidinedione insulin sensitizers experienced the greatest growth now accounting for the second largest portion of the market share (see Commercial Insight: Antidiabetic Drugs). Today’s featured press release from Metabolex announces the initiation of a Phase 2/3 trial of another insulin sensitizer, metaglidasen. Unlike Actos and Avandia, both of which are marketed insulin sensitizing thiazolidinediones, metaglidasen is not a thiazolidinedione and moreover it acts as a Selective PPAR Modulator (SPPARM) rather than as a full agonist of the PPAR nuclear receptors. The PPAR receptor controls the expression of genes involved in glucose metabolism, lipid metabolism and inflammation. Again contrasting with currently available thiazolidinediones, metaglidasen modulate the genes needed for insulin sensitization without activating those responsible for weight gain and edema, adverse effects associated with Actos and Avandia. A phase 2 trial in patients with diabetes has already shown metaglidasen to be well tolerated and to lower blood glucose, triglycerides and uric acid levels without causing any increase in weight gain or edema. Preclinical findings have demonstrated that in addition, metaglidasen helps preserve the function of beta cells. The trial initiated today is designed to compare metaglidasen with Actos.

• Featured Journal Article (from DailyUpdates-InfectiousDiseases): Advanced Life Sciences set to advance our treatment of HIV/tuberculosis a highly prevalent co-infection with serious medical consequences: Tuberculosis is one of the leading causes of infectious disease mortality, with 2–3 million deaths annually worldwide. One-third of the world population is estimated to be infected with Mycobacterium tuberculosis however it has been nearly 30 years since the introduction of a novel compound for the treatment of tuberculosis. New treatments are urgently required since existing approaches require a combination of 3-4 drugs, a prolonged treatment time, and cause significant adverse effects. Whilst therapeutic options have remained stagnant the epidemiology of tuberculosis has changed drastically, and of note during this time period HIV infection has emmerged as a global health problem. Notably half of all patients infected with HIV are also infected with tuberculosis. Here we feature potentially breakthrough work by Xu et al from Advanced Life Sciences who describe the optimization of the Calanolides, a therapeutic class which is able to block replication of both HIV and M. tuberculosis class. This is not only important clinically but from a pharmacoeconomic perspective given the importance attached to developing new HIV therapeutics, it should dramatically increase the perceived value of developing novel antituberculosis drugs, a barrier up untill now.