By Sherri Kimmel
Forty years ago, it was common to see wheelchairs lining the halls of clinics treating patients with crippling arthritis, says the FDA’s Janet Woodcock ’70, who began her distinguished medical career as a rheumatologist. “Biologic agents have changed the face of rheumatoid arthritis, and my colleagues say, ‘We don’t have people in wheelchairs anymore in our clinics,’ ” Woodcock explains.
Arthritis drugs are among the few Woodcock mentions when asked to list breakthrough drugs. Another is a blood thinner that acts as a clot buster — tissue plasminogen activator (tPA). “It’s the protocol now to rush people who seem to be having thrombotic strokes in to see if their clot can be dissolved,” Woodcock says. Often, paralysis on the left side of the body can be prevented by quickly administering tPA, she adds.
“A lot of the other drugs the FDA has approved lately really are triumphs,” says Woodcock, whose office approves 20 to 45 novel drugs each year. Those that treat hepatitis C are among the most groundbreaking, despite their expense, she says. “If you can cure hepatitis C, you can interrupt transmission [to others] as well as treat the person.”
A few other alumni physicians recently identified drugs they consider to be game changers. David Bresticker '82, a family physician in Williamsport, Pa., asked several colleagues to list their top drugs. They agreed on four.
Metformin has made the greatest impact in diabetes treatment during his 25 years of practice, says Bresticker. Not only does it lower blood sugar, but it reduces the complications of diabetes. “There are fewer heart attacks and strokes,” he says.
Lovastatin, which “gave rise to a whole family of cholesterol-lowering drugs,” is another one the docs agree on. Statins are “now used for people with risk factors,” Bresticker says. “Even though my numbers [LDL, HDL, triglycerides] look great, I take Lipitor because I have a terrible family history [of heart disease].”
The third breakthrough drug the doctors champion is the now-over-the-counter medicine Prilosec, used to treat heartburn, stomach ulcers and acid reflux. “This is an A-plus drug that has revolutionized how we treat these problems,” Bresticker says.
The final drug on the doctors’ shortlist is Prozac. “That one really changed everything about the way we treated mental illness,” Bresticker contends. “It helps people not just with depression but with anxiety, OCD and eating disorders and is now the standard of care.”
Prozac also was singled out by Margaret Wetmore Chappen ’79 of Geisinger Health System in Lewisburg. “I’m in internal medicine and primary care, so much of what I do is psychology and psychiatry,” she says. “The development of an effective, safe and affordable antidepressant has made the biggest difference to my practice. The breakthrough drug was Prozac in the early ’90s, but there are even better medicines now in that classification — Lexapro, Celexa, Paxil, Zoloft. They have been refined so they have fewer side effects.”
Like Woodcock, Douglass Drelich ’98 has a specialty — his is cancer. “It’s been a busy decade or so for oncologists,” says Drelich, who is affiliated with Thomas Jefferson University Hospital in Philadelphia. Chronic myelogenous leukemia took a serious hit with the advent of Gleevec, he says. It was the first molecularly targeted therapy, which means it homes in on “what it is about a cancer cell that makes it a cancer cell,” he says.
Another miraculous drug is Rituxan, a monoclonal antibody that “makes your immune system target a cancer,” Drelich says. “It’s very important historically, and we use it by the gallon for a wide variety of autoimmune diseases as well as non-Hodgkin’s lymphoma.”
The final drug he cites is Yervoy, used to treat melanoma. “It was the first drug that activates the immune system to destroy cancer cells,” he says.
He freely admits that the cancer drugs he lauds are very expensive — a problem he feels will not be cured anytime soon. Some countries, such as Great Britain, assess the extent to which a patient’s lifespan will be lengthened before approving an expensive drug. Says Drelich, “Pharmaceuticals are an extremely well-funded lobby, and until we address campaign-finance reform, there are unlikely to be any changes.”
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