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Arena Pharmaceuticals, Inc. Message Board

jeremiahthirtythreeone 20 posts  |  Last Activity: Jul 25, 2015 1:01 PM Member since: Feb 16, 2010
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  • 1. Massachusetts General Hospital, Boston
    2. Mayo Clinic, Rochester, Minnesota
    3. Johns Hopkins Hospital, Baltimore, Maryland
    3. UCLA Medical Center, Los Angeles
    5. Cleveland Clinic, Ohio
    6. Brigham and Women's Hospital, Boston, Massachusetts
    7. New York-Presbyterian University Hospital of Columbia and Cornell, New York City
    8. UCSF Medical Center, San Francisco
    9. Hospitals of the University of Pennsylvania-Penn Presbyterian, Philadelphia
    10. Barnes-Jewish Hospital/Washington University, St. Louis, Missouri
    11. Northwestern Memorial Hospital, Chicago, Illinois
    12. NYU Langone Medical Center, New York City
    13. UPMC-University of Pittsburgh Medical Center, Pennsylvania
    14. Duke University Hospital, Durham, North Carolina
    15. Stanford Health-Stanford Hospital, Stanford, California

    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • Reply to

    Ralinepag's STEALING THE SHOW, by-Stockvadar

    by stockvadar Jul 24, 2015 9:59 AM
    jeremiahthirtythreeone jeremiahthirtythreeone Jul 24, 2015 12:10 PM Flag

    Yes, and UCLA was recently ranked the third best hospital in the nation, tide with John Hopkins.
    Thanks Sharon

    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • Reply to

    Ralinepag's STEALING THE SHOW, by-Stockvadar

    by stockvadar Jul 24, 2015 9:59 AM
    jeremiahthirtythreeone jeremiahthirtythreeone Jul 24, 2015 11:03 AM Flag

    PAH prognosis:
    Goldman-Cecil Medicine, Twenty-Fifth Edition
    Goldman, Lee, MD
    Copyright © 2016

    Prognosis
    Several clinical factors are correlated with prognosis The natural history of symptomatic idiopathic pulmonary arterial hypertension is a median survival of 2.8 years with 1-, 3-, and 5-year survival rates of 68%, 48%, and 34%, respectively. In the era of targeted therapies, survival has improved but still remains suboptimal, with 1-, 2-, and 3-year survival of 86%, 70%, and 55% for incident cases.
    Pulmonary hypertension itself is the direct cause of death in about 50% of patients and contributes to but does not directly cause death in the other 50%.

    This is why there may be some basis to stockvadar's post.
    It's only a matter of time

    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • Reply to

    Eisai Japan Belviq XR

    by sharonconk Jul 23, 2015 8:31 AM
    jeremiahthirtythreeone jeremiahthirtythreeone Jul 24, 2015 10:31 AM Flag

    Thank you Sharon for your diligence!!
    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • jeremiahthirtythreeone jeremiahthirtythreeone Jul 24, 2015 10:28 AM Flag

    Therapeutic Potential of 5-HT2C Receptor Agonists for Addictive Disorders. Higgins GA, Fletcher PJ - ACS Chem Neurosci - July 15, 2015; 6 (7); 1071-88

    Abstract
    The neurotransmitter 5-hydroxytryptamine (5-HT; serotonin) has long been associated with the control of a variety of motivated behaviors, including feeding. Much of the evidence linking 5-HT and feeding behavior was obtained from studies of the effects of the 5-HT releaser (dex)fenfluramine in laboratory animals and humans. Recently, the selective 5-HT2C receptor agonist lorcaserin received FDA approval for the treatment of obesity. This review examines evidence to support the use of selective 5-HT2C receptor agonists as treatments for conditions beyond obesity, including substance abuse (particularly nicotine, psychostimulant, and alcohol dependence), obsessive compulsive, and excessive gambling disorder. Following a brief survey of the early literature supporting a role for 5-HT in modulating food and drug reinforcement, we propose that intrinsic differences between SSRI and serotonin releasers may have underestimated the value of serotonin-based pharmacotherapeutics to treat clinical forms of addictive behavior beyond obesity. We then highlight the critical involvement of the 5-HT2C receptor and the evidence that 5-HT2C receptor agonists reduce measures of drug reward and impulsivity. A recent report of lorcaserin efficacy in a smoking cessation trial further strengthens the idea that 5-HT2C receptor agonists may have potential as a treatment for addiction. This review was prepared as a contribution to the proceedings of the 11th International Society for Serotonin Research Meeting held in Hermanus, South Africa, July 9-12, 2014.

    It is just a matter of time.
    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • jeremiahthirtythreeone by jeremiahthirtythreeone Jul 24, 2015 10:26 AM Flag

    The Serotonin 2C Receptor Agonist Lorcaserin Attenuates Intracranial Self-Stimulation and Blocks the Reward-Enhancing Effects of Nicotine
    The Serotonin 2C Receptor Agonist Lorcaserin Attenuates Intracranial Self-Stimulation and Blocks the Reward-Enhancing Effects of Nicotine. Zeeb FD, Higgins GA, Fletcher PJ - ACS Chem Neurosci - July 15, 2015; 6 (7); 1231-40
    Abstract
    Lorcaserin, a serotonin (5-hydroxytryptamine, 5-HT) 2C receptor agonist, was recently approved for the treatment of obesity. We previously suggested that 5-HT2C receptor agonists affect reward processes and reduce the rewarding effects of drugs of abuse. Here, we determined whether lorcaserin (1) decreases responding for brain stimulation reward (BSR) and (2) prevents nicotine from enhancing the efficacy of BSR. Rats were trained on the intracranial self-stimulation (ICSS) paradigm to nosepoke for BSR of either the dorsal raphé nucleus or left medial forebrain bundle. In Experiment 1, lorcaserin (0.3-1.0 mg/kg) dose-dependently reduced the efficacy of BSR. This effect was blocked by prior administration of the 5-HT2C receptor antagonist SB242084. In Experiment 2, separate groups of rats received saline or nicotine (0.4 mg/kg) for eight sessions prior to testing. Although thresholds were unaltered in saline-treated rats, nicotine reduced reward thresholds. An injection of lorcaserin (0.3 mg/kg) prior to nicotine prevented the reward-enhancing effect of nicotine across multiple test sessions. These results demonstrated that lorcaserin reduces the rewarding value of BSR and also prevents nicotine from facilitating ICSS. Hence, lorcaserin may be effective in treating psychiatric disorders, including obesity and nicotine addiction, by reducing the value of food or drug rewards.

    FYI

    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • jeremiahthirtythreeone by jeremiahthirtythreeone Jun 28, 2015 9:08 AM Flag

    US Obese Now Overtake the Merely Overweight

    120 million Americans affected by obesity and overweight and Arena/Eisai cannot and does not appear to know how to address the problem with a proper and aggressive marketing approach. The need is clearly there and it is a huge -pardon the pun-need which has not be solved despite millions of dollars spent on diet and exercise awareness. Hopefully there is a big pharma who understands this potential

    MEDSCAPE June 25, 2015

    More Americans are now obese than are overweight, say researchers, who base this new conclusion on a reanalysis of data from the National Health and Nutrition Examination Survey (NHANES).

    They estimate that 67.6 million Americans over the age of 25 are obese and an additional 65.2 million are overweight.

    The finding shows the urgent need for government action that could improve Americans' diets and physical activity, coauthor Lin Yang, PhD, from the division of public-health sciences, Washington University, in Saint Louis, Missouri, told Medscape Medical News.

    "We really need the environment and support for people to keep their healthy behaviors sustainable," said Dr Yang.

    Dr Yang and her colleague, Graham A Colditz, MD, PhD, published the new data as a research letter June 22 in JAMA Internal Medicine

    They estimate that the proportion of women who are overweight or obese increased from 55% in the 1988–1994 NHANES to 63% in an aggregate of NHANES from 2007 to 2012. The figures for overweight or obese men went from 63% to 75%, they said.

    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • jeremiahthirtythreeone jeremiahthirtythreeone Jun 9, 2015 10:46 AM Flag

    Citation for this article (forgot to place it on my lead post:
    Cost implication of using Lorcaserin in Weight Management prior to Bariatric Surgery Z. Wang, X. Li, R. Knoth and K. Fujioka
    Value in Health, 2015-05-01, Volume 18, Issue 3, Pages A295-A295
    1Eisai Inc., Woodcliff Lake, NJ, USA, 2Eisai, Inc., Woodcliff Lake, NJ, USA, 3Scripps Health, San Diego, CA, USA

    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • jeremiahthirtythreeone jeremiahthirtythreeone Jun 9, 2015 10:41 AM Flag

    OBJECTIVES: Payers may grant coverage for bariatric surgery (BaS) for patients with BMI greater than 40 or BMI 35-39.9 with greater than 1 obesity-related comorbidities. Trial of weight loss medications before BaS may be beneficial to both payers and patients if some patients can avoid BaS. This analysis evaluated the cost impact of lorcaserin, a FDA- approved WL medication, in weight management prior to BaS from payer’s perspective.
    METHODS: Cost impact of lorcaserin for WL prior to BaS was assessed in a hypothetical US health plan of one million members over a 2-year horizon. Key assumptions include: 1) Average cost per BaS is $29,517; 2) Patients with BMI reduced to below 35 with pre-BaS WL can avoid BaS; 3) Only BaS and lorcaserin drug costs are included; 4) Only patients who achieve greater than 5% weight loss at week 12 continue lorcaserin treatment (WK-12 responders). For modeling purpose, WL data for lorcaserin were drawn from a subset of patients in three clinical trials (BLOSSOM, BLOOM, BLOOM-DM) evaluating the efficacy and safety of lorcaserin for WL.

    It's only a matter of time, " perseverance creates character, and character creates confidence."

    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • The cost analysis estimated cumulative saving of $1,033,407 over 2 years if patients who reduced their BMI to below 35 with lorcaserin can avoid BaS!!! And this is the savings based on the BLOSSOM, BLOOM, BLOOM DM studies. The real world weight loss has been greater so cost savings are likely significantly higher!!!

    RESULTS: 42.5% of patients with baseline BMI≥40 were WK-12 responders (average BMI 42.3) and 17.6% of them reduced BMI to below 35 at one year with lorcaserin treatment. In patients with baseline BMI 35-39.9 and greater than 1 obesity-related comorbidities, 49.3% were WK-12 responders (average BMI 37.2), and 72.6% of them reduced BMI to below 35 at one year with lorcaserin treatment. The cost analysis estimated cumulative saving of $1,033,407 over 2 years if patients who reduced their BMI to below 35 with lorcaserin can avoid BaS.

    CONCLUSIONS: From payer’s perspective, using lorcaserin for WL prior to BaS may lead to significant cost saving over a 2-year horizon. Real world, long-term evidence is needed for further evaluation of the role of lorcaserin for weight management in patients considering BaS.

    CONTINUED

    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • jeremiahthirtythreeone jeremiahthirtythreeone Jun 9, 2015 9:46 AM Flag

    The books are published but are not available for sale til later this year. I have access as pdf files to individual chapters. So it is not a typo
    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • jeremiahthirtythreeone jeremiahthirtythreeone Jun 8, 2015 5:01 PM Flag

    Thank you for posting this. There will be more to come!!!

    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • jeremiahthirtythreeone jeremiahthirtythreeone Jun 8, 2015 4:59 PM Flag

    The key finding " In contrast, although some synergistic interactions between lorcaserin and phen… were observed, these combinations were largely additive." These means that hypophagia related to phen and hypophagia related to lorcaserin were additive. This is a good finding suggesting little interaction between the two drugs. And since we already know the safety profile of both we can conclude that there is no or minimal effect on the safety of using both together!!!! By contrast, the brain levels of phen were increased through a synergistic effect, rather than additive thus causing an increase in the brain levels of phen.

    Overall this supports a safe use with the use of pen and belviq combination and, as we have seen, an increase in weight loss that with either one alone.

    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • jeremiahthirtythreeone jeremiahthirtythreeone Jun 8, 2015 4:01 PM Flag

    And there are several ongoing trials looking at this indication...thanks Sharon

    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • jeremiahthirtythreeone jeremiahthirtythreeone Jun 8, 2015 3:56 PM Flag

    These books are spme of the more common books used by primary care physicians

    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • jeremiahthirtythreeone jeremiahthirtythreeone Jun 8, 2015 3:55 PM Flag

    The YMB patrol will not let me post the rest how ever there are at least 15 books published this year that discuss lorcaserin as a treatment for obesity.

    I didn't have time to post excerpts from each book but lorcaserin is discussed as a treatment option in each one...the medical community is getting the info on BELVIQ!!!!!

    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • Book Chapter
    Diabetes Mellitus
    Textbook of Family Medicine.
    Unger, Jeff; White, Russell. Published January 1, 2016. Pages 782-816.e3. © 2016.

    Weight loss medications (i.e., Qysmia ER, lorcaserin) should be considered for overweight or obese patients with T2DM who fail to achieve moderate weight loss (i.e., ≈10% of their baseline weight) through lifestyle modification (Garvey, 2013). Weight loss drugs can also be used in conjunction with certain oral agents for diabetes (e.g., metformin, SGLT2 inhibitors, and GLP-1 receptor ago¬nists), which are discussed in greater detail in the Long-Term Complications of Diabetes section of this chapter. Patients who fail to improve their metabolic profiles while using FDA-approved weight loss agents may be candidates for bariatric surgery (also known as “metabolic surgery”).

    Book Chapter
    Obesity
    Goldman-Cecil Medicine.
    Jensen, Michael D.. Published January 1, 2016. Pages 1458-1466.e3. © 2016.

    Lorcaserin inhibits the serotonin pathway in a manner similar to phen…, but without the cardiac valvulopathy effects.

    Also discussed in all the following:

    • Obesity
    Ferri's Clinical Advisor 2016.
    Published January 1, 2016. Pages 882-885.e5. © 2016.

    • Book Chapter
    Nonalcoholic Fatty Liver Disease
    Sleisenger and Fordtran's Gastrointestinal and Liver Disease.
    Torres, Dawn M.; Harrison, Stephen A.. Published January 1, 2016. Pages 1428-1441.e5. © 2016.

    • Book Chapter
    Obesity
    Sleisenger and Fordtran's Gastrointestinal and Liver Disease.
    Bray, George A.. Published January 1, 2016. Pages 102-118.e5. © 2016.

    • Book Chapter
    Other transmitters and modulators
    Rang & Dale's Pharmacology.
    Published January 1, 2016. Pages 467-481. © 2016.

    • Book Chapter
    Obesity
    Rang & Dale's Pharmacology.
    Published January 1, 2016. Pages 393-401. © 2016.

    continued...
    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • jeremiahthirtythreeone jeremiahthirtythreeone Jun 8, 2015 3:39 PM Flag

    Childhood obesity: Current and novel approaches Get rights and content
    • Matthew A. Sabin MRCPCH (UK), FRACP, PhD
    • and Wieland Kiess MD
    Best Practice & Research: Clinical Endocrinology & Metabolism, 2015-06-01, Volume 29, Issue 3, Pages 327-338, Copyright © 2015 Elsevier Ltd

    Some of the novelty around treatment of paediatric obesity may simply come from the trialling of
    obesity medications which are licensed, or under consideration for licence, in obese adults. These
    include (but are not limited to) lorcaserin,….

    You get the picture

    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • jeremiahthirtythreeone jeremiahthirtythreeone Jun 8, 2015 3:37 PM Flag

    5-hydroxytryptamine medications for the treatment of obesity.
    Burke LK, Heisler LK. - J. Neuroendocrinol. - June 1, 2015; 27 (6); 389-98

    Abstract
    The central 5-hydroxytryptamine (5-HT; serotonin) system represents a fundamental component of the brain's control of energy homeostasis. Medications targeting the 5-HT pathway have been at the forefront of obesity treatment for the past 15 years. Pharmacological agents targeting 5-HT receptors (5-HTR), in combination with genetic models of 5-HTR manipulation, have uncovered a role for specific 5-HTRs in energy balance and reveal the 5-HT2 C R as the principal 5-HTR mediating this homeostatic process. Capitalising on this neurophysiological machinery, 5-HT2 C R agonists improve obesity and glycaemic control in patient populations. The underlying therapeutic mechanism has been probed using model systems and appears to be achieved primarily through 5-HT2 C R modulation of the brain melanocortin circuit via activation of pro-opiomelanocortin neurones signalling at melanocortin4 receptors. Thus, 5-HT2 C R agonists offer a means to improve obesity and type 2 diabetes, which are conditions that now represent global challenges to human health.
    Citation

    Daniel
    UCLA MD

    Sentiment: Strong Buy

  • Investigating interactions between phen…, dex…., and 5-HT2C agonists, on food intake in the rat.
    Grottick AJ, Whelan K, Sanabria EK, Behan DP, Morgan M, Sage C. - Psychopharmacology (Berl.) - June 1, 2015; 232 (11); 1973-82
    Abstract
    Synergistic or supra-additive interactions between the anorectics (dex)… and phen… have been reported previously in the rat and in the clinic. Studies with 5-HT2C antagonists and 5-HT2C knockouts have demonstrated dex….. hypophagia in the rodent to be mediated by actions at the 5-HT2C receptor. Given the recent FDA approval of the selective 5-HT2C agonist lorcaserin (BELVIQ®) for weight management, we investigated the interaction between phen… and 5-HT2C agonists on food intake.
    This study aims to confirm dex…phe synergy in a rat food intake assay, to extend these findings to other 5-HT2C agonists, and to determine whether pharmacokinetic interactions could explain synergistic findings with particular drug combinations.
    Isobolographic analyses were performed in which phen…. was paired with either dex…, the 5-HT2C agonist AR630, or the 5-HT2C agonist lorcaserin, and inhibition of food intake measured in the rat. Subsequent studies assessed these same phen….-drug pair combinations spanning both the full effect range and a range of fixed ratio drug combinations. Satellite groups received single doses of each drug either alone or in combination with phen…., and free brain concentrations were measured.
    Dex-ph… synergy was confirmed in the rat and extended to the 5-HT2C agonist AR630. In contrast, although some synergistic interactions between lorcaserin and phen… were observed, these combinations were largely additive. Synergistic interactions between phen… and dex…or AR630 were accompanied by combination-induced increases in brain levels of phen…..
    Dex-ph… synergy in the rat is caused by a pharmacokinetic interaction, resulting in increased central concentrations of phen…..

    Continued
    Daniel
    UCLA MD

    Sentiment: Strong Buy

ARNA
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