A range of promising life-saving medicines are being developed by pharmaceutical companies, from the first gene therapies impacting devastating rare genetic diseases to a series of CAR-T cell therapies driving unprecedented remission rates for cancer patients. But their full benefits may never reach patients because of the policies that govern drug pricing and coverage.
Pomalidomide
Pomalidomide manufacturers, sold under the brand name Pomalyst, is a cancer medicine that interferes with the growth of multiple myeloma cells. It is used together with dexamethasone to treat multiple myeloma that has not responded to other medicines. It is also used to treat AIDS-related Kaposi sarcoma in people who do not have HIV infection (HIV negative). Pomalidomide works by stopping the cancer cells from growing and dividing. This medicine also causes the cancer cells to break down and die. The dead cancer cells then release their contents, such as uric acid and potassium, into the blood. This can cause a serious reaction called tumor lysis syndrome (TLS). Your healthcare provider will check you often for signs of TLS, such as a low amount of urine or dark urine.
Several clinical trials have shown that pomalidomide alone or in combination with other medicines improves survival for people with relapsed or refractory multiple myeloma, especially those who have a high risk of disease progression or are heavily pretreated. It is also an effective therapy for patients whose disease is refractory to lenalidomide and bortezomib, which are standard therapies.
The drug acts as a third-generation immunomodulatory agent, with antitumor activity and immune-boosting effects. Its mechanism of action is similar to other IMiDs and includes induction of apoptosis against myeloma cells, interference of tumor interactions with the cellular microenvironment, and improvement of the patient’s innate immunity.
Because pomalidomide may harm an unborn baby, it is important that women who are pregnant or might become pregnant do not take the medication. It is also important for men to use condoms during sexual intercourse.
A recent phase II MM-014 trial showed that pomalidomide can be added to lenalidomide and low-dose dexamethasone after the failure of earlier therapies in the first two treatment lines in relapsed or refractory MM. The combination showed significant efficacy in a subset of patients, with a doubling time of less than six months and an objective response rate of 49%.
A person can only get pomalidomide under special authorization from the FDA. This is because it can cause a severe, life-threatening birth defect. Patients can only receive pomalidomide if they are registered with the program called Pomalyst REMS and have a prescription from a doctor who is registered with this program and fills it at a pharmacy that is registered as well. If you have tubal ligation or other procedures that prevent pregnancy, you can still register with this program. You can also ask your doctor about sperm banking or egg storage before beginning this medication.
Lamivudine
This medication prevents human immunodeficiency virus (HIV) and hepatitis B virus (HBV) from multiplying in your body. It may also help your immune system work better. It can be taken alone or with other antiretroviral medicines. It is usually given as a tablet or liquid, and it must be taken by mouth. Use a special measuring device/spoon to get the right dose. The dose is based on your medical condition and weight. Children should take this medicine only under a doctor’s care.
Lamivudine belongs to a class of drugs known as nucleoside reverse transcriptase inhibitors. It works by blocking the synthesis of viral DNA in your cells. Its toxicity is relatively low compared to other drugs of this type and it has an excellent safety profile. The drug is a pro drug, and it is phosphorylation to the active triphosphate by cellular kinases before entering your bloodstream. The triphosphate has a high affinity for HIV and hepatitis B virus RT. It is an antagonist of the hepatitis B RT, and it blocks the activity of this protein in the cells of the liver and intestines.
The FDA has approved lamivudine in combination with other drugs to treat HIV and hepatitis B. It is also an effective monotherapy against hepatitis B. It is available under the brand name Epivir and as an oral solution called Epivir-HBV.
Taking lamivudine during pregnancy can reduce the risk of passing HIV to your baby. It can also be used to treat HIV in infants born to mothers who are infected with the virus. However, it is important to talk to your health care provider before you begin treatment.
Some people can develop serious side effects from this medicine. These include a swollen liver and a buildup of acid in the blood (lactic acidosis). Lamivudine supplier can also cause pancreatitis, especially in women and in people who have been taking it for a long time.
Other side effects of this medication may include nausea, vomiting, diarrhea, a rash, and trouble breathing. If you notice any of these side effects, contact your doctor or pharmacist immediately. Keep this medication out of reach of children and pets. Do not flush it down a toilet or throw it away in a drain unless instructed to do so. There are drug-take back programs in many communities. Talk to your pharmacist about how to dispose of unused or expired medications.
