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Company
Organon ‘Samsung’s Humira biosimilar to make KRW 100 billi
by
Jung, Sae-Im
Feb 20, 2023 05:53am
Samsung Bioepeis’ U.S partner Organon projected that the sales of the company’s Humira biosimilar will reach a maximum of KRW 123.5 billion in the first year of its release. On the 16th (local time), Organon projected so while presenting its full-year 2022 financial results, announcing that the company “will be launching the Humira biosimilar ‘Hadlima’ in the U.S. July this year.” Hadlima is a Humira biosimilar that was developed by Samsung Bioepis. Humira is a blockbuster drug that held the ranks as the most-sold drug worldwide for a decade. Its global sales recorded USD 21.24 billion (approximately KRW 27 trillion) last year, of which sales in the U.S. accounted for USD 18.62 billion (approximately KRW 24 trillion). Starting with Amgen, various companies including Samsung Bioepis, Boehringer Ingelheim, Pfizer, and Coherus are set to release Humira biosimilars this year. Amgen’s ‘Amjevita’ has already been released to the market. In particular, up to 8 companies including Samsung Bioepis are expected to competitively release their biosimilar products in July this year. Building on their successful launch of Hadlima in Canada and Australia, the company expects the experience to positively impact the launch in the U.S. market. Also, it pointed to Hadlima’s equal product composition and pen device technology as what differentiates its biosimilar from other products. Organon said, “We have launched Hadlima in Canada and Australia in 2021 and achieved good results. The data we collected from the launches will support our launch of the same in the U.S. Both the citrate-free, high-concentration formulation and the low-concentration formulation will be released then. The design of the pen that contains the drug can also be a differentiating factor. As a device design and manufacturing expert, the company designed the pen to ensure a smooth transition for the patients switching from Humira to Hadlima.” Organon expects Hadlima to make sales of up to USD 96.75 million (KRW 123.5 billion) this year, the first year of its launch in the US. This amount was derived based on the expectation that Hadlima sales will not exceed 1.5% of the estimated total sales of USD 92.25-96.75 million (KRW 117.8-123.5 billion), which roughly amounts to USD 92.25-96.75 million (KRW 117.8-123.5 billion). This will be around fivefold of what Hadlima made last year (USD 19 million, KRW 24.2 billion). Organon said, “We expect sales of Hadlima to rise gradually with competition among biosimilars to be officially listed by major Pharmacy Benefit Managers (PBMs) in the U.S. From the next year after the biosimilar market is formed in earnest, Hadlima will grow into Organon's second largest grossing product.” The ‘interchangeable biosimilar’ designation sought by Samsung Bioepis was expected to be achieved in Q2 to Q3 of 2024. The interchangeable biosimilar designation is made by the U.S. Food and Drug Administration for biosimilars that are very similar to and have no clinically meaningful differences from the original drug. Drugs that are approved as interchangeable biosimilars may be substituted at the pharmacy without a separate order for switching by the prescribing health care provider. Organon said, “We expect to be able to receive the interchangeable biosimilar designation around one year after Hadlima’s release in July. Our other Humira biosimilar competitors will also be able to receive designation by then. For the first 1-2 years after a drug is launched, whether the drug received the interchangeable biosimilar designation does not become a key point of differentiation for biosimilars during discussions with PBMs. As long as give convince them that we can receive the designation within a reasonable period of time, it will not be a major point for discussion at the negotiation table."
Company
Novartis’s Jakavi makes a step towards reimb for GvHD
by
Eo, Yun-Ho
Feb 20, 2023 05:52am
‘Jakavi’ is now one step closer to extending reimbursement to Graft versus Host Disease (GvHD) in Korea. According to industry sources, Novartis Kroea’s Jakavi (ruxolitinib) recently passed deliberation by the Drug Reimbursement Evaluation Standard Subcommittee. The next step is for the drug to be reviewed by the Drug Reimbursement Evaluation Committee. Novartis Korea submitted an application to extend reimbursement for Jakavi (ruxolitinib) to Graft-versus-Host Disease (GvHD), immediately after receiving approval for the indication in May 2022. The application passed review after being pending at this stage for 8 months. GvHD is a potentially serious complication that may occur after allogeneic stem cell transplantation. When the donor’s T cells (the graft) view the patient’s healthy cells (the host) as foreign and attack and damages them, affecting various organs including the skin, the gastrointestinal tract, the liver, and the lungs. As symptoms can appear throughout the body, GvHD poses another challenge to patients who have survived allogeneic hematopoietic stem cell transplantations by affecting the patient’s quality of life. Steroids are used as standard first-line therapy, but unmet needs exist as no standard-line therapy exists in the second-line for the 50% of patients that fail treatment in the first-line. In this area, Jakavi arose as an option that can be used to treat patients aged 12 years and older with acute or chronic GvHD who have an inadequate response to corticosteroids or other systemic therapies. Hee-Jae Kim, the Chief Chair of the Korean Society of Blood and Marrow Transplantation (Professor of Hematology at the Catholic University of Korea), said, “Jakavi demonstrated superior effect in treating acute and chronic GvHD patients in clinical studies and has shown similar results in the field, and opened up new possibilities for patients suffering from the lack of an appropriate treatment option” Meanwhile, Jakavi has demonstrated its efficacy in the Phase III REACH2 trial. Results showed that the overall response rate with Jakavi at Day 28 was 62% (96/154), compared to the 39% that was achieved with the best available therapy (61/155) Also, the durable overall response was found to be twice higher in the Jakavi group at Day 56 at 22% (34/155) compared with 40% (61/154) in the control group.
Company
Leclza’s partner ‘Rybrevant’ lands in Big 5 hospitals
by
Eo, Yun-Ho
Feb 17, 2023 05:50am
The anticancer drug Rybrevant which targets a small number of lung cancer patients has landed at general hospitals in Korea. According to industry sources, Janssen Korea’s Rybrevant (amivantamab), which is used to treat EGFR exon 20 insertion non-small-cell lung cancer (NSCLC) that is insensitive to currently available EGFR tyrosine kinase inhibitors (TKIs), has passed the drug committees of 18 medical institutions in Korea including tertiary hospitals such as the Samsung Medical Center, Seoul National University Hospital, Seoul St.Mary’s Hospital, Seoul Asan Medical Center, and Sinchon Severance Hospital, as well as other institutions nationwide, such as Gangnam Severance Hospital, National Cancer Center, Konyang University Hospital, Kyungpook National University Hospital, Ajou University Hospital, Incehon St.Mary’s Hospital, Jeonbuk National University Hospital, Chungnam National University Hospital, Kyungpook National University Chilgok Hospital, and Chonnam National University Hwasun Hospital. The drug has landed relatively quickly for prescriptions after being approved in Korea in February last year. However, Rybrevant is currently a non-reimbursed drug. Janssen applied for reimbursement but was unable to pass deliberations by the Health Insurance Review and Assessment Service’s Cancer Disease Deliberation Committee. The company is known to be preparing to reapply for reimbursement. EGFR exon 20 insertion mutations in NSCLC are so rare that it is found in only 2% of all NSCLC patients harboring EGFR mutations in Korea. With no suitable treatment available for the specific condition, even the NCCN guidelines have only been recommending platinum-based chemotherapy for the patients. And even this is subject to expenditure cuts. Although lung cancer in itself is not a rare disease, NSCLC with EGFR exon 20 insertions can be classified as a rare condition. Unlike other common EGFR mutations, NSCLC patients with EGFR exon 20 insertion mutations have a 75% higher risk of death, a 5-year survival rate of 8%, and a life expectancy of less than 2 years. Rybrevant, which is well known for its combined use with ‘lasertinib (Leclaza),’ was the first targeted therapy approved in Korea for the treatment of NSCLC with EGFR exon 20 insertion mutations in February this year. The approval for the drug was based on the results from the CHRYSALIS study, where the drug demonstrated an overall response rate (ORR) of 40%, a 4% complete response (CR), and 36% partial response (PR) rate. The U.S. Food and Drug Administration (FDA) granted accelerated approval for the drug based on Phase I trial results in recognition of its value as a treatment for a rare type of cancer. Following the approval in the U.S., the drug also was designated for expedited review and approved in Korea. However, the issue lies in whether its value will be accepted during the reimbursement review. As the drug was approved based on data from a single-arm clinical trial that was conducted without a control group, Rybrevant needs to take the pharmacoeconomic evaluation exemption track for reimbursement. Therefore, the key issue lies in whether Rybrevant’s value as a treatment for a rare cancer, not just lung cancer, will be acknowledged during the reimbursement review. Byoung-Chul Cho, Chief of the Lung Cancer Center at Yonsei Cancer Center, said “EGFR exon 20 insertion presents in various subtypes, and the sub-analysis of the CHRYSALIS study showed that Rybrevant showed an even response rate across several subtypes. In addition to its target inhibition effect, Rybrevant shows more promise due to its immune cell-directing activity.”
Company
Samsung Bioepis Soliris patent partially invalidated
by
Kim, Jin-Gu
Feb 16, 2023 05:52am
SolirisSamsung Bioepis succeeded in partially invalidating the 'Solaris patent. A blue light has been turned on for the release of the Soliris biosimilar this year. According to the pharmaceutical industry on the 13th, the Korean Intellectual Property Tribunal ruled in favor of Samsung Bioepis and ruled in favor of Samsung Bioepis in the invalidation trial filed in the Soliris usage patent. Soliris is a rare disease treatment developed by Alexion in the U.S. It is known to be an ultra-high-priced drug with an annual drug cost of 500 million won. Handok is in charge of sales in Korea. In January 2010, PNH was approved in Korea as an indication. Since then, the indications have expanded to the atypical uremic syndrome, systemic severe work history, and optic nerve scoliosis. In Korea, Samsung Bioepis is challenging the development of Soliris biosimilars. Phase 3 clinical trials were completed in October 2021. In July last year, the Ministry of Food and Drug Safety applied for an item license. It then applied for and registered trademarks named "EPYSQLI" and "EPIZQA." At the same time, the Soliris patent was requested to be invalidated. Soliris has two patents registered. However, among the two patents, the patent for "a method for treating glomerulonephritis and other inflammatory diseases and a composition for treatment" expired in July 2015. The remaining "how to treat hemolytic diseases" patents expire in February 2025. However, as Samsung Bioepis succeeded in partially invalidating the patent, the possibility of releasing related biosimilars within this year has increased. The pharmaceutical industry is paying attention to the timing of the release of the Soliris biosimilar. This is because Soliris is rapidly being replaced by Ultomiris, a follow-up drug. According to IQVIA, an actual drug market research firm, Soliris' cumulative sales in the third quarter of last year were KRW 7.7 billion, down a quarter from 28.4 billion won a year earlier. Ultomiris, on the other hand, increased 3.7 times from 8.9 billion won to 32.7 billion won during the period. Samsung Bioepis should release the product as soon as possible. Soliris should be administered daily for the first four weeks and then administered with a retention dose every two weeks thereafter. On the other hand, Ultomiris can be administered once every 8 weeks from 2 weeks after the initial dose administration.
Company
Open Innovation Trend
by
Jung, Sae-Im
Feb 16, 2023 05:52am
China is pushing for a policy to restrict its biopharmaceutical technology from escaping abroad. In the pharmaceutical industry, where open innovation has become a trend, the U.S. and China are taking the opposite step by fighting for technological supremacy. According to a report published by the Bioeconomic Research Center of the Korea Bio Association on the 14th, China's Ministry of Commerce recently collected public opinions on revising its export-restricted technology catalog. The notice posted on China's commerce ministry's website calls for revising the list of technologies that will restrict exports based on the Foreign Trade Act and the Technology Import and Export Management Regulations with the Ministry of Science and Technology. The technology export referred to here refers to the transfer of technology from China to overseas through the transfer of patent rights or patent application rights, patent enforcement permits, technology secret transfer, and technology services. In the revision of the list of technology export restrictions, technologies such as the Internet, solar and new energy, autonomous driving, and biopharmaceuticals that have made rapid progress in China in recent years have been raised. Biopharmaceutical technology includes human-related cell cloning and gene editing technology, CRISPR gene editing technology, and synthetic biology technology. In particular, gene editing and synthetic biology are areas that are actively being studied around the world. Genetic editing technology refers to deleting or rewriting genetic information by cutting a specific part of DNA for the purpose of treating or preventing diseases. Reproductive cell editing is strictly limited to ethical issues and potential risks, so most companies use patient somatic cells. Synthetic biology technology is a technology that redesigns biological systems such as enzymes, biosynthetic pathways, and cells to create biological systems with new functions. China is promoting innovation in synthetic biology technology and applying it to a wide range of areas such as new drug development and resource supply through the 14th Five-Year Bio-Economic Development Plan. While open innovation, which is jointly conducted by multinational pharmaceutical companies, is actively carried out, the battle for supremacy between China and the United States over innovative technologies continues. Earlier, the U.S. strengthened its trading monitoring for fear of China taking biotechnology away. In 2018, the Foreign Investment Risk Review Modernization Act (FIRMA) was enacted, which could restrict foreign investors such as China from accessing the U.S. market. This is to strengthen transaction monitoring on Chinese capital, from simple license transactions to M&A transactions. Recently, the government is also pushing for the enactment of the National Core Capacity Defense Act (NCCDA), which regulates investment and transaction activities in overseas concerned countries such as China. In addition to semiconductors, batteries, artificial intelligence, and quantum technologies, pharmaceuticals and bioeconomics were included in the technologies subject to national core competencies. China's push to restrict exports of biopharmaceutical technology is seen as a countermeasure to the U.S. move. It also shows confidence that China is not behind the U.S. in gene editing technology and synthetic biology. The report said, "China's recent attempt to designate bio-medicine-related technologies such as gene editing technology and synthetic biology as export-restricted technologies are believed to be on par with the U.S. in this technology field."
Company
Sorrento Theraputics Inc. filed for bankruptcy protection
by
Hwang, Jin-joon
Feb 16, 2023 05:51am
Sorrento Theraputics Inc. researchers are studying candidate materialsSorrento Theraputics Inc., a U.S. bio company invested by Yuhan Corporation, filed for bankruptcy protection in the Southern Texas Bankruptcy Court. Bankruptcy protection is a system similar to Korean court receivership. Sorrento Theraputics Inc. recently lost a damage suit worth 222 billion won, resulting in a short-term cash liquidity crisis. Its subsidiary Sciplex plans to continue its business regardless of Sorrento Theraputics Inc.'s bankruptcy protection procedures. According to industries on the 14th, Sorrento Theraputics Inc. filed for bankruptcy protection with the bankruptcy court in accordance with Chapter 11 of the U.S. Bankruptcy Act the previous day. Sorrento Theraputics Inc. is a new antibody drug development bio company listed on the Nasdaq. In 2016, 12.1 billion won was invested by Yuhan Corporation in the name of simple investment. Yuhan Corporation's stake in Sorrento is 0.6%. Through a joint venture, the two companies also established ImmuneOncia, a bio company specializing in developing new drugs specializing in immuno-cancer drugs. Chapter 11 of the Bankruptcy Act, which Sorrento filed with the Bankruptcy Court, is a system that seeks corporate rehabilitation by conducting restructuring procedures under the supervision of the Bankruptcy Court. It can be seen as similar to domestic court management. Unlike liquidation, which closes its business after clearing assets and liabilities, bankruptcy protection is a way to revive companies through government support and debt restructuring while carrying out projects such as R&D and investment attraction. Earlier, United Airlines, General Motors, and Chrysler revived through Chapter 11. The bankruptcy court accepts the Chapter 11 application if it deems it more economically profitable to normalize a company by means of cancellation or suspension of repayment of some or all of its liabilities. However, if the bankruptcy court determines that the rehabilitation plan is inappropriate, it may proceed with liquidation in accordance with Chapter 7 of the Bankruptcy Act. Sorrento filed for bankruptcy protection due to a short-term cash liquidity crisis. Sorrento explained that as of the date of filing for bankruptcy protection, it has more than 1.2685 trillion won in assets, including 158.6 billion won in damages against NantPharma and others, regarding the dispute over the right to sell the anticancer drug Cynviloq. During the same period, the debt was 298.1 billion won. The cash liquidity crisis occurred when Sorrento filed a lawsuit with Nant Pharma and others. NantPharma introduced the North American copyrights and pipelines of the anti-cancer drug Sinbilock, which was introduced by Samyang Holdings in 2015, with an advance of 114.2 billion won. The maximum contract amount, including technical fees according to the development stage, is 1.6491 trillion won. NantPharma has not released Sinviloc in the North American market. Sorrento filed a lawsuit, claiming that Patrick Sunxion, chairman of Abraxis Bioscience, who had a relationship with NantPharma for not releasing Sinviloc, introduced competitive drugs to protect the market status of Abraxane, an anticancer drug, in the early stages of its launch. The court recently ruled that Sorrento should compensate NantPharma subsidiary Nantcell for 222 billion won worth of damage. Of the total, 158.6 billion won was suspended for 70 days, but 63.4 billion won was decided to be immediately enforceable. If not implemented, the interest rate is 9%. After the results of the lawsuit were announced, Sorrento's stock price fell 72% from $0.94 the previous day to $0.26. Sorrento explained that it submitted an application for bankruptcy protection to protect the company, judging that the business operation and development of new drugs could be suspended due to the cash liquidity crisis following the result of the damage suit. As of the third quarter of last year, Sorrento's cashable assets are worth 88.8 billion won. Sorrento Theraputics Inc. also stressed that it will continue to develop new drugs in connection with the bankruptcy protection filing.
Company
Exports of Dong-A ST’s anemia biosimilar exceed KRW 10 bil
by
Chon, Seung-Hyun
Feb 16, 2023 05:51am
The first biosimilar developed by Dong-A ST has made over KRW 10 billion in exports for 2 consecutive years. The cumulative export sales amount of the drug reached KRW 35.6 billion only 3 years after the drug entered the Japanese market. According to Dong-A ST on the 1st, the overseas sales of ‘Darbepoetin-α’ last year recorded KRW 13.3 billion, a 6.4% increase from KRW 12.5 billion in 2021. Darbepoetin-α is a biosimilar of the second-generation anemia treatment ‘Nesp (darbepoetin-α)’ that was co-developed by Amgen and Kyowa Kirin. The erythropoietin (EPO) in the drug accelerates red blood cell production by stimulating the erythroblasts and is used to treat chronic kidney disease or anemia in patients who receive chemotherapy. Annual exports of Darbepoetin-α (Unit: KRW 100 million, Data: Dong-A ST The overseas sales of ‘Darbepoetin-α’ solely depend on the drug’s exports to Japan. After conducting the Phase 1 clinical trial on’ Darbepoetin-α,’ Dong-A ST signed a licensing-out agreement on the development and sale of its drug to Sanwa Kagaku Kenkyusho (SKK). Based on a Phase III trial conducted in Japan to compare the efficacy and safety of ‘Darbepoetin-α’ to the original ‘Nesp,’ SKK received marketing approval from Japan's Ministry of Health, Labor and Welfare the drug in September 2019, and launched the drug for sale in November of the same year. Since then, Dong-A ST has been exporting the finished product to SKK, which was produced by STGen Bio, a biosimilar company under Dong-A Socio Group, with SKK responsible for its local sales. After generating KRW 1 billion in exports in Q4 2019, the drug sold KRW 8.8 billion and KRW 12.5 billions' worth each in exports in 2020 and last year, respectively. In Q4 last year, exports amounted to KRW 35.6 billion. By last year, the cumulative exports of Darbepoetin-α were found to be 35.6 billion won. The rise in sales is analyzed to be connected to the increase in reliability based on accumulated use experience in the field. Following Japan, Darbepoetin-α is now set to be introduced to the Turkish market. Dong-A ST singed signed a licensing and supply deal with the Turkish pharmaceutical company Polifarma in November last year, Under the agreement, Dong-A ST will transfer the exclusive development and marketing rights to Darbepoetin-α in Turkey, Brazil, and Mexico to Polifarma. Under the deal, Dong-A ST will receive an upfront payment and milestone payments for each stage of development and commercialization while being in charge of the exclusive supply of finished products. Polifarma is a Turkish pharmaceutical company that owns a global sales network in over 50 countries. The company has experience exporting more than 500 drugs to the United States, Europe, Brazil, and Mexico, among other countries, and accumulated relevant approval experience.
Company
Will Piqray benefit be successful again?
by
Eo, Yun-Ho
Feb 16, 2023 05:50am
Attention is focusing on whether Piqray, a PIK3CA gene target anticancer drug, can succeed in re-challenge insurance benefits. According to related industries, Novartis Korea's breast cancer treatment Piqray is expected to be presented to the HIRA Cancer Disease Review Committee in March. The drug failed to pass the deliberation committee once in February last year and submitted a re-application at the end of last year. Piqray, approved in Korea in May 2021, is a "PIK3CA억제 inhibitor" that blocks excessive activation of PI3K-의 due to PIK3CA gene mutation and is a target anticancer drug prescribed in combination with Faslodex in patients with HR+/HER2- metastatic and progressive breast cancer who have previously failed treatment. Piqray proved its effectiveness through a SOLAR-1 study conducted in 572 menopausal women and patients with advanced or metastatic breast cancer who were given or received HR-positive, HER2 negative, aromatase inhibitor, or AI. Clinical results showed that when Faslodex and Piqray were used together in tumor patients with PIK3CA mutations, the median progression-free survival (PFS) in patients with PIK3 tumors improved from 5.7 months to 11 months. The objective response rate (ORR), which represents the proportion of patients whose tumor size decreased by at least 30%, was 35.7% in the combination therapy group, more than twice as different as 16.2% in the single therapy group. The secondary evaluation variable, Overall Survival in patients with PIK3CA mutation, was 39.3 months in the combination therapy group, which was about 8 months longer than 31.4 months in the monotherapy group, but was not statistically significant.
Company
Astellas Korea appoints Junil Kim as new head
by
Eo, Yun-Ho
Feb 15, 2023 05:59am
Astellas Pharma Korea will now be run by a Korean head. According to industry sources, Junil Kim (50) was appointed to succeed Marker Weber and head the Korean subsidiary of Astellas Pharma. With the appointment, Astellas Korea will be welcoming the first Korean head in 7 years since the resignation of Jung Hae-doh in 2017. After Jung, Astellas Korea maintained a foreign representative system, appointing Takenoya Osamu, Masujima Keita, then Marcus Weber as General Manager of the Korean subsidiary. Junil Kim is a seasoned veteran in the field. After graduating from Chung-Ang University School of Pharmacy, Kim entered the industry as a medical representative for GSK Korea, then held various roles at Bayer Singapore Asia Pacific headquarters, Bayer Korea, Bayer headquarters in Germany, and served as General Manager at Bayer Philippines. Astella Korea's former GM, Marker Weber, was appointed GM of the Korean subsidiary in April 2020. Weber was appointed to head the company's German subsidiary in 2023.
Company
Dementia with Lewy bodies rises as a new blue ocean
by
Feb 15, 2023 05:58am
Byoung-Suk Ye, Professor of Neurology at Severance Hospital is presenting the latest findings in dementia (Pic: Dailypharm reporter Jin-Joong Hwang Dementia with Lewy bodies (DLB), the second most common type of neurodegenerative disease, is expected to rise as a blue ocean in the development of diagnostics and treatments for dementia. DLB has the limitation of being difficult to diagnose in the field as no clear diagnostic method has been developed for the disease. In the industry, the prevailing opinion is that Lewy bodies should also be considered in addition to Alzheimer's to develop more effective drugs for dementia. ◆No method available to diagnose Lewy bodies...additional studies needed According to industry sources on the 14th, Byoung-Suk Ye, Professor of Neurology at Severance Hospital, said, “Alzheimer’s is characterized by memory loss and is the most common cause of dementia, but it is not dementia itself. DLB is the second most common cause of dementia that often accompanies Alzheimer’s, but is rarely diagnosed clinically in the field" while presenting at the Seoul Innovative Medicine Salon that was held at Korea Development Bank the day before. Lewy bodies are pathologically defined by the cytoplasmic accumulation of alpha-synuclein deposited inside the patient's cerebral cortical neurons. The dementia symptoms are considered to occur when the cytoplasmic accumulation of alpha-synuclein (aSyn) deposition creates Lewy bodies. Alzheimer’s dementia, a representative neurodegenerative disease, and symptoms of dementia are known to be caused by beta-amyloid aggregation or hyperphosphorylated tau proteins. DLB and Parkinson's disease dementia (PDD) share pathological causes. In Parkinson's disease, a decline in motor function appears first, and dementia symptoms usually occur after a period of 1 to 2 years. However, in DLB, a decline in cognitive function occurs first or a decline in motor function and cognitive function at the same time. Characteristic symptoms of Alzheimer’s (left) and Lewy Body disease (Pic: Dailypharm reporter Jin-Joong Hwang) Major symptoms of DLB include a decline in cognitive function, visual disorder, REM (rapid eye movement sleep) behavior disorder, autonomic nervous system abnormalities, hypersomnia, loss of smell, hallucinations, and depression. Cognitive decline is more prominently shown in a loss in concentration, executive ability, and visuospatial function than in memory. Also, another characteristic is the unstable decline and improvement in cognitive function. On the other hand, in Alzheimer's dementia, memory relatively steadily declines. As of now, no clear method exists for its diagnosis. In the field, it is believed that Lewy bodies may be diagnosed using fluorodeoxyglucose (FDG)-positron emission tomography (PET). However, there is no study that quantitatively proves that Lewy bodies can be diagnosed with PDG-PET. With no proven diagnostic method available, there are limitations to distinguishing and diagnosing Lewy bodies in the clinical field. On the other hand, as Alzheimer's is known to be caused by the deposition of beta-amyloid, it can be identified relatively easily using amyloid-PET. Professor Ye said, “According to autopsy studies, 40% of patients with Alzheimer's disease also showed the pathological presence of Lewy body. Unless DLB is included in the diagnostic model, there is possibility that all dementias will be considered as Alzheimer's." Also, no diagnostic method yet exists to differentiate Lewy bodies from Alzheimer's in amyloid-positive patients. Professor Ye said, “When diagnosing dementia using only amyloid-PET, it is highly likely that many of the patients may have amyloid-positive and tau-negative Lewy bodies.” ◆Should consider patients with mixed dementia that may have a combined Alzheimer's, Parkinson’s, or Lewy body disease when developing a drug for dementia The reason why it is necessary to distinguish not only Alzheimer's or Parkinson's when diagnosing dementia-causing diseases, but also Lewy body disease, is that there are many cases where a mix of the three diseases appear. Even if a new drug that reduces beta amyloid proteins or tau proteins is developed, if alpha-synuclein, the cause of Lewy body disease remains accumulated in the brain, it is highly likely that the new drug’s treatment effect will not appear. In addition to diagnostics for Lewy body disease, a diagnostic method is also needed to distinguish mixed Alzheimer's, where a patient suffers from Alzheimer's and Lewy body disease at the same time. Professor Ye emphasized, “Patients with just Alzheimer's disease and patients with mixed Alzheimer's have different natural courses and responses to drugs. These patients need to be distinguished to accurately determine the effect of dementia treatments. Professor Ye added, "It is important to secure real-world data (RWD) by using approved Alzheimer's treatments in clinical practice. I have been explaining the importance of distinguishing Lewy bodies from other causes of dementia to large multinational pharmaceutical companies, however, the need has not been delivered well because the people in charge are not practicing on-site. However, interest has been increasing recently after scholars and experts in dementia treatment overseas began to emphasize the need to distinguish Lewy body disease.
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