Biologics and the bottom line

Biotech drugs are helping pharmaceutical companies' bottom line because, unlike simple pharmaceuticals, biotech isn't subject to expiring patents. Pharmaceutical companies can lose billions in income when a drug patent expires, though we benefit when a cheaper generic equivalent hits the market. So biotech's profit potential is much greater, because it is -- at least for now -- more or less perpetual.

Why is this of interest? Because biotech includes TNF-alpha blockers like Enbrel, Humira and Remicade. (Humira is specifically mentioned in the article: it contributes $2 billion, or nearly 10 per cent, to Abbott's bottom line.) And these are the drugs that we, as ankylosing spondylitis patients, are increasingly being put on.

We know we're being marketed to about these drugs. To what extent is these drugs' extreme profitability playing a role in getting us on them? It's hard to think objectively about these drugs in this context. They may well be better. But I can't help but wonder if the industry would prefer it if I (or my spouse's drug plan) was spending $1,500 on a biologic, rather than $30 a month on generic naproxen.

Inflammatory rheumatic disease and aortic inflammation

Another thing to worry about: a new study suggests that inflammatory rheumatic diseases like ankylosing spondylitis are a predictor of aortic inflammation.

PEI lags in drug approvals

The Arthritis Society is campaigning to raise the profile of arthritis patients during the upcoming provincial election in Prince Edward Island. Notably, they point to how long it takes the provincial drug plan to approve drugs: approvals for biologics lag behind other provinces, and even Celebrex isn't covered. Don't miss the boneheaded responses from the provincial parties that sidestep the question and talk about disease prevention and lifestyle choices: when you've got an inflammatory autoimmune disease, it's already too late for that, and you don't catch what we have from eating too many Ding-Dongs, you assclowns.

Left field for the Corsicana Tigers

The Daily Sun of Corsicana, Texas profiles a local baseball player with ankylosing spondylitis: Aaron Bland plays left field for the Corsicana Tigers.

Spokane support group

The Spokane Spokesman Review reports on a new local support group for those with ankylosing spondylitis.

When rest makes pain worse

In its profile of ankylosing spondylitis, and of a local patient, Gino Brancolino, the Melbourne Herald Sun focuses on the counterintuitive nature of the disease. Quoting a rheumatologist, Lionel Schachna:

"Most people present with what we call inflammatory back pain, which is different to the common type of back pain people get," Dr Schachna said.

"Inflammatory back pain is better with activity and worse with rest, as opposed to mechanical back pain which is better with rest and worse with activity.

"People will often experience pain early in the morning because they have been resting in bed in one position.

"Often people do wake up in the early hours of the morning, say 3am or 4am, with pain and stiffness and have to get out of bed to stretch or have a shower in order to gain some relief and get back to sleep."

Gender differences in ankylosing spondylitis

Via About.com Arthritis, a clinical study examining the influence of gender on the severity of ankylosing spondylitis. The study looked at 302 men and 100 women who had AS for more than 20 years. The women had an earlier onset of disease, were more likely to have a first-degree family member with the disease, and had more peripheral symptoms. But the study also observed the following:

1. Radiographic spinal damage was worse among men.
2. Functional disability was the same among men and women.
3. After adjusting for radiographic spinal damage, women reported worse functioning.

I'm having trouble understanding what that means -- and it's probably beyond the scope of any medical study to infer general conclusions from such data. But these data suggest to me a discrepancy: either the disease is worse in women for a given level of spinal damage (although, on average, the men were in worse shape -- median scores of 10 vs. 6.5 -- just that a woman with 6.5 would report worse functioning than a man with 6.5), in some as-yet unquantifiable way, or women are overreporting/men are underreporting their symptoms.

Something subtler, I hope, than "women bitch more about pain," but I recall a study a few years back -- I'm too tired to look for a link at the moment -- that said that if men and women reported the same amount of pain, the men got more medication for it, on the assumption that women were more likely to complain and men were more likely to suck it up. Now, I'm male and a big wuss and I complain all the time, so I'm leery of stereotypes and would hate to see them confirmed, but you know ... how do you explain worse self-reported functioning for the same observed data?

Celebrex approved for AS in Britain

As a result, I think, of the European Union's approval of Celebrex (celecoxib) to treat ankylosing spondylitis, the drug has now been granted a label extension for treating AS in the UK, Pfizer announced in a media release yesterday.

Florida sisters with AS

An article in -- so help me -- the Florida Baptist Witness looks at how two sisters, aged 12 and 16, cope with ankylosing spondylitis. The article focuses more on their family's faith than on the sisters' treatment -- other than Tiger Balm, ice and prayer, there's no mention of it -- but despite the fact that they're people of faith and I'm not, the article rings true for me when it deals with the older sister's frustrations:

"So many people just can't understand how I could look fine and be sick, because I don't look sick," the teen said. "You know, so many people think if they were in my position, they could live my life better than I can. And that's one thing that really gets me."

Sometimes overwhelmed by well-meaning friends who want the girls to look at alternative medicine or the latest diet related to the illness, Stephanie said people get offended if the family doesn't choose to respond.

Stephanie apparently has a MySpace blog, but I haven't been able to find it.