Drug shows promise against vision-robbing disease in seniors

More than 5mn people worldwide have advanced AMD 1,100 lives lost as caseload mounts

WASHINGTON, June 22, (AP): An experimental drug is showing promise against an untreatable eye disease that blinds older adults — and intriguingly, it seems to work in patients who carry a particular gene flaw that fuels the damage to their vision.

Age-related macular degeneration, or AMD, is the leading cause of vision loss among seniors, gradually eroding crucial central vision. There are different forms but more than 5 million people worldwide, and a million in the US, have an advanced type of so-called “dry” macular degeneration that has no treatment. At first patients may notice blurriness when they look straight ahead. Eventually many develop blank spots, becoming legally blind.

“These are seniors who are entering their golden years and now they’ve lost the ability to read, watch television, see their loved ones,” said Dr Rahul Khurana, a retina specialist and spokesman for the American Academy of Ophthalmology.

The experimental drug, lampalizumab, aims to slow the destruction of light-sensing cells in the retina, creeping lesions that characterize the stage of dry AMD called “geographic atrophy.” When those cells die, they can’t grow back — the vision loss is irreversible.

In an 18-month study of 129 patients, monthly eye injections of the drug modestly slowed worsening of the disease when compared with patients given dummy shots. What’s exciting for scientists came next, when researchers from drugmaker Genentech Inc. took a closer look at exactly who was being helped.

It turns out that nearly 6 in 10 of the GENEVA, June 22, (AP): The UN health agency and some major partners have agreed to send 1 million doses of cholera vaccine to Yemen to help stanch a spiraling and increasingly deadly caseload in the impoverished country, which is already facing war and the risk of famine.

A spokesman for the World Health Organization said Wednesday that it didn’t initially want to publicize last week’s decision because questions remain about when and how the doses could reach the neediest people in a country sliced up along front lines and grappling with a nearly-collapsed health system.

WHO said the 1 million doses for Yemen were approved on June 15 by the International Coordinating Group, which manages vaccine stocks and includes the Red Cross, Doctors Without Borders, UNICEF, and Gavi, the Vaccine Alliance along with WHO. Such a shipment

study’s participants carry a gene variation that makes part of the immune system go awry — a genetic flaw already known to increase the risk of getting macular degeneration in the first place.

Those are the only patients who appeared to benefit from the drug; they had 44 percent less eye damage than the untreated patients, the Genentech would be the largest since 1 million doses were sent to Haiti after Hurricane Matthew last fall — and would amount to about half of the usual world stockpile, which would then be replenished.

In just over two years, violence from Yemen’s war involving Shiite rebels known as Houthis and the internationally recognized government backed by a Saudi-led alliance has killed over 10,000 civilians. Now, in just over two months, the cholera outbreak has taken over 1,100 lives and the caseload is rising, with peak levels unpredictable, WHO says.

Vaccines will be but part of a complex response effort.

“The fact that over a thousand people have died during this rapidly spreading cholera outbreak is shocking,” said Dr. Seth Berkley, CEO of Gavi, in an e-mail. “We cannot underestimate the huge logistical challenges of delivering vaccines in a warzone where the

team reported Wednesday in the journal Science Translational Medicine. While the study is too small to prove if lampalizumab really helps maintain vision, that’s a bigger difference than the overall results suggested.

One arm of the immune system, the complement pathway, helps fight infections by attracting immune cells health system, as well as basic infrastructure, has been all but destroyed.”

Berkley said the doses could help slow the spread of the disease as part of a broader strategy to contain it.

WHO spokesman Tarik Jasarevic said Tuesday that a tally from the cholera outbreak between April 27 and June 19 turned up 170,286 suspected cases and 1,170 deaths. He said the agency and UNICEF, which has a key role in sending water to needy populations, are “refining their approach by focusing on the worst-affected areas in the worst-affected districts.”

“To stop the spread, it is vital that people have access to safe drinking water, oral rehydration solutions and effective treatment such as antibiotics and intravenous fluids for those severely affected,” he said in an e-mail.

Jasarevic said about 2,000 new cases were appearing each day,

to attack bacteria. Normally, there’s a barrier that keeps such cells away from the retina. But that barrier can break down with age, opening sensitive eye cells to harm from the spillover, explained Genentech immunologist Menno van Lookeren Campagne.

Now for the gene connection: Previous studies have linked macular though the International Federation of Red Cross and Red Crescent Societies (IFRC) on Wednesday put the figure at 6,000. A week ago, the UN humanitarian chief in Yemen said 923 people had died of the disease and warned the caseload could reach nearly a quarter-million cases by September.

A WHO map of the outbreaks from its latest “situation report” on Yemen show the highest concentrations in urban areas and in western Yemen where fighting and the front lines divvy up control of the territory.

While vaccines could help, it’s basics like clean water, functioning sanitation and proper hygiene that are most needed against what experts say is a disease that’s relatively easy to fight — but potentially deadly if not fought adequately. Above all, the response will require access and information campaigns in the hardest-hit areas.

degeneration to gene variations that remove some of that pathway’s natural brakes, so it can become too active.

The hypothesis: Genentech’s drug, lampalizumab, essentially offers a backup method for tamping down the immune reaction. An antibody, it works by inhibiting a particular enzyme named factor D that helps power the immune pathway.

“We try to reinsert the braking ability,” said study lead author Brian Yaspan, a Genentech senior scientist.

LONDON:

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The highest court of the European Union ruled Wednesday that courts can consider whether a vaccination led to someone developing an illness even when there is no scientific proof.

The decision was issued on Wednesday in relation to the case of a Frenchman known as Mr. J.W., who was immunized against hepatitis B in late 1998-99. About a year later, Mr. J.W. was diagnosed with multiple sclerosis. In 2006, he and his family sued vaccine-maker Sanofi Pasteur in an attempt to be compensated for the damage they claim he suffered due to the vaccine. Mr. J.W. died in 2011.

France’s Court of Appeal ruled there was no causal link between the hepatitis B vaccine and multiple sclerosis, and dismissed the case. Numerous studies have found no relationship between the hepatitis B shot and multiple sclerosis. After the case went to France’s Court of Cassation, it was brought to the European Union.

On Wednesday, the EU’s top court said that despite the lack of scientific consensus on the issue, a vaccine could be considered defective if there was “specific and consistent evidence,” including the time between a vaccine’s administration and the onset of a disease, an individual’s previous state of health, the lack of any family history of the disease and a significant number of reported cases of the disease occurring following vaccination.