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The completed double-blind, placebo controlled, cross-over craving study was designed to investigate the acute effect of EVT 302 alone and in combination with nicotine replacement therapy (NRT) on craving and withdrawal symptoms after short-term deprivation of cigarettes in 90 smokers. On the day before short-term abstinence from smoking, smokers received either a single dose of EVT 302 or placebo matching EVT 302. On the next day, at the start of the 12-hour smoking deprivation phase, the subjects received additionally either NRT or corresponding placebo (i.e. subjects received either placebo only, or NRT only, or EVT 302 only, or NRT plus EVT 302). This was an exploratory study to investigate a potential short-term role of MAO-B inhibition in improving signs of withdrawal, but was also intended to help the design of the Phase II proof-of-concept study, announced recently, on the absolute quit rate, the endpoint of clinical and regulatory significance.
Results from the craving study confirmed that EVT 302 was well tolerated in all patients. As expected, NRT reduced craving during the period of abstinence more than placebo. EVT 302 alone showed no acute effect on craving compared to placebo, and there was no statistically significant difference between the combination of NRT and EVT 302 and NRT alone. Regarding other withdrawal symptoms, smoking cessation was associated with moderate deterioration in psychomotor function attention. The amelioration of this deterioration by NRT was facilitated by EVT 302.
The just announced quit rate study is intended to provide the proof-of-concept for the efficacy of EVT 302 in smoking cessation, and, in addition, provide data on a potential useful interaction between EVT 302 and NRT. In this multi-centre, double-blind, parallel group design study, the effectiveness and safety of EVT 302 once daily on its own and in combination with NRT compared to placebo will be investigated in 400 smokers.
We are pleased to announce the start of the Phase II quit rate study following approvals by the Ethics Committee and by the German central regulatory authority BfArM. Based on published research of other MAO-B inhibitors in quit rate studies, we believe that EVT 302 will improve quit rates in this longer term smoking cessation study and plan to confirm initial signals for a potentially useful interaction between EVT 302 and NRT, commented Dr Tim Tasker, Executive Vice President Clinical Development at Evotec.
About Evotec AG
Evotec is a leader in the discovery and development of novel small molecule drugs. Both through its own discovery programs and through research collaborations, it is generating the highest quality research results to its partners in the pharmaceutical and biotechnology industries. In proprietary projects, Evotec specializes in finding new treatments for diseases of the Central Nervous System. Evotec has three programs in clinical development: EVT 201, a partial positive allosteric modulator (pPAM) of the GABAA receptor complex for the treatment of insomnia, EVT 101, a subtype selective NMDA receptor antagonist for the treatment of Alzheimers disease and/or pain, and EVT 302, a MAO-B inhibitor in development for smoking cessation. Evotecs proprietary preclinical research programs focus on the purinergic receptors, P2X3 and P2X7, for the potential treatment of pain and inflammatory diseases. In addition, Evotec has worldwide collaboration and license agreements with Pfizer to research, develop and commercialize small molecule vanilloid receptor (VR1) antagonists. For additional information please go to http://www.evotec.com
Forward-Looking Statements
Information set forth in this press release contains forward-looking statements, which involve a number of risks and uncertainties. Such forward-looking statements include, but are not limited to, statements about our expectations and assumptions concerning regulatory, clinical and business strategies, the progress of our clinical development programs and timing of the results of our clinical trials, strategic collaborations and managements plans, objectives and strategies. These statements are neither promises nor guarantees, but are subject to a variety of risks and uncertainties, many of which are beyond our control, and which could cause actual results to differ materially from those contemplated in these forward-looking statements. In particular, the risks and uncertainties include, among other things: risks that product candidates may fail in the clinic or may not be successfully marketed or manufactured; risks relating to our ability to advance the development of product candidates currently in the pipeline or in clinical trials; our inability to further identify, develop and achieve commercial success for new products and technologies; competing products may be more successful; our inability to interest potential partners in our technologies and products; our inability to achieve commercial success for our products and technologies; our inability to protect our intellectual property and the cost of enforcing or defending our intellectual property rights; our failure to comply with regulations relating to our products and product candidates, including FDA requirements; the risk that the FDA may interpret the results of our studies differently than we have; the risk that clinical trials may not result in marketable products; the risk that we may be unable to successfully secure regulatory approval of and market our drug candidates; and risks of new, changing and competitive technologies and regulations in the U.S. and internationally.
The list of risks above is not exhaustive. Our Annual Report on Form 20-F, filed with the Securities and Exchange Commission, and other documents filed with, or furnished to the Securities and Exchange Commission, contain additional factors that could impact our businesses and financial performance. We expressly disclaim any obligation or undertaking to release publicly any updates or revisions to any such statements to reflect any change in our expectations or any change in events, conditions or circumstances on which any such statement is based.
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i've had two reoccurring issues with my back over the years, neither of them serious and both of them rather fixable. the first is some lower back pain. once the orthopedist discovered that i have a pretty serious discrepancy in my leg length (how did they miss this before??) and prescribed a shoe lift over twelve years ago, its been a non-issue. unless, of course, i decide that fashion is more important than my back and spend more time than i should without my lift for various reasons. its annoying - there are many types of shoes i cannot wear - but an annoyance i'll live with, thank you very much, seeing that it saves me from all types of pain and lessens the occurrence of the second issue i've had.
the second had something to do with my left shoulder blade. i must admit, i can only use my paltry lay language to describe it. it somehow gets out-of-wack. my shoulder blades, which post-surgery can touch at their tips (kinda freaky), all of a sudden do not touch - the left one is not where it should be. at times its accompanied by the sensation of pins up and down my back. the only solution i've found is to lie flat on my back for a while until my back figures it out. i remember distinctly having this pain when i took the SAT - unfortunate, eh? the first year of our marriage, i dealt with this pain alot since i commuted 3 hours in the car each day to work. my own assessment of the situation was that b/c i was sitting and not allowing the shoe lift to even out my legs, it screwed up my upper back. simplistic, i'm sure. probably doesn't touch the medical diagnosis. i spent time each week for a while in physical therapy, strengthening my back. i honestly don't remember having many problems with my back since then.
until last night.
the shoulder blade is not. quite. right. dunno if i just carried ben too much or what - all i know is that my back is out-of-wack. and that my personal, easy remedy for it - lying on my back - is not a possibility since i'm pregnant. (lying on one's back after 12 weeks makes it more difficult for oxygen to get to the baby - why, then, does western medicine make women lie on their backs in labor is beyond me. i digress.) i've tried sleeping sitting up tonight, propped on pillows, ignoring the pain. and generally not. getting. sleep.
annoying.
here's to back pain, memories, gross 12-year-old shoe lifts, and my wonderful left shoulder that needs to find its way back to its place again.
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The alarm went off at 4:30 and I jumped out of bed to take a shower quietly while she slept another 20 minutes. Other than the early morning wakeup call and the lack of food (no eating before the surgery) this was our normal routine. I checked a few emails, put the bags in the car and read the paper while I waited for her to come down. I smiled at all her last minute things she wanted to get done - mail bills, throw her iPod in the overnight bag, make sure the kids had all their stuff ready for school. She grabbed her pillow and took one look around the house. I caught her crying and didnt want to look or Id start crying too, I looked out the window and said the only words I could think of to make her smile, The weather looks gloomy, I wouldnt be playing golf anyway. I got a kidding hit to the abdomen and turned to see her smiling. We were ready to go. Check in time6am.
While I went to the mailbox she waited for a second in the lobby holding her pillow. She ran into her surgeon who gave her a hug. She didnt recognize her at first holding a flowery pillow and told her, you looked like a little 15 year old girl. Our surgeon is well respected (10 years of practice and a professor at one of the best teaching hospitals in the country) and like most, she has her idiosyncrasies when it comes to bedside manner, but that I can live with.
Upstairs we got checked in and my wife undressed and we put her clothes in the bag they provided. Reminder to some, leave your jewelry at home (I pocketed her wedding rings). If I didnt know my wifes exact weight by now, I got it told one more time as she got on the scale and we signed more consent forms. The administrative nurses walked off with her clothes and pillow (I kept her toiletry kit, cell phone and other valuables). The first doctor to some in was the plastic surgeon. He marked her body up like a smiley face and was really pragmatic. You definitely have to have vision. You could see his mind working like an artist as he marked up her body. Next was the anaesthesiology team. They once again confirmed my wifes allergy to Codine. Last was the main surgeon. Always nice when they come in fresh faced and ready to go even at 7am! She said all was on schedule and spoke with me about when shed come out to tell me how it went.
They then gave her the cocktail and within five seconds my wife was loopy. The cocktail has an effect of amnesia which will relieve any trauma in the mind. She was already laughing within 30 seconds and kissed me one last time before they wheeled her off into surgery.
I cant believe that was two and a half hours ago. Surgery is half over already, I am assuming, and they are on to the second breast. I did go to move the car and drove a few blocks home to make sure my mom was okay and that the kids got off to school without any hassle. She said they didnt have a clue as to the fact that their mother was off to surgery this morning. At least they didnt say anything, but we think our son might know.
As they wheeled her off, I called her parents to let them know that she is off to surgery. Her father says hes proud of her strength, but Im sure her mother is worried being far away. She got a chance to speak to them yesterday, but waiting doors away is probably no easier than waiting 3000 miles away.
I will let them know this afternoon when I pick them up from school that mom is okay and will be gone just one more night. Whew..now the wait continues. Thank heaven for internet access and Starbucks coffee.
PS, I do think it ironic that as we spoke to the surgeons this morning and they asked if my wife had any reservations, the TV overhead playing in the room announced that Lance Armstrong, a cancer survivor was announcing that he was un-retiring.
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I did sort of promised that I would not post anything about medical school and all that wonderful stuff but that's not going to stop me from blogging about my first day shadowing a cardiologist :o)
Last Friday I had an informal meeting with the doctor that I will be shadowing for less than a fortnight. Basically I will be following her around, accompanying her during rounds, sitting in during outpatient clinic time (with permission of the patient, of course).
Today I found out that we'll also be making chika among many other things when she's not seeing a patient. I witnessed a procedure in which radioactive thallium-201 was used to diagnose coronary artery disease, followed by thallium stress induced by a scan (another procedure) - it was fantastic.
During rounds we saw a couple of her inpatients. One is an elderly man who looked even older with all the machinery attached to him. He was in intensive care, enclosed in an isolated negative pressure room to avoid contamination - he had an infectious disease among many others. That was hard because that man is someone's grandfather, someone's father, he should be out playing with his grandchildren, not in the room writhing in his bed :o(
Around lunch time we attended a little conference organised by the cardiology fellows. There I was with cardiology studs, learning about the effects of ivabradine from a double-blind study. I understood almost everything save for a handful of terms and medicines that I know nothing about. I have been reading up on cardiovascular diseases and treatments as to be a little more savvy for when I follow the doctor around you see ;o) Hey Philippines, we're a little behind when it comes to newer, alternative treatment for CAD.
Afternoon time means clinic time so I sat in and stayed out of view, blending into the wall. I am very pleased to say that the doctor and I made the same diagnoses (hers being way more complicated, elaborately explained and thorough, of course WITH plan of action) but I got the gist and that's one heck of a confidence booster.
I learned more about how it is like to be a doctor, practicing in the Philippines. How the hospital works and who does what. So many things. I hope to learn more in the coming days.
In a way, I am happy that I have a sincere interest in medicine, I really do see myself in the profession, but at the same time, the pressure is ever more present. Stupid graduate tests. Hey, maybe I will change my mind as time goes right? Or maybe I really should just have more faith in myself.
Whatever this life brings, I am glad a had a good day today.
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Tiiired. Too many days short on sleep, but wanted to update here before I curl up in bed.
School started on the 25th of last month. Definitely more work at SJSU than it was at Cabrillo...and more fun/interesting/thought-provoking. Marcie and I have been having some really interesting conversations. It's a little thing, but I do regret not having a full five years at SJSU...I would have learned more.
A raccoon got into the master bathroom last night by causing the skylight screen to fall out of place. Marcie had to catch it safely and toss it out. That was rather exciting. o.o
I did my first day of doctor shadowing today. Seriously fun. I am absolutely pursuing the right field: nowhere was there any feeling of "oh I totally don't want to do that". It was just a day of office visits, but...there's no "just" about it. Every patient was so different that there was this sense of not knowing what one would find just past the door. Very, very cool. Also...got to listen to a heart murmur and an artificial (mechanical) heart. Seriously amazing, especially the latter. Will hopefully get to see an echo next week, too.
One thing that especially struck me was the combination of the science of medicine and the psychology. It was more obvious than I thought it would be, and that's pleasing to look back at. I mean, that I was able to observe it and readjust my perceptions.
...uhm....yeah. No idea whether or not I'm actually making sense here. It's bedtime. Time to fall over.
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