An early morning WSJ story:
Technology & Health:
Pfizer Rivals Present Studies on Drugs
They Hope Can Compete With Viagra
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By Robert Langreth And Rochelle Sharpe
Staff Reporters of The Wall Street Journal
SAN DIEGO -- Several companies developing medicines to compete with Viagra presented study results yesterday showing their drugs could successfully treat impotence. But none appear likely to present a serious threat to the Pfizer Inc. blockbuster.
The companies presenting results at the American Urological Association convention included Zonagen Inc., which has resurrected an old blood pressure drug as an experimental impotence medicine; and TAP Holdings Inc., which is developing an impotence drug that, in contrast to Viagra, acts directly on the brain to create erections.
Researchers also presented test results of a topical impotence treatment being developed by MacroChem Corp. as well as findings showing that an older impotence medication marketed by Vivus Inc. may be far less effective than previously touted.
Researchers cautioned that none of the drugs had been directly compared with Viagra in scientific studies and that definitive conclusions couldn't be made. Nevertheless, all appeared to either be somewhat less effective, have more side effects or be more difficult to use than Viagra.
"My initial impression is that {if the drugs under development are approved} the first-choice drug will still be Viagra," said Drogo Montague, a leading urologist and impotence expert at the Cleveland Clinic. Still, he and other urologists said the newer drugs could prove very useful in patients who cannot take Viagra because they are on nitrate heart medications. Also, the drugs could be helpful in combination with Viagra to improve its effect or could work as single agents in patients who don't respond to Viagra.
Scientists presented results showing that 37% to 45% of about 300 patients taking Vasomax, the drug being developed by Zonagen of the Woodlands, Texas, got better erections than without the drug. Viagra, by contrast, helps about 70% of impotent men. Moreover, some doctors worry that Vasomax could lower blood pressure and cause cardiovascular side effects, although this wasn't seen in the trial.
Other results showing that apomorphine, the brain-acting drug from TAP Holdings, a joint venture of Abbott Laboratories and Takeda Chemical Industries Ltd. of Japan, helped impotent men between 45% and 60% of the time. But at the two most effective doses 20% to 39% of patients became mildly nauseous. On the plus side, both drugs were able to work somewhat faster than Viagra, aiding erections in 10 to 20 minutes; Viagra takes a half hour or more to kick in.
Vivus, of Mountain View, Calif., received more bad news about its MUSE product, an impotence treatment that must be inserted directly into the urethra. Sales have declined dramatically since the much more convenient Viagra was approved, according to IMS America, a market-research firm. Now a study presented by researchers from Presbyterian Hospital in Dallas showed that the treatment may be far less effective than believed.
The Dallas researchers tested the drug on 115 impotent men and found that it only helped 27% of them achieve rigidity sufficient for intercourse, while it caused penile pain and burning in 41% of patients; only 18% of patients in the study decided to renew their prescriptions. This study contradicts a much larger study published last year in the New England Journal of Medicine showing that MUSE helped 65% of men get erections sufficient for sex.
The Dallas researchers, led by urologist Pat Fulgham, said that typical patients using MUSE might have more severe problems than patients in the clinic trial. Doctors noted that MUSE is difficult to use as well. Vivus discounted the study's results. "MUSE will do very well on Viagra failures," said Mike Miller, Vivus's marketing director.
Finally, urologist Irwin Goldstein of Boston University School of Medicine said a preliminary test of MacroChem's Topiglan topical impotence treatment, applied to the tip of the penis, found the drug often worked without the burning sensations reported in some previous tests. However, this preliminary test was done in a doctor's office and doesn't necessarily predict how well the drug would work in the patients' bedrooms, he noted.
Separately, the American Urological Association shut down a convention-floor booth operated by a local pharmacy to fill Viagra prescriptions, ruling the booth violated a policy against prescriptions being sold during the meeting. Foreign doctors who cannot get Viagra in their countries had been badgering their American colleagues to write them prescriptions so they could get Viagra and take it home. Many other pharmacies in San Diego ran out of the drug because of the strong demand from urologists at the convention. |
