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Biotech / Medical : XOMA. Bull or Bear? -- Ignore unavailable to you. Want to Upgrade?

To: Cacaito who wrote (8646)	2/7/1999 2:16:00 PM
From: aknahow	Respond to of 17367

I had to invite tonyt as RobertS has not held up his end. We made a secret agreement, he was supposed to post at least one negative for each two positive post he read. He insisted on being able to cut and paste as well as repeat previous post but even with these concessions he apparently has just given up. Now tonyt appears to have stamina and endurance which may make up for lack of character.

To: Cacaito who wrote (8646)	2/7/1999 5:14:00 PM
From: Robert K.	Read Replies (1) \| Respond to of 17367

Nice posting there Cacaito.

To: Cacaito who wrote (8646)	2/7/1999 11:11:00 PM
From: Slugger	Read Replies (1) \| Respond to of 17367

<<Even in a strictly define Xoma's protocol is used for BPI and assuming that 25% deaths vs 15% with , then a physician will treat 75 out of 100 that did not needed BPI to survive, (less keep other benefits out of the calculations to make it easier for me to calculate), and despite compassionate care and hope the 15 deaths despite treatment will not "need" it since it will not help then anyway. In a strict protocol out of 100 patients, 90 will not need the drug, to benefit the other 10.>> :-) Now I understand! What you are saying is that in only 10 out of 100 cases the drug makes a difference (or 1 out of 100 in the case of Refludan).

To: Cacaito who wrote (8646)	2/8/1999 12:10:00 AM
From: aknahow	Read Replies (1) \| Respond to of 17367

Looking for new filings on Edgar? With 100% confidence I can say you won't find them, apparently even on the XOMA site. They have changed domicile and of course that means no more filings for XOMA are required!!!!! Of course they are filing under their new name XOMA Ltd. In fact they have made 3 filings under the new name but IMO not much new information. BTW Cacaito, I also think your answer was great. Next time tell me what the answer is going to be and I will ask the right question.<g> I do see you point and it is interesting and valid. Usage will be potentially much higher than one would believe by looking at the number of reported cases for any disease since some of those treated don't have the disease. Simplification of what you said. I would only add that to some extent people with a specified disease may have gotten well without use of the drug under consideration and this situation in no way results in increased potential use of a drug over and above what case statistics would indicate. That's o.k. you got Slugger and Bob to cave in, but remember I am trying to get tonyt over here and he will nay say both your post as well as mine. BTW I have heard that RobertS, has taken ill and even though told by Dr. Biostock, Dr. Bob and and old but not forgotten friend Dr.Dr. that the only hope he had was Neuprex, stubbornly refused to be treated, even though unable to talk. He did this by a repost of various abstracts showing BPI did not work, and that translocation was just a theory.

To: Cacaito who wrote (8646)	2/11/1999 9:14:00 PM
From: Robert S.	Read Replies (3) \| Respond to of 17367

It is my understanding that intravenous BPI treatment does not come cheaply; thus, it never fails to amaze me how the high costs of intravenous BPI treatment are so cavalierly dismissed by the more enthusiastic members of this board. If memory serves me, 2 out of 3 HMOs operated in the red in 1997 and I am willing to guess that cutting costs is of paramount concern to these health care providers. If BPI is approved, it will have a role, but I have trouble believing that it will be utilized to the extent envisioned by some on this board. The 4 part article below pertains to the above and an excerpt follows: Correcting erroneous concepts If intravenous-to-oral switch therapy is an economically attractive proposition that makes perfect sense, why is it not used by everyone? Misconception: Infectious diseases need intravenous treatment The main obstacle to use of switch programs is the preconceived notion that oral antibiotic therapy is somehow not equivalent to intravenous therapy. This misunderstanding can be remedied by educational programs and, of course, through studying the literature (1,2). In the past, clinicians were taught to look at infectious diseases as best treated only by intravenous antibiotics. This is an erroneous concept but one that is widely adhered to. It is essential to think in terms of effective antibiotic therapy regardless of the route of administration. If orally administered antibiotics are well absorbed, have excellent bioavailability, and provide blood and tissue levels that are virtually the same as those attained by intravenous administration, then there is no difference therapeutically between oral and intravenous antibiotics. And, indeed, this is the case. Of course, only antibiotics that have the characteristics just mentioned lend themselves to switch programs. Antibiotics that are equally efficacious when administered intravenously or orally (table 3) include doxycycline (Doryx, Vibramycin, Vibra-Tabs), metronidazole (Flagyl, Protostat), trimethoprim-sulfamethoxazole (TMP-SMX) (Bactrim, Cotrim, Septra), clindamycin hydrochloride (Cleocin), minocycline, and the oral quinolones (eg, levofloxacin, ciprofloxacin). Thus the notion that certain diseases require intravenous therapy needs to be moderated. Intravenous therapy is necessary only if the patient is unable to tolerate oral administration of the drugs, not because of the inherent nature of the infectious disease being treated (6-8). Table 3. Antibiotics with excellent bioavailability both orally and intravenously* Amoxicillin Doxycycline Minocycline HCl Trimethoprim-sulfamethoxazole (TMP-SMX) Azithromycin Metronidazole Chloramphenicol (Chloromycetin) Levofloxacin Ciprofloxacin Clindamycin HCl See text and table 2 for drug brand names not listed here. Misconception: The same agent must be used both ways Another common misconception is that the antibiotics chosen for a switch regimen must be of the same type or class. This is not the case at all. The only requirement is that the agents cover essentially the same spectrum and have the same characteristics of tissue penetration. For example, if intravenous ampicillin is being used, oral ampicillin would not be appropriate in a switch program because it does not give anything close to the blood and tissue levels achieved by intravenous administration. For another example, intravenous ceftriaxone has no oral equivalent, but oral TMP-SMX provides exactly the same spectrum of activity and tissue penetration; even though the two drugs are from dissimilar classes and work by different mechanisms, they are therapeutically equivalent. Clearly, it is not necessary that both oral and intravenous forms of a given agent be available to use in switch therapy. As noted, the task is to be sure that the spectrum of activity and the pharmacokinetics of intravenous and oral drugs are similar. Examples are provided in table 4. Table 4. Agents used in empirical intravenous-to-oral switch therapy at Winthrop-University Hospital, Mineola, New York Infection Intravenous agent Oral agent* Acute bacterial meningitis Ceftriaxone sodium Chloramphenicol Community-acquired pneumonia Intra-abdominal sepsis (excluding biliary tract) Biliary tract sepsis Urosepsis postgradmed.com