Health Predictions for 2009
Experts predict medical trends in the new year.
Arthritis and a New Gout Drug continued...
What's more, 2009 will likely usher in the first new gout drug to come to
market in 40 years. The drug, Uloric
(febuxostat) recently got a nod from an FDA advisory panel. The FDA is not
obligated to follow the advice of its advisory arms, but it usually does. As it
stands, allopurinol (trade name, Zyloprim) is the only FDA-approved drug that
prevents formation of the uric-acid-related crystals that cause gout, but side
effects limit the amount of allopurinol that can be tolerated.
Personalized medicine will also play a role in arthritis, he predicts.
"I would hope we will see the routine use of biomarkers for assessing
disease severity and for treatment decisions."
Cancer: More Targeted Therapies
"There are some major cancer trials due to report in 2009 [including]
whether or not prostate cancer screening saves
lives," says Otis W. Brawley, MD, chief medical officer at the American
Cancer Society in Atlanta. In this study, prostate cancer screening involves
measuring blood levels of prostate-specific antigen (PSA), which is produced by
the prostate gland. High PSA levels may indicate prostate cancer. This is
coupled with a digital (finger) rectal examination.
There should also be a verdict on whether screening for lung cancer with spiral computed
tomography (CT) scans saves lives in the coming year, he predicts. Both tests
are considered controversial because they may have inaccurate results, and it
is not clear if the benefits of screening outweigh the risks of any follow-up
diagnostic tests and cancer treatments.
Screening aside, personalized medicine and targeted therapies will also be
important for cancer care in 2009, he says. "We will continue to move
toward targeted drugs and find some more targets for drugs such as Iressa,"
Brawley tells WebMD. Iressa blocks an enzyme called tyrosine kinase, which may
help cancer grow and spread. This drug is only allowed to be used in patients
who have previously taken it and are benefiting or have benefited from it. But,
Brawley says, if doctors could find the Iressa receptor and only use this drug
in patients who are positive for this receptor, it could be a great drug for
those people. In a nutshell, this is personalized medicine. Iressa and other
cancer drugs such as the breast cancer drug Herceptin that are known to benefit
people with specific genes may be just the tip of the personalized medicine
While 2009 may not be the year we win the war on cancer, "I anticipate
that cancer mortality will continue going down in 2009," he says.
Heart Disease: New technologies and Old Prevention Strategies
"Diet and exercise are here to stay in terms
of heart disease prevention,"
says Nieca Goldberg, MD, the medical director of New York University Women's
Heart Program and author of several books including Dr. Nieca Goldberg's
Complete Guide to Women's Health. She also thinks that 2009 will herald the
emergence of computed tomography (CT) machines that use lower radiation doses
when scanning arteries for blockages. "This may have an important safety
advantage," she says.
The obesity epidemic will also
continue to soar in 2009, she says. "We will see rising rates of diabetes
as a result of obesity and greater efforts from national associations and
communities targeting young people as kids are getting adult heart disease risk
factors such as high cholesterol, high blood pressure and type 2 diabetes."