Advances in molecular biology and genomic medicine are increasing the odds that compounds dreamed up by scientists make it from the lab to the pharmacy. Here are some of the latest candidates, either just approved by the Food and Drug Administration (FDA) or under review. •DIABETES If you're a diabetic and the daily injections of insulin are torture, then get ready for some relief. Pfizer received FDA approval in January to market the first inhaled insulin, Exubera, which should become available around midyear. The powdered insulin, taken just before meals, is released into the mouth and lungs through an inhaler similar to the ones that asthma patients use. In studies of more than 2,500 adults with either Type 1 or Type 2 diabetes, the needle-free insulin was as effective as short-acting insulin shots in controlling blood-sugar levels. •OBESITY
When scientists at Sanofi-Aventis took on the challenge of developing a weight-loss drug, they chose an unusual approach. Instead of studying ways to curb the body's natural desire to eat, they decided to home in on the very biological circuits that activate hunger. Even more unorthodox was the craving phenomenon they decided to analyze: the marijuana munchies. If marijuana can trigger the appetite, then perhaps that system could be coaxed into switching off.
Rimonabant, the weight-loss compound they developed, is the first drug that manipulates the endocannabinoid system, a network of cells in the brain, the liver and fat tissue that regulates hunger by linking appetite to the body's reward and satisfaction system. Rimonabant reduces food cravings by deactivating the cannabinoid receptors. The drug, to be marketed as Acomplia, is being reviewed by the FDA and will be targeted at those who not only carry excess weight but also harbor unhealthy signs of metabolic disorders such as diabetes and hypertension. In half a dozen clinical trials, the compound helped 6,000 patients lose up to 10% of their body weight over a year and maintain that loss for another year. And because rimonabant works in liver and fat cells as well, it also improved the patients' cholesterol profiles, boosting "good" HDL levels and lowering amounts of dangerous triglyceride fats in the blood. •CERVICAL CANCER Cancer is always tricky to treat, but if the malignancy is caused by a virus, then the disease becomes a little more manageable, thanks to vaccine technology. Both Merck and GlaxoSmithKline have created cervical-cancer vaccines, but Merck's Gardasil was first to the FDA, which is expected to make its decision by June.
Gardasil protects against four types of human papillomavirus, which account for the vast majority of the 500,000 cervical-cancer cases and the 32 million new cases of genital warts around the world each year. Last fall Merck released encouraging results from its clinical trial in which 755 healthy sexually active women were injected with the protective shots three times over six months and none developed precancerous growths in the cervix after four years.