Healthcare online Keeping you up-to-date
VOL.  20     ISSUE:  12  December   2022 Medical Services Department

SQUARE Pharmaceuticals Ltd.





P G Dip. Business Management



Rubyeat Adnan



Dear Doctor,

Hope that you are enjoying this online healthcare bulletin.
Our current issue focused on some interesting features like -

"Antibody & Multiple Myeloma !", "Vit-D & Aging Brain !", "Vaping Alert !", "Gene Therapy !",  "Heart Failure Alert !", "Cold Sores !".

In our regular feature, we have some products information of SQUARE Pharmaceuticals Ltd. as well.

Please send your feedback !  We always value your comments !

Click on to reply mode.

On behalf of the management of SQUARE, we wish you all a very happy, healthy and prosperous life.

 Yours sincerely,


Editorial Team

Reply Mode      : e-square@squaregroup.com

The views expressed in this publication do not necessarily reflect those of its editor or SQUARE Pharmaceuticals Ltd.

 Antibody & Multiple Myeloma !

    Antibody Treatment Makes Inroads Against Multiple Myeloma

An experimental immunotherapy appears highly effective in attacking bone marrow cancer, with nearly three in four patients responding to the treatment, new clinical trial results show. The drug, talquetamab, works by binding to the body's immune cells as well as to multiple myeloma cancer cells. The therapy -- called a bispecific antibody -- directs white blood cells to attack and kill multiple myeloma cells. Researchers described the strategy as bringing army right to the enemy. In phase 2 clinical trials, about 73% of patients were helped by the drug, researchers reported over the weekend at an American Society of Hematology meeting. A phase 2 trial reveals more about the safety and effectiveness of a treatment. The trial included nearly 300 patients whose multiple myeloma had returned despite treatment with at least three different cancer drugs. More than 30% of patients who responded to the drug appeared to be cancer-free following treatment with talquetamab, researchers report. Another 60% of those who responded had a very good response, where their cancer was substantially reduced. It took a little over a month for patients to respond to the drug, and the average duration of response to date is more than nine months, researchers said. Multiple myeloma patients whose cancer returns after standard and targeted treatment tend to have a poor prognosis. But talquetamab targets a different receptor on the cancer cells from other myeloma drugs, offering fresh hope to those patients, researchers said. "This means that almost three-quarters of these patients are looking at a new lease on life," said lead researcher. The response rate seen with talquetamab is higher than that for most currently accessible therapies for multiple myeloma, he said. He added it could offer a viable option to those whose blood cancer has become resistant to treatment. "Talquetamab induced a substantial response among patients with heavily pretreated, relapsed or refractory multiple myeloma, the second-most-common blood cancer," he said in an institute news release. "It is the first bispecific agent targeting the protein GPRC5D in multiple myeloma patients." Side effects were relatively frequent, but described by researchers as typically mild. About three-quarters of patients experienced cytokine release syndrome, a dangerous but treatable inflammatory response that often occurs with immunotherapy. About 60% also developed skin-related side effects like rash, about half reported that their taste had changed, and about half reported nail disorders. However, only about 5% of patients dropped out due to the side effects.
One expert unconnected to the new trial said the results could be a big win for patients.

SOURCE: HealthDay News, December 2022

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 Vit-D & Aging Brain !

     Vitamin D Might Help Shield the Aging Brain

Older adults who harbor more vitamin D in their brains may stay mentally sharper, a new study suggests. Researchers found that when older adults had higher levels of vitamin D in their brain tissue, they tended to perform better on standard tests of memory and thinking. They were also less likely to have dementia or milder cognitive impairments. Experts stressed that the study does not prove that vitamin D, itself, protects against dementia -- a complex brain disease that has many contributors. And no one should start downing supplements based on the findings, they said. For one, too much vitamin D can be harmful. And the study did not assess how much vitamin D participants were actually getting day to day. "We have no evidence that getting more than the recommended amount of vitamin D is better for the brain," senior researcher said.Vitamin D is known to have critical roles such as keeping bones and muscles healthy, as well as supporting immune defenses. But whether it helps shield the aging brain is unclear. Some studies have found a correlation between low vitamin D levels in the blood and a higher risk of dementia in older adults. Others have not. Meanwhile, a few trials have tested the effects of vitamin D supplements on older adults' memory and thinking. And so far, there is no clear proof of benefits. According to lead researcher, her team wanted to take a step back and ask a basic question: Does vitamin D even get to the brain? To do that, they studied autopsied brain tissue from older adults who had participated in the Rush Memory and Aging Project before their deaths. That project, begun in the 1990s, is a long-term study looking to better understand normal and abnormal brain aging. Participants undergo yearly cognitive tests and consent to have their brain tissue donated for study after their deaths. Research team analyzed brain tissue from 290 study participants, who were an average age of 92 when they died. It turned out that vitamin D was, in fact, present in all of the brain regions the researchers analyzed -- including two where Alzheimer's-related abnormalities are known to manifest. And overall, older adults whose brains harbored greater amounts of vitamin D had typically performed better on the study's cognitive tests. For every doubling in vitamin D concentrations, participants were 25% to 33% less likely to have had dementia or mild cognitive impairment at their last study visit. She said one possibility is that good nutrition, including adequate vitamin D, helps "buffer" the brain against the pathologic changes that mark dementia. In fact, researchers theorize that various environmental factors -- including education, exercise and mental stimulation -- may help older adults maintain their cognitive function for a longer time, even when those brain changes set in.
The recommended intake for adults up to age 70 is 600 IU per day; older people should get 800 IU. It's not actually clear why some people have more vitamin D in the brain than others. In this study, she said, there was only a "modest" correlation between vitamin D levels in the blood and those in the brain. And blood levels of vitamin D were not related to older adults' cognitive test performance. More research, including those of racially diverse groups, is needed to understand what is going on, she added. Most people in this study were white, and few had low blood levels of vitamin D. People with darker skin are at increased risk of being deficient in the vitamin.

SOURCE: HealthDay News, December 2022

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 Vaping Alert !

                           Smoking, Vaping Both Bad for Teeth & Gums: Study

For those who care about their teeth, a new study sounds a pretty clear alarm: using tobacco in any form — including the increasingly popular practice of vaping — is a recipe for a dental nightmare. The warning comes from the U.S. National Institute of Dental and Craniofacial Research (NIDCR), after scientists analyzed several years of tracking data that looked at associations between smoking and poor dental health among thousands of American men and women. The bottom line: regular users of cigarettes, electronic cigarettes (vapes), cigars, pipes, hookahs and/or smokeless tobacco face a notably higher risk for various forms of dental trouble. Depending on the type of tobacco involved, that includes a significantly heightened likelihood for six different types of dental concerns, including gum disease; precancerous oral lesions; bone loss surrounding the teeth; loose teeth; and/or tooth loss due to tooth decay or gum disease. And vaping, which is sometimes viewed as a safer form of tobacco use, was linked to a 27% higher risk for bleeding following brushing or flossing. Between 2022 and 2022, lead researcher and her colleagues analyzed three to five years of annual tracking data collected from 2013 to 2019. The six dental issues under consideration were tracked among roughly 10,000 to 16,000 men and women. About 16% to 19% of them smoked cigarettes regularly, while 2% to 3% smoked cigars or used smokeless tobacco, respectively. In the end, cigarettes were linked to a 33% greater risk for gum disease, a 35% higher risk for loose teeth and a 43% higher risk for losing teeth, while cigar use was linked to a more than doubling of the risk for precancerous oral lesions. But the investigators also focused on the 2% to 3% of participants who regularly vaped. Even so, she was not at all surprised by the finding of a significantly higher risk for gum bleeding after flossing/brushing among vapers. The concern, she explained, is predicated on what her own prior work has already revealed about vaping's impact on the bacteria that lives in everyone's mouth, an environment that researchers refer to as "the biofilm." In fact, after stacking the dental health of people who had vaped for only five months against smokers who had been smoking for at least fiveyears, "what we found is that the amount of inflammation among vapers was as much as among smokers, even though vapers had far less exposure to tobacco in terms of time. And that means that vapers appear to get to the point of bacterial destruction much faster." Exactly if or how that all translates into serious dental damage among vapers is not entirely clear, the researchers cautioned. They noted, for example, that most vapers are former smokers. And they pointed out that means the increased gum bleeding risk among vapers could potentially have something to do with quitting cigarette smoking. On the other hand, the team warned that despite only linking gum bleeding to vaping, it could be that such bleeding is a early warning for dental problems as yet undetected. More research to track such longer-term risk will be needed, the study team said.

SOURCE: HealthDay News, December 2022

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 Gene Therapy !

                                FDA Approves Gene Therapy for Tough-To-Treat Bladder Cancer

Patients with a high-risk bladder cancer now have a new option to treat it. The U.S. Food and Drug Administration approved a gene therapy called Adstiladrin, which is designed to work for patients who have what's called high-risk non-muscle-invasive bladder cancer (NMIBC) that hasn't responded to the standard treatment, Bacillus Calmette-Guérin (BCG), but hasn't spread. BCG is a vaccine typically used for tuberculosis. "This approval provides health care professionals with an innovative treatment option for patients with high-risk NMIBC that is unresponsive to BCG therapy," Director of the FDA's Center for Biologics Evaluation and Research, said in an agency news release. "Today's action addresses an area of critical need. The FDA remains committed to facilitating the development and approval of safe and effective cancer treatments." About 75% to 80% of newly diagnosed bladder cancers have grown through the lining of the bladder, but not yet invaded the muscle. About 30% to 80% of cases recur and risk spreading. Treatment typically involves removing the tumor and using BCG to reduce the risk that the cancer will recur. But for patients whose cancer is unresponsive to BCG, there are few treatment options. Patients will receive Adstiladrin once every three months into the bladder through a urinary catheter. About 57,000 men and 18,000 women are diagnosed with bladder cancer annually, according to the U.S. Centers for Disease Control and Prevention. About 12,000 men and 4,700 women die from the disease each year in the United States. FDA officials approved Adstiladrin based on a multicenter clinical study of 157 patients, 98 of whom had BCG-unresponsive disease that hadn't spread. Patients received Adstiladrin once every three months for up to 12 months or until the treatment became too toxic. About 51% of enrolled patients using Adstiladrin therapy had all signs of cancer disappear. Median response was 9.7 months. About 46% of patients who responded were in complete remission for at least one year. The most common adverse reactions associated with Adstiladrin were bladder discharge, fatigue, bladder spasm, urinary urgency, presence of blood in urine, chills, fever and painful urination. People who are immunosuppressed or immune-deficient should not use Adstiladrin, the FDA said.

SOURCE: HealthDay News, December 2022

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 Heart Failure Alert !

                          Heart Failure More Common in Heart Defect Survivors Starting at Young Age !

People born with heart defects may face a nearly ninefold higher lifetime risk for heart failure and develop it decades earlier than people born without heart abnormalities, new research shows. Though heart failure is extremely rare in young people, any occurrence in young congenital heart defect survivors signals a need for better screening and follow-up, starting early and continuing throughout their lifetime, lead study author said. "Increased awareness of the high risk of heart failure in this population may lead to an earlier diagnosis as well as more appropriate treatment, which may have implications for survival," he said. Congenital heart defects describe any heart abnormality present at birth. This happens when the heart, or blood vessels near the heart, fail to develop normally during pregnancy. There are at least 18 types of structural abnormalities that can occur. According to the Centers for Disease Control and Prevention, congenital heart defects occur in about 1% of – or 40,000 – babies born in the U.S. each year. Prior studies have shown that people born with heart defects face a higher risk for heart failure than others. Heart failure – a condition in which the heart doesn't pump blood as well as it should – is the leading cause of death for people with heart defects, who have a lower life expectancy than people without them. Because it rarely occurs in young people, most heart failure research focuses on adults, whereas the new research looked at people from birth. The new study, published Monday in the American Heart Association journal Circulation, used national health records and cause of death data for people in Sweden. The researchers compared 89,532 people born with heart defects between 1930 and 2017 with a control group of 890,469 people without heart defects. During an average 25 years of follow-up, 7.8% of people with congenital heart defects were diagnosed with heart failure. In people born with healthy hearts, 1.1% developed heart failure during an average 27 years of follow-up. Overall, the lifetime risk for heart failure was 8.7 times higher for people born with heart defects than those born without. And the more complex the defect, the greater the risk. Those with more complex defects faced a threefold higher risk of heart failure than those with less complex defects. The risk for developing heart failure differed greatly by age group. Those 17 and younger with heart defects faced 220 times higher risk than their peers without heart defects. The differential fell as the groups aged. For those 60 to 69, the risk was five times higher in people with heart defects. "There is such a lack of attention to this population," he said. "We need to understand that these patients are unique and different. We need research for how to evaluate and treat heart failure in this group earlier in life."

SOURCE: HealthDay News, December 2022

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 Cold Sores !

                                                   Cold sores: Discovery reveals how stress, illness trigger flareups

Researchers shed light on what causes herpes simplex virus to flare up, explaining how stress, illness and even sunburn can trigger unwanted outbreaks. The discovery could lead to new ways to prevent cold sores and herpes-related eye disease from reoccurring, the researchers report. Herpes simplex recurrence has long been associated with stress, fever and sunburn. Once you're infected with herpes simplex virus (HSV) are the virus never really goes away. Instead, it lurks inside neurons, waiting for the right moment to strike again, a process known as reactivation. Cold sores, also known as fever blisters, are one of the most common symptoms of HSV reactivation. Recurrent reactivation in the eye leads to herpes keratitis, which, if left untreated, can result in blindness. HSV infection has also been linked to the progression of Alzheimer's disease. Recurrences of HSV are typically associated with stress, illness or sunburn, but doctors have been uncertain exactly what causes the virus to reactivate. The researchers determined that the virus highjacks an important immune response within the body. In response to prolonged periods of inflammation or stress, the immune system releases a particular cytokine, Interleukin 1 beta. This cytokine is also present in epithelial cells in the skin and eye and is released when these cells are damaged by ultraviolet light. Interleukin 1 beta then increases the excitability in the affected neurons, setting the stage for HSV to flare up, the UVA researchers discovered. The scientists say that more research will need to be done to fully understand the potential factors which play into herpes simplex disease. It may vary depending on the virus strain or the type of neuron infected, even. And it is still unknown if the virus alters how neurons respond to cytokines such as Interleukin 1 beta. But the new insights help doctors better understand what is happening in neurons and the immune system, and that could lead to ways to prevent unwanted outbreaks, the researchers hope.

SOURCE: Science Daily News, December 2022

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Products of SQUARE Pharmaceuticals Ltd.

  Product GleazyTM   
  Generic Name Hydroxyethyl Cellulose USP & Glycerol BP
  Strength 50 mg
  Dosage form Tablet
  Therapeutic Category Personal Lubricant
  Product MolvirTM
Generic Name

Molnupiravir INN

Strength 200 mg
Dosage form Capsule
Therapeutic Category Anti Viral
  Product GlycoventTM 
  Generic Name Glycopyrronium Bromide
  Strength 25 mcg/ml
  Dosage form Nebuliser Solution
  Therapeutic Category Long acting muscarinic antagonist (LAMA)

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