Nature Medicine

Questions raised about whether compulsory licenses get best prices

The use of so-called ‘compulsory licenses’ by developing countries to obtain cheaper drugs for HIV and AIDS by circumventing patents has not been the best strategy for achieving the lowest prices over the past decade, a new study claims. Instead, the best prices were often obtained by countries that procured their drugs through voluntary negotiations, often facilitated by third parties such as UNICEF or the Global Fund to Fight AIDS, Tuberculosis and Malaria. Read more in Nature Medicine.

With pot now legal, therapies sought to blunt high of marijuana

Marijuana is going mainstream in the US. On 1 January, Colorado became the first state in the country to allow recreational use of the drug. Washington is set to do the same within the next few months, and many others are considering similar measures.

Critics of these moves say that legalizing marijuana will increase consumption, leading to an uptick in substance use problems. And with more than 4 million Americans already dependent on or abusing marijuana—making cannabis the number 3 recreational drug after alcohol and tobacco—scientists and public health officials are increasingly fretting over the dearth of available pharmacologic treatments for marijuana addiction. “Every day we are growing more concerned about the number of people seeking treatment,” says Ivan Montoya, a psychiatrist and epidemiologist who serves as deputy director in the division of pharmacotherapies at the US National Institute on Drug Abuse (NIDA) in Bethesda, Maryland. Read more in Nature Medicine.

Kinesin inhibitor marches toward first-in-class pivotal trial

The key to treating cancer is to put a stop to the out-of-control cell growth that leads to tumor formation. One way to do this is to go after the microtubules that help coordinate this rampant cell division. Yet because microtubules function in both dividing and non-dividing cells—for example, in non-dividing neurons they’re involved in intracellular transport—drugs that target microtubules directly tend to cause nerve pain and other side effects. That’s why researchers have been on the lookout for more specific targets in the microtubule machinery—ones that are only active in rapidly growing cells during mitosis.

The kinesin spindle protein (KSP), a molecular motor that crawls along the microtubules to help the cells divide, provides one such candidate target. To date, drugs designed to block this protein (which is also known as Eg5) have failed to live up to their potential, with something of a KSP inhibitor graveyard littered with failed and abandoned products from companies including Cytokinetics, AstraZeneca, Eli Lilly and others. Read more in Nature Medicine.

Bacteria-killing dispute casts doubt on antibiotic development

Antibiotic drugs are one of the cornerstones of modern medicine, but, surprisingly, scientists still don’t understand all of the ways in which they work. So when biomedical engineer James Collins and his team at Boston University announced several years back that they had discovered a common mechanism of cell death underlying all major classes of antibiotics—and that the pathway could be used to combat resistance, an increasingly growing problem—the report generated a lot of excitement. It even spawned a new company, called EnBiotix, which aims to develop antibiotic ‘adjuvants’—agents designed to weaken the defenses of superbugs and resensitize them to existing antimicrobials.

But in recent months, several different researchers have tested Collins’s idea and found it wanting. “When you look at bacteria killed by different antibiotics, it’s hard to believe there is a common mechanism,” says Frédéric Barras, a bacterial geneticist at Aix-Marseille University in France. Read more in Nature Medicine.