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Then & Now

It's easy to forget, but not very long ago the treatments we might today take for granted hadn't yet been developed. Perhaps there weren't any medicines at all for the disease, or those that did exist weren't very effective or had serious side effects. The contrast between treatments of yesteryear and today highlights how far we have come, as well as the importance of continued innovation.


Read below to find out what's changed in treating: Leukemia, HIV/AIDS, Alzheimer's disease, high cholesterol, schizophrenia, ulcers, organ transplants, rheumatoid arthritis, and polio.
 
If you had been diagnosed with chronic myeloid leukemia (CML) in 1999, chances were that you would not be alive today. Just three out of ten patients survived for even five years. In the meantime, you had two daunting treatment options: a high-risk bone marrow transplant or daily injections of interferon, the side effects of which have been compared to "having a bad case of the flu every day of your life."
A new generation of targeted hematologic cancer medicines is improving health outcomes for patients. Nearly 90 percent of CML patients taking the drug imatinib, for example, live at least five years. This daily pill has a good chance of driving your cancer into remission - normalizing your blood count with few, if any, side effects. The medicine targets CML on a molecular level, so it affects only the enzyme responsible for the disease. For those individuals who are resistant to imatinib, alternative treatment options are available.

If you were diagnosed with AIDS in 1990, you might expect to live for only 26 months. During that time, you would be likely to contract a number of opportunistic infections that would make your remaining days unpleasant and painful. The only treatment available had to be taken every four hours - around the clock - and had serious side effects. Most drugs could not be used in patients who had been previously treated for HIV/AIDS due to the weakened state of their immune system.
Thanks to the approval in 1995 of protease inhibitors - and further advancements in new medicines and combination therapies in the decade since - the AIDS death rate in the U.S. has fallen by over 80 percent. If diagnosed today, a range of treatment options (including different combinations of drugs) might be able to keep you symptom-free for years to come, whether you have been previously treated or not. This medicinal approach has also been found to reduce the chance of transmission to unaffected partners by 96 percent.

Prior to the 1990s, there were no medicines available to someone with Alzheimer's disease. All you could do was hope that your decline into dementia would be slow, that your memory and independence would last as long as possible, that someone would come up with an effective treatment.
Both early diagnosis and aggressive treatments are key to slowing the progression of Alzheimer's disease. Currently, there are several FDA-approved medicines to help manage memory loss and thinking/reasoning difficulties in Alzheimer's patients – and nearly 100 medicines for dementia diseases are in development. While more innovations are needed to target the disease directly, researchers are building on the knowledge gained from not only the rapid progress of the past two decades but also the setbacks in order to make a real difference in the lives of families dealing with this devastating disease.

Although high cholesterol was recognized as a key risk factor for cardiovascular disease in the 1970s, there were no good ways to reduce it. The best drug available was a grainy powder called cholestyramine. Patients mixed it with juice, but it tasted like sand - one patient said it was like drinking Miami Beach. Taking it was so unpleasant that it was only prescribed for the most severe cases.
Millions of people now control their cholesterol, and reduce their risk of heart disease, by swallowing a small pill just once a day. A new class of medicines, statins, was introduced in 1987 and offers a safe and effective way to lower cholesterol. One NIH official, Dr. Claude Lenfant, even said that if all patients took statins according to guidelines, heart disease would no longer be the No. 1 killer.

Between the 1950s and the 1980s, the antipsychotic medications available to treat this devastating mental illness were a double-edged sword. On the one hand, they helped control symptoms like hallucinations and paranoid thoughts. But they also had unpleasant side effects, like muscle stiffness, tremors, and abnormal movements, that grew worse over time.
Thanks to new medicines introduced in the 1990s, people living with schizophrenia can now manage their condition more effectively than ever, and with fewer side effects. These medicines - dubbed "atypical antipsychotics" to distinguish them from earlier, "typical" drugs - also help people whose schizophrenia had not previously responded to treatment, making it possible for them to leave institutionalized care, return to work, and lead normal lives.

Thirty-five years ago, treating an ulcer meant painful surgery that brought with it the risk of life-threatening infection and more ulcers in the future. Along with surgery, doctors often recommended weeks of bed rest, a mild fatty diet including boiled milk, and increased tobacco use, in an effort to stop the suspected culprits: a stressful lifestyle and spicy food. But none of these remedies made much difference to ulcer sufferers.
In the late 1970s, new medicines were developed to heal the lining in the stomach or duodenum, making it possible for the first time to treat ulcers effectively without surgery. With the discovery that the bacterium H. pylori causes the vast majority of ulcers in 1982, doctors are now able to treat ulcers both quickly and permanently by targeting the real root of the problem - bacteria.

In the 1950s and early 1960s, patients needing an organ transplant were in a tragic bind. Transplants were surgically possible, but the body's immune response rapidly rejected organs donated by unrelated individuals. People either died or led greatly diminished lives.
Thanks to anti-rejection medicines that were developed in the 1960s and 1980s, tens of thousands of Americans have received transplants of a wide variety of organs and are able to prolong their lives, regain their health, and maintain their independence.

In previous generations, a person with this debilitating autoimmune disease, which causes severe joint inflammation, had no choice but to take large doses of steroids, anti-inflammatories, and anti-malarials to control swelling, reduce pain, and manage other symptoms of the disease.
Today, thanks to earlier diagnosis and proactive, aggressive treatments, bone abnormalities in patients with rheumatoid arthritis (RA) are becoming a thing of the past. In addition to being able to better manage the symptoms of the disease, newer biologic medicines and disease modifying anti-rheumatic drugs (DMARDs) allow patients to directly target the disease, slow the progression of joint damage and even put the disease into remission.

In the early 1950s, summers were filled with fear. Swimming pools, summer camps, and playgrounds lay empty as children were kept at home to keep them safe from a crippling and sometimes deadly disease: polio. Everyone knew someone with polio - there were 60,000 cases diagnosed in one summer alone - but no one knew how to prevent it. The most unlucky ones were completely paralyzed, spending the rest of their lives inside an iron lung.
Polio is fast becoming a distant memory - something many of us know only from history books or stories we hear from our grandparents. Within five years of the 1954 introduction of the now-historic Salk vaccine, polio lost its grip on the nation; the last case in the U.S. was recorded in 1979. It's a testament to the tremendous achievements of pharmaceutical innovation, and the profound impact it has had on people's lives.


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