The Canadian Medical Association (CMA) and the Canadian Pharmacists Association (CPhA) have approved a joint statement on the future of e-prescribing that aims to have all prescriptions for Canadians created, signed and transmitted electronically by 2015. The joint statement identifies the core principles that must be captured in a pan-Canadian system of e-prescribing, as well as its potential benefits and challenges. “Canada’s pharmacists and physicians have set forth a bold vision for the future of e-prescribing in Canada,” said Dr. Anna Reid, CMA president. “However, now that bold vision must be matched with bold action to advance e-prescribing for the benefit of patients.” The CMA and CPhA developed the joint statement as a first step in bringing partners together to develop a strategy and action plan. The two associations recognize that, while achieving full e-prescribing functionality by 2015 will not necessarily be an easy vision to achieve, the benefits to patients, health care providers, and the overall health system are undeniable and well worth the effort.

Abbott announced it has been granted license by the Medical Device Bureau of Health Canada, for its RealTime High Risk HPV molecular diagnostic test for the detection of human papillomavirus (HPV), the leading cause of cervical cancer. Abbott’s RealTime High Risk HPV test is designed to detect 14 high-risk HPV genotypes with simultaneous detection of HPV genotypes 16 and 18 in one assay. HPV genotypes 16 and 18 are known to pose the highest risk to progress to cervical cancer. “Molecular detection of high-risk HPV infections, in women over the age of 30, is an important adjunct to cervical cancer screening in Canada,” said Barbara Romanowski, MD, FRCPC, Clinical Professor, University of Alberta, Edmonton, Canada. “Women with abnormal pap tests, especially those at borderline, can be tested with a rapid HPV DNA test to detect the presence of high-risk HPV,” said Judy Yu, Ph.D., director, scientific affairs, Molecular Diagnostics, Abbott. “HPV DNA tests, like the Abbott RealTime High Risk HPV test, combined with high specificity of cytology, can direct the appropriate management strategies for women with abnormal pap results.” HPV is a group of viruses with more than 150 different genotypes. Fourteen genotypes are classified as high-risk HPV because of their association with cervical cancer. HPV genotypes 16 and 18 are known to pose the highest risk to progress to cervical cancer and are found in approximately 70 percent of cervical cancer cases.

New research on Canada’s number one cancer killer is further proof that patients need personalized treatments targeted to their specific type of lung cancer for better outcomes. Boehringer Ingelheim (Canada) Ltd. announced highly anticipated results from the Phase III LUME-Lung 1 study in patients with advanced non-small cell lung cancer (NSCLC). The primary endpoint was progression-free survival (PFS) and the results showed patients treated with nintedanib plus chemotherapy (docetaxel) lived for a median of 3.4 months before their tumour started to grow again, versus 2.7 months with docetaxel alone (HR 0.79; p=0.0019). The study also examined the secondary endpoint of overall survival (OS), and in the process uncovered a specific group of patients who respond particularly well to the combination therapy. The trial examined a sub-group of patients with adenocarcinoma histology – the most common type of NSCLC. It showed that patients with adenocarcinoma whose disease progressed during first-line therapy or shortly after lived for an additional 2.3 months in the nintedanib combination treatment arm versus with docetaxel alone. Specifically, the median overall survival (the gold standard measure of success in lung cancer treatment) was 12.6 months in the nintedanib combination treatment arm versus 10.3 months with docetaxel alone (HR 0.75; p=0.0073).

An international committee of leading nutrition scientists from ten countries on three continents released an important Scientific Consensus Statement. They concluded that carbohydrate quality (measured by the glycemic index or GI) matters and that the carbohydrates present in different foods affect post-meal blood sugar differently, with important health implications. They also confirmed that there is convincing evidence from a large body of research that low glycemic index/glycemic load (GI/GL) diets reduce the risk of type 2 diabetes and coronary heart disease, help control blood glucose in people with diabetes, and may also help with weight management. The Committee recommended inclusion of glycemic index and glycemic load in national dietary guidelines and food composition tables, and that packaging labels and symbols on low-GI foods should be considered. They also confirmed low GI measurements complement other ways of characterizing carbohydrate foods (such as fiber and whole grain content), and should be considered in the context of an overall healthy diet.

A statement by the president of the Canadian Medical Association was provided recently. Canada’s doctors worry that the announcement of new regulations to govern the use of medical marijuana ignores the fact that there is no clinical evidence to back up its use as a medical therapy. This approach runs contrary to Canadians’ position on this issue as reported in an Ipsos Reid poll conducted for the CMA earlier this year. The poll found that 85 per cent of Canadians believe that medical marijuana should go through the same rigorous testing and approval as other medicines. Marijuana is a complex substance with strains that vary greatly in power and effect, but we have no information on potency, dosage or how it interacts with other therapies. The beneficial effects of marijuana have not been rigorously tested and it has a huge potential to cause harm. With the federal government vacating its role, there is no one to certify that the drug will not harm the patient. The Ipsos Reid poll also found that almost eight in 10 Canadians agreed that Health Canada, as the body that approves prescription medicines for safety and efficacy, should maintain its current role in authorizing the use of medical marijuana for patients. The use of medical marijuana has grown because there aren’t better treatments for people battling chronic pain. This is an area that definitely needs greater attention. The federal government will not help address this lack by abdicating its responsibility to protect the health of Canadians.

XtandiTM (enzalutamide capsules) is now available in Canada. Health Canada approved Xtandi for the treatment of patients with metastatic castration-resistant prostate cancer, or mCRPC, who have received prior docetaxel therapy (chemotherapy medication). The announcement was made today by Astellas Pharma Canada, Inc., the Canadian subsidiary of Tokyo-based Astellas Pharma, Inc. Prostate cancer is the most common cancer to affect Canadian men, generally 40 years of age and older, with one in seven developing the disease in their lifetime. Most often, initial presentation of the disease may be asymptomatic or show minimal symptoms. However, approximately 10-20 per cent of cases will present with metastatic disease and another 33 per cent with early stage disease will go on to develop metastatic disease. The efficacy and safety of Xtandi were assessed in a randomized, placebo-controlled, multinational phase III clinical trial, called AFFIRM, that included eleven Canadian trial sites across the country. A total of 1,199 patients with mCRPC who had previously received docetaxel were randomized 2:1 to receive either Xtandi orally at a dose of 160 mg once daily (N = 800) or placebo (N = 399). Patients with a history of seizure, taking medications known to decrease the seizure threshold, or with other risk factors for seizure were excluded from the clinical trial. The primary endpoint of the trial was overall survival.

GeneDx, one of the world’s foremost genetic testing laboratories and a subsidiary of Bio-Reference Laboratories, Inc. announced today its intention to launch a suite of comprehensive genetic tests for inherited cancers including BRCA1 and BRCA2 genes. GeneDx, which was the first commercial laboratory to utilize next generation sequencing technologies to answer meaningful clinical questions in cardiology, neurology, ophthalmology, among other clinical areas, will now bring its expertise and reputation for service to inherited cancers and will offer a 27-gene panel for breast and ovarian cancers. GeneDx will also provide next generation sequencing based multi-gene panels for gastrointestinal and colorectal cancers, pancreatic cancer, endometrial cancer and renal cell carcinoma. GeneDx has distinguished itself and gained the trust of the genetics community for its clinical and scientific expertise and experience. Founded in 2000 by geneticists and still managed today by geneticists, GeneDx started offering Whole Exome Sequencing in 2012 to help end the diagnostic odyssey for families who for years have been looking for a molecular diagnosis. Currently, GeneDx offers testing for more than 350 genetic disorders, and has over 30 board-certified geneticists and genetic counselors on staff available to physicians to address their concerns and questions about genetic testing.

PharmaxTM, a leading-edge, comprehensive line of professional grade nutraceutical products announced its Topical PROTM series of creams use the innovative clinically studied DelivraTM trans-dermal technology from Delivra Inc. Following a recent multi-million dollar investment, this unique technology and specific PharmaxTM products will be the subject of a large scale research project spearheaded by Dr. Joseph Gabriele, the developer of the DelivraTM technology and a close and long-time collaborator of PharmaxTM. The DelivraTM trans-dermal technology takes advantage of established interactions between natural substances and human cellular and nerve tissues to address pain management without the side effects associated with typical interventions. “In 2011, we were first-to-market exclusively for the healthcare practitioner segment with novel natural topical creams using the Delivra delivery system,” said Yves Yau, Head of the PharmaxTM brand. “We are proud of this latest advancement that emphasizes our ongoing commitment to provide only the highest quality, research-driven products offering cutting-edge ingredients. The new research project and our close collaboration with Dr. Joseph Gabriele will continue to place PharmaxTM at the forefront of trans-dermal technology.”

Over half of Canadian employees (55 per cent) struggle with chronic illness or injury and subsequently place a greater burden on the Canadian healthcare system. As this issue becomes prevalent, Canadians look to their employers for assistance in navigating the bureaucratic maze between the private and public healthcare systems. According to the 16th annual edition of The Sanofi Canada Healthcare Survey, nearly two-thirds (61 per cent) of employees who have yet to experience the system expect their plan sponsor to provide a high level of support. According to the survey, both plan members (81 per cent) and employers (90 per cent) acknowledge the importance of workplace-based health promotion programs to maintain the sustainability of the public healthcare system over the long-term. As such, provision of public programs in the workplace could be part of the solution to disease prevention and the management of chronic illness. Three-quarters (74 per cent) of employees indicate they would like their workplaces to allow public health programs such as flu shot clinics, disease screenings or health risk assessments to be available on-site during work hours. As well, close to nine in 10 (88 per cent) report that if there were on-site screening for a condition they were personally concerned with, they would be likely to participate. Plan sponsors are increasingly open to public and disease prevention programs in the workplace. Nine in 10 (91 per cent) say they would implement immunization clinics if supported by tax incentives, while a similar number indicate they would offer workplace-based health risk screening (87 per cent) and chronic disease prevention programs (88 per cent) pending increased government or public health support.

Two of the world’s most acclaimed cancer researchers, Drs. Tak Mak of the Princess Margaret Cancer Centre, and Dennis Slamon of the University of California, Los Angeles, shared news of a major breakthrough in the decade-long pursuit to develop a new class of “sharpshooter” cancer drugs. Together they have submitted an Investigational New Drug (IND) application to the Food and Drug Administration for a new drug they have developed based on our research of a target enzyme, PLK4, which plays a crucial role in the process of cell division, particularly in cancer cells. This new drug, CFI- 400945, will enter clinical trials phase in the months ahead. In the lab, it has been shown to effectively inhibit the growth of human breast and ovarian cancers as well as colorectal, glioblastoma, lung, melanoma, pancreatic and prostate cancers. Drs. Mak and Slamon are very confident about their submissions to the FDA and Health Canada and anticipate that, following a successful regulatory review, the research team will be able to move quickly to the clinical testing stage.