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Oncology

Cancer ranks as a leading cause of death and an important barrier to increase life expectancy in every country of the world. According to estimates from the World Health Organization (WHO) in 2019, cancer is the first or second leading cause of death before the age of 70 years in 112 of 183 countries and ranks third or fourth in a further 23 countries. Cancer’s rising prominence as a leading cause of death partly reflects marked declines in mortality rates of stroke and coronary heart disease, relative to cancer, in many countries.
According to GLOBOCAN 2018, an estimated 18.1 million new cancer cases and 9.6 million cancer deaths occurred in 2018 worldwide. Targeted agents are superior to traditional oncologic ones in selectivity, efficacy, and safety by acting on specific targets involved in proliferation and differentiation of cancer cells with minimal activity on normal cells.

 

Anti Diabetic

Diabetes mellitus (DM) is a major public health problem that is determined with impaired carbohydrate metabolism, protein, and fat due to unstable insulin secretion, insulin resistance secretion, or both. With an 8.5% global prevalence of diabetes in 2014; various estimates suggest that the number of affected people will be risen from 422 million to 642 million in the world by 2040
The prevalence of diabetes is estimated to be 8.5% in adults aged over 18 years in 2014 which has increased significantly over the past three decades, especially in low and middle-income countries. In the Eastern Mediterranean Region (EMRO), the average prevalence of diabetes in adult population was 13.7% in 2014, which is the highest prevalence compared to other WHO regions.
In Iran, the prevalence of diabetes in adults aged 25–70 years was reported 11.9% (2011) which shows an increase of 35% compared to 2005. It is estimated that in the year 2030 nearly 9.2 million Iranians likely to have diabetes.

Multiple Sclerosis

In multiple sclerosis , damage to the myelin in the central nervous system (CNS) — and to the nerve fibers themselves — interferes with the transmission of nerve signals between the brain and spinal cord and other parts of the body.
Between September 2019 and March 2020, MSIF collected epidemiologic data from 115 countries representing 87% of the world’s population. Consistent with previous editions of the Atlas, country coordinators reported the incidence and prevalence of MS in adults and children.The estimated number of people with MS worldwide has increased to 2.8 million in 2020. When applying the same methodology as in 2013, the estimate is 30% higher than in 2013. The 2020 global prevalence is 35.9 [95% CI: 35.87, 35.95] per 100,000 people. If the analysis is restricted to countries who reported prevalence data in 2013 and 2020, the increase in global prevalence is higher at 50%.

Cardiovascular

One of the most important cardiovascular diseases is thrombosis as leading cause of acute coronary syndromes, stroke, and venous thromboembolism.
The oral anticoagulants have been classified as high alert medications according to the Institute of Safe Medication Practices (ISMP) because they have the potential for harm when used clinically. Many reports have appeared on the risk of bleeding when the anticoagulants are used concurrently with other similar agents (anti-platelet drugs), when the drug treatment is duplicated, in the presence of dosing errors, when there is accidental discontinuation of treatment and when there are problems with monitoring.
Prior to 2010, warfarin was the only approved oral anticoagulant on the market but since then several newer oral anticoagulants have been introduced like apixaban and rivaroxaban.
Rivaroxaban and apixaban, are approved by FDA for the lowering the risk of stroke and embolism in non-valvular atrial fibrillation as well as deep vein thrombosis and pulmonary embolism treatment/prophylaxis.

Covid-19

The COVID-19 pandemic needs no introduction at present, but a large number of drugs have been evaluated since the beginning of the pandemic and many of them have been used for the treatment of COVID-19 despite the preliminary or conflicting results of the clinical trials. There are 2 main drug groups for SARS-CoV-2: Agents that target proteins or RNA of the virus or interfere with proteins or biological processes in the host that support the virus. The main drug groups include inhibitors of viral entry into the human cell (convalescent plasma, monoclonal antibodies, nanobodies, mini proteins, human soluble ACE-2, camostat, dutasteride, proxalutamide, bromhexin, hydroxychloroquine, umifenovir nitazoxanid, niclosamide, lactoferrin), inhibitors of viral proteases (lopinavir/ritonavir), inhibitors of viral RNA (remdesivir, favipiravir, molnupiravir, AT-527, merimepodib, PTC299); inhibitors of host proteins supporting virus (plitidepsin, fluvoxamine, ivermectin) and agents supporting host natural immunity (Interferons). When taking into account the results of all the available laboratory and clinical trials on the subject. Finally, Molnupiravir, an orally active RdRp inhibitor, is in a phase 3 clinical trial against COVID-19.

Central Nervous

Amyotrophic lateral sclerosis (ALS) is a progressive neurological disease that results in the death of nerve cells called motor neurons in the brain and spinal cord. These neurons control voluntary muscles. ALS can affect anyone worldwide regardless of racial, ethnic, or socioeconomic status. In general, symptoms commonly develop between the ages of 40 and 70, with the average being 55 years at diagnosis. The disease is most common among people 60 years or older, but nearly 10 percent of ALS patients are 45 or younger.
Only four drugs are currently FDA-approved to treat ALS: Riluzole, Nuedexta, Radicava, and Tiglutik.
Although ALS is 20 percent more likely to develop in men than in women, with advancing age, the gender difference disappears.
The mode of action of Riluzole is unknown. Its pharmacological properties include the following, some of which may be related to its effect. an inhibitory effect on glutamate release, inactivation of voltage-dependent sodium channels, and ability to interfere with intracellular events that follow transmitter binding at excitatory amino acid receptors

Anti Rheumatic

Rheumatoid Arthritis is the result of an immune response in which the body’s immune system attacks its own healthy cells, especially the lining of the joints, known as the synovial membrane, or synovium, causing an inflammatory response. The disease can lead to premature mortality, disability, and decreased quality of life due to bone erosion and joint deformity.
The epidemiologists forecast an increase in the diagnosed incident cases of RA from 389,747 cases in 2019 to 425,455 cases in 2029, at an AGR of 0.92% over the forecast period. The diagnosed prevalent cases of RA in the 8MM will increase from 4,605,338 cases in 2019 to 5,093,229 cases in 2029, at an AGR of 1.06% over the forecast period.
The total prevalent cases of RA in the 8MM will increase from 6,308,268 cases in 2019 to 6,980,823 cases in 2029, at an AGR of 1.07% over the forecast period. RA is more common in women, and the incidence and prevalence of RA typically increases with advancing age.
Recent European Alliance of Associations for Rheumatology, recommendations for the management of rheumatoid arthritis (RA) state that following failure of 1 or more conventional synthetic disease-modifying anti-rheumatic drug (csDMARD) and in the presence of at least one poor prognostic factor, a Janus kinase (JAK) inhibitor or a biological DMARD (bDMARD) should be started.
Tofacitinib is an oral JAK inhibitor for the treatment of RA. In cellular settings where JAKs signal in pairs, tofacitinib preferentially inhibits signalling by heterodimeric receptors associated with JAK1 and/or JAK3 and has functional selectivity over JAK2.

Anti Anemic

The World Health Organisation (WHO) estimates that 1.62 billion people (95% confidence interval [CI]: 1.50, 1.74 billion), corresponding to 24.8% (95% CI: 22.9, 26.7) of the global population, are affected by Anaemia However, although anaemia affects all population groups in all countries of the world, certain groups are more vulnerable than others. The highest prevalence tends to be in preschool-age children (ie, those aged 6–59 months), women of reproductive age (ie, those aged 15–49 years), and pregnant women

Hb is the main component of erythrocytes or red blood cells (RBCs). Red cell synthesis takes place in the bone marrow and is under the control of erythropoietin produced by interstitial fibroblasts in the kidney.

Anemia in chronic Kidney disease (CDK) is typically normocytic, normochromic, and hypoproliferative. The demonstration of a circulating factor responsible for stimulating erythropoiesis, and the kidney as the main source of erythropoietin (EPO).

Roxadustat is a potentially novel, orally active small-molecule hypoxia-inducible factor (HIF) stabilizer and is being used clinically to treat chronic kidney disease (CKD) anemia.