Pharmaceutical industry, Japanese innovation also speaks Italian
From Japan to Italy, to innovate and develop new therapies. Above all (but not only) in three areas: for diseases of the central nervous system, for those of the kidneys and for blood cancers. Let's talk about Otsuka, one of the Japanese pharmaceuticals with a very long tradition (one hundred years in 2021), which has also had an office in Italy since 2009. Today the company has 47,000 employees worldwide in 33 countries, of which around 70 in our country, 175 production plants and a network of 44 research institutes, and in 2021 it invested 1.8 billion euros in research and development. The company's numbers were presented today in Milan, in a press conference on the theme of innovation and collaboration between the public and private sectors, which was also attended by the Consul General of Japan, Yuji Amamiya.
Innovation in psychiatry
Among the molecules developed by Otsuka that marked an important step forward in neuroscience are antipsychotics for schizophrenia and bipolar disorder, including long acting (ie with prolonged therapeutic activity). “The history of antipsychotics begins in the 1950s, but the treatment of psychotic disorders has changed a lot in recent years,” he says. Bernardo Dell'Osso, Professor of Psychiatry at the University of Milan: “In the last decade, in fact, we have had a new class of drugs available, the partial dopaminergic agonists, which has completely changed the paradigm. These are compounds with an antipsychotic action, which in addition to being as effective - if not more - than the previous ones, have a much better tolerability profile. This means that long-term adherence rates may be better. And improving adherence means improving the prognosis, also thanks to long-acting molecules. However, it is very important that the new molecules are not the prerogative of only some patients: we must ensure that prescribers and the whole community are informed and that these possibilities become accessible to all people who could benefit from them".
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Making acute myeloid leukemia “chronic”.
Even in onco-hematology, pharmacological innovation has profoundly changed the paradigm of many tumors, such as leukemia. "In recent years we have witnessed an increase in the cure and survival rates even of acute forms, such as acute myeloid leukemia, a typical pathology of elderly adults", he explains Stefano Cascinu, Director of the Oncology Department IRCCS San Raffaele Hospital in Milan: “In this tumor it was initially possible to obtain excellent remissions, but not to maintain them over time, because they were aggressive therapies. An important innovation, therefore, was to develop therapies that could be sustained in the long term”. In short, we can identify three fundamental steps: first, having managed to have an increase in recoveries and survivals, second, having been able to treat elderly patients, third, having managed to maintain remission thanks to the new therapies. “This - resumes Cascinu - shows how the history of a company that innovates has repercussions on the ability of an entire system to offer new therapeutic opportunities. I believe that this has nothing to do with conflicts of interest, on the contrary: the transparency, research and application of what we clinicians do every day for patients is the elimination of conflicts of interest”.
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Investing in kidney disease
Last but not least, there is the area of nephrology, where however the innovations have been minor and there are still important unmet needs. "Kidney function is destined, even in the healthiest of us, to decline over time and today it is estimated that 8-10% of people in Italy have chronic kidney disease", he explains Piergiorgio Mass, former Director of Nephrology, Dialysis and Renal Transplantation at the Milan Polyclinic. These are many patients, often drug orphans. Among the very few we have, one was developed by Otsuka, effective for the treatment of hyponatremia and in slowing the evolution of genetic diseases with a renal impact (in particular the development of cysts and renal failure associated with autosomal polycystic kidney dominant, ADPKD, ed.)". Another great chapter concerns lupus nephritis, a manifestation of systemic lupus erythematosus. "The renal complication affects 70-80% of patients, who are mostly young women - continues Messa - hence the need for more effective and less toxic drugs".
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The importance of collaborations, even between companies
In these areas, Otsuka has established important collaborations with Lundbeck (in neuroscience), with Aurinia (in nephrology) and with Astex (in oncohematology). “Alliances with other companies are essential for innovative molecules to arrive quickly at the disposal of the patient,” he says Alessandro Lattuada, Chief Executive Officer of Otsuka Italia: “We are proud of the results achieved, which have allowed us to introduce innovative therapies capable of filling unmet clinical needs. Digital therapies are also in development in our pipeline.” Among the company's objectives there is also the certification of "carbon neutrality": to achieve it, a forest of 500 trees has been planted in Italy, in Meda, and wind farms will be installed in India, in the state of Tamil Nadu.
