Future Directions

The incidence of disorders and dysfunctions of the urogenital tract including the kidney are increasing with the aging of the population. Drug treatments for both bona fide organic disorders (endometriosis, prostatitis, BPH, incontinence, BOO) and those more psychologically related (sexual dysfunction) are limited in their efficacy and side effect liabilities and perhaps with new insights into potential genetic causes of these disorders, may be treated via newer targets that have a lesser impact on cardiovascular system function.

The more effective treatment of the spectrum of disorders related to women's health has spurred initiatives both within the industry and government. The latter, the National Institutes of Health's Women's Health Initiative, now 15 years old has spent $725 million in studying 161000 females. It is reportedly plagued with flawed clinical trial designs, patient enrollment criteria, and data misinterpretation, and has raised issues regarding the effectiveness of hormone therapy in the treatment of postmenopausal orders,21 confounding the search for improvements on existing medications. Similarly, the evolution of drug treatments for the lifestyle disorders of ED and FSD, like that of nonmorbid obesity, are confounded by the major psychological component of each making it challenging to prioritize the targeting of new drugs for peripheral versus central targets.

References

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2. de Groat, W C.; Yoshimura, N. Annu. Rev. Pharmacol. Toxicol. 2001, 41, 691-721.

3. Speakman, M.; Batista, J.; Berges, R.; Chartier-Kastler, E.; Conti, G.; Desgrandchamps, F; Dreikorn, K.; Lowe, F; O'Leary, M.; Perez, M. et al. Prostate Cancer Prostatic Dis. 2005, 8, 369-374.

4. Bent, S.; Kane, C.; Shinohara, K.; Neuhaus, J.; Hudes, E. S.; Goldberg, H.; Avins, A. L. N. Engl. J. Med. 2006, 354, 557-566.

5. Lemack, G. E. Nat. Clin. Pract. Urol. 2006, 3, 38-44.

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18. Djerassi, C. In Discoveries in Pharmacology, Vol. 2, Hemodynamics, Hormones and Inflammation; Parnham, M. J., Bruinvels, J., Eds.; Elsevier: Amsterdam, The Netherlands, 2004, pp 339-361.

19. Greep, R. O. In Discoveries in Pharmacology, Vol. 2, Hemodynamics, Hormones and Inflammation; Parnham, M. J., Bruinvels, J., Eds.; Elsevier: Amsterdam, The Netherlands, 2004, pp 321-337.

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21. Parker-Pope, T. Wall Street Journal, Feb 28, 2006, pp A1/A13.

Biography

Michael Williams received his PhD in 1974 from the Institute of Psychiatry and his Doctor of Science degree in Pharmacology (1987) both from the University of London. Dr Williams has worked for 30 years in the US-based pharmaceutical industry at Merck, Sharp, and Dohme Research Laboratories, Nova Pharmaceutical, CIBA-Geigy, and Abbott Laboratories. He retired from the latter in 2000 and served as a consultant with various biotechnology/ pharmaceutical companies in the US and Europe. In 2003 he joined Cephalon, Inc. in West Chester, where he is vice president of Worldwide Discovery Research. He has published some 300 articles, book chapters, and reviews and is adjunct professor in the Department of Molecular Pharmacology and Biological Chemistry at the Feinberg School of Medicine, Northwestern University, Chicago, IL from which vantage point he publishes his personal viewpoints on the drug discovery process.

© 2007 Elsevier Ltd. All Rights Reserved Comprehensive Medicinal Chemistry II

No part of this publication may be reproduced, stored in any retrieval system or transmitted ISBN (set): 0-08-044513-6 in any form by any means electronic, electrostatic, magnetic tape, mechanical, photocopying, recording or otherwise, without permission in writing from the publishers ISBN (Volume 6) 0-08-044519-5; pp. 541-550

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