The Blue Vanguard Vol.24

Yonsei Student Pharmacist

THE

BLUE

VANGUARD 2023

DECEMBER

Vol.24

MAIN ARTICLES Interviews

Jinnyoo Park, Drug test kit: key of the drug war-professor heesun

Pharmaceuticals

Daeun Choi, The fast-growing domestic growth hormone market

Column

Jungyoon Ryu, Organ-on-a-chip for enhanced in vitro testing in drug development

Life Issues

Jaeeun Park, Excellence in technology of KIST doping control

International issues

Yoonah Jung, Advancements in drug development aim to tackle the obesity epidemic

National issues

Hyunjin Lee, Pathbreaking anti-obesity drug: KDS2010, a brain’s weight control switch

Editor's note Daeun choi Hello everyone, Thank you for checking out the 24th edition of the BlueVanguard!

I’m excited to share this year’s edition because it’s packed with interesting articles about the future of pharmacies. We discuss topics such as the digitalization of pharmacies, the possibilities for future drug markets and disease treatments. I hope you take a moment to explore and think about the futures we talk about in our articles. In addition, our articles look into how drugs are used to fight crimes.

Starting with an interview with Professor Heesun Chung, we also discuss the issues of drug counterfeiting and doping tests.

A big thank you to our journalists for their fantastic job in writing these articles! I want to highlight the awesome work of our new freshman journalists and designers this year. It was only their first year in Blue Vanguard but they had done a wonderful job. The 24th edition is also the last edition where some Blue Vangardians from the class of 2020 participate in. I’d like to thank them for a good 2 years of work.

You can find the names of the journalists and designers who wrote and designed each article :) I hope you enjoy reading our 24th edition. Merry Christmas and a happy New Year!

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Contents Interview • drug test kit: key of the drug war-professor heesun chung interview

Pharmaceuticals • The fast-growing domestic growth hormone market • Pharmaceutical branding and marketing • The development of new pharmaceuticals using AI • The trend and perspection of the Dyslipidemia market • Understanding Pharmaceutical regulations • Pharmacologic Management of Parkinsonism • Current Status and Future of Digital Therapeutics

Column • Organ-on-a-chip for enhanced in vitro testing in drug development • Data Science in Pharmaceutical Industry • Preventing Drug Counterfeiting

National issues • Telemedicine and Non-Reimbursable High-Risk Medications • Pathbreaking Anti-Obesity Drug: KDS2010, a Brain’s Weight Control Switch

International issues • Advancements in Drug Development aim to Tackle the Obesity Epidemic • Cancer Research and the Future of Cancer Treatment

Life Issues • Proper and exact ways of taking medication for elders • Excellence in technology of KIST Doping Control Center 2023 VOL.24

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INTERVIEW

Drug Test Kit: Key of the Drug WarProfessor Heesun Chung Interview Journalist | Jinyoo Park | truthfree@yonsei.ac.kr Designer | Jinyoo Park | truthfree@yonsei.ac.kr 1.Professor, you had graduated from Sookmyung Women’s University with a degree in Pharmacy and chose the National Forensic Service (NFS), which was not wellknown at that time, as your career path. Was there any specific reason for this choice?

During my third year of college, I attended a lecture by the director of the National Forensic Service (NFS), which was then known as the Research Institute. I was deeply impressed by the idea that I could contribute to solving crimes with a pharmaceutical background. When I found that there was job opening at NFS just before my graduation, I made up my mind to apply immediately.

In the past, NFS was primarily associated with autopsy work, so it was unusual for a pharmacist, rather than a medical doctor, to work there. Most pharmacy graduates chose to pursue careers in pharmacies, thus, there was strong opposition from those around me when I decided to join NFS.

2. What was the situation at NFS when you joined, in terms of the number of pharmacists and the initial responsibilities you had?

At that time, there were hardly any pharmacists at NFS. Aside from myself, there was only one pharmacist. It seemed that perhaps due to societal beliefs, women were not well-represented in NFS. There was a prevalent belief that if a woman got married, she should quit working. I remember that during the interview, they repeatedly asked if I could work for more than three years (laughs).

The actual work at NFS was quite different from what I had expected, so it was challenging at the beginning. It took some time before I took part in tasks directly related to investigations. I spent almost eight months mainly cleaning beakers and such chores...

After a long internal struggle, I finally mustered the courage to walk up to my supervisor and say, “I want to work.” From that point on, I gradually took

<Representative drugs for each category>

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INTERVIEW on more responsibilities, and instead of three years, I ended up working at NFS for 30 years. In the end, I became the director of NFS. Nowadays, when people think of NFS, they often associate it with “drugs.” However, in the past, NFS handled many cases unrelated to narcotics.

For instance, there were cases involving counterfeit honey. It’s easy to distinguish them now, but back then, it was quite a challenging task (laughs).

"Advancements in narcotics investigations are progressing in tandem with developments in pharmacology."

3. How has the development of drug investigations progressed? It seems that a lot of effort must have gone into establishing Korea’s worldwide-recognized drug investigation techniques.

In the early days, drug investigations mainly involved determining whether a particular substance was a narcotic or not. However, in the mid-1980s when I had the opportunity to visit the United States, suspected drug users are often subjected to urine tests to confirm their drug usage. When I saw this, I thought we should introduce this practice to Korea.

This marked the beginning of our efforts to gradually accumulate research data, starting with animal experiments and urine tests.

We spent a long time establishing guidelines, from minimum detection levels to detection methods and quantitative analysis methods, for each type of narcotics. Ten years later from that time, we also established guidelines for hair analysis. The current technology at NFS is the result of years of steadily accumulating experimental data and refining techniques.

A sample of a drug self-test kit. If there is a reaction to methamphetamine (philonium), a black circle appears.

The results of testing with (1)soju, (2) beer, (3) red wine, (4) white wine, (5) orange juice, and (6) cola all indicated the presence of narcotic substances in the contents.

4. What undergraduate subject studied by pharmacy students is most closely related to drug investigations?

During my undergraduate studies, the most relevant subjects to drug investigations were ‘analytical chemistry’ and ‘toxicology’. Analytical chemistry is crucial because the quantitative measurement of a detected drug has a significant impact on the outcome of investigations and legal proceedings. For example, in Singapore, having 3 grams of cocaine can lead to a death penalty verdict.

However, if it’s 3 grams of cocaine with a 90% purity level, the sentence could be different. While this is an extreme example, it illustrates how accurate analysis can decide a person’s fate.

Understanding the metabolism of specific substances, their effects on organs, and their pharmacokinetic properties are fundamental aspects of drug investigations, making toxicology an essential field of study.

In addition to toxicology, the pharmaceutical sciences, including ‘pharmacology’ and ‘medicinal chemistry’, also play a significant role in drug investigations. Thus, the pharmacy curriculum covers subjects closely related to drug investigations.

5. What are the main differences between hair and urine drug tests when it comes to confirming drug use?

The most significant difference is the quantity of the substance being analyzed. In hair testing, we are quantifying drugs in the order of a few nanograms, whereas in urine testing, we are dealing with milligrams of the drug. The difference in units is substantial, with hair testing requiring measurements approximately 1000 times smaller. Consequently, the approach to these two types of testing is significantly different. An additional challenge with hair testing is that only growth-phase hairs can be tested, making it more complex.

Another difference is that hair testing can provide a history of drug use over an extended period, while urine testing primarily indicates only recent drug use.

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INTERVIEW 6. I understand that you’ve recently succeeded in commercializing a drug test kit that you’ve been developing for several years. What is the purpose and functionality of this test kit?

Yes, we have successfully developed a drug test kit over the past few years, and it’s currently in the final packaging stage before launching. This kit is designed to serve multiple purposes and functions.

It can test for the presence or absence of over 10 different drugs using a single strip, and it’s much more user-friendly compared to existing drug test kits. It enables law enforcement to determine the presence of drugs at the scene of an investigation, providing a quick and convenient tool. Furthermore, the general public can also use it to check if narcotics have been mixed into various beverages, including alcohol.

Considering recent incidents where drugs were added to drinks and given to unsuspecting individuals, such as the case in Apgujeong, I believe that utilizing this kit could help mitigate potential harm and protect people.

7. What are the main differences between this newly developed drug test kit and the ones already available in the market?

The main difference lies in the principles and objectives. Conventional kits use antibodies to test for drug use, whereas the kit we’ve newly developed doesn’t rely on antibodies, making the production cost lower and the process less complicated. This makes the drug test kit more accessible and costeffective.

8. Could you provide more details about your plans for commercialization? I’m curious about your ultimate goals with this kit.

It seems like the starting point is to make it available for use by law enforcement agencies. In Korea, law enforcement agencies use expensive kits and equipment, so having a more affordable kit could greatly assist in drug control efforts. Particularly in developing countries, the inability to afford such expensive equipment can hinder drug investigations.

As a consultant for UNODC, I plan to advocate for the use of this kit in many developing countries. It’s clear that the kit could also be used by the general public to prevent drug-related crimes in everyday life, but personally, I hope such a need doesn’t arise.

<Main status of drug crimes>

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INTERVIEW 9. I’m curious about your thoughts on the recent surge in drug-related crimes in South Korea, and how it has shifted from being considered a “drug-free” country.

Both the United States and South Korea have seen a significant increase in drug-related crimes, but the patterns seem different. In the United States, many deaths are attributed to fentanyl, and synthetic opioids in the opioid class are causing significant problems. In contrast, in South Korea, there is a higher prevalence of marijuana and Philopon. Recently, we have seen an increase in ketamine, ecstasy, and MDMA use. It’s shocking to see how society has become more accessible to obtaining drugs easily and remotely. While the proportion of fentanyl may not be high yet, it’s a concern as drugs like fentanyl can transcend borders and affect multiple countries.

"The new drug testing kit is expected to have a significant impact on the detection of drug crimes. However, on the other hand, the bitter reality of South Korea, once called the 'Drug-free Korea,' also looms large."

10. What advantages do you think pharmacists working at the National Forensic Service (NFS) have?

Working at NFS goes beyond being just a scientist; it’s about contributing to a ‘just society’.

During my time at NFS, I’ve apprehended numerous criminals, as well as proven the innocence of many individuals. There have been instances where we uncovered that what seemed like a drug overdose suicide was actually a homicide through drug investigations. There are not many professions that directly protect the safety of the nation, society, and the lives of its citizens. It’s a profession with a deep sense of satisfaction in contributing to society.

Additionally, there’s always something new waiting for you. Handling a wide variety of cases means it’s an intriguing job. These unique advantages make working at NFS quite special, and it’s something you wouldn’t experience elsewhere.

11. Do you have any words of advice or guidance for junior pharmacy students?

During your time in school, studying is, in fact, the most crucial thing, so make sure to excel in your studies (laughs). Also, participating in club activities and sharing your thoughts with peers is an essential experience.

But above all, I want to emphasize that individuals who major in pharmacy have a wide range of career opportunities. Not only at NFS but also at the Korea Food and Drug Administration and many other places. There are important roles that only pharmacists can fulfill, and society needs these pharmacists. Unfortunately, these roles often don’t receive the attention they deserve from future pharmacists. It’s a shame to see that these important roles are sometimes overlooked due to immediate concerns about low salaries or inadequate job rewards. If future pharmacists neglect these roles, they will eventually be taken over by non-pharmacy professionals. This, in turn, will lead to a gradual reduction in the scope of practice for pharmacists. B

<key career of Interviewee > 1978 Appointed as a forensic pharmacist at the National Institute of Scientific Investigation 1993 Head of the Department of Poisonous Drugs at the National Institute of Scientific Investigation 1996 Head of the Narcotics Analysis Department at the National Institute of Scientific Investigation 2002 Director of the Forensic Science Department at the National Institute of Scientific Investigation 2008 11th Director of the National Institute of Scientific Investigation 2019 Professor of the Department of Scientific Investigation at Sungkyunkwan University 2019 international scientific investigation expert advisory member at UNODC (UN Office on Drugs and Crime)

*This article was co-authored by students Jeongwoo Son and Eunyoung Song from Gachon University College of Pharmacy.

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The Fast-Growing Domestic Growth Hormone Market Journalist | Daeun Choi | daeundownchoi@naver.com Designer | Seungwoo Lee | seungwu210@yonsei.ac.kr The popularity of Growth Hormones The average height of South Koreans today is 159.6 cm for females and 172.5 cm for males. This represents a remarkable increase compared to the average height in 1979 which was 154.3cm for females and 166.1 cm for males.

This growth spurt is certainly related to increases in overall nutrition and health. However, some people’s obsession to become taller seems to also play a big part in this growth.

The social bias on height, heightism, first appeared in media in 2009 when a female guest panel on the KBS show “Global Talk Show” called all men below 180cm, “losers”. Since then, height has become an important part of Korea’s beauty standards. In a 2016 survey, over 50 percent of Koreans aged 9 to 16 replied that height is an important part of one’s life. Heightism can also be seen in K-pop idol groups as debuting idols seem to be getting taller and taller. The mean height of idol groups that debuted in 2022 was 3 centimeters taller than the average height of idol groups that debuted in 2007.

Due to the prevalent “heightism” in Korea’s society, many parents see height as a direct connection to their children’s future potential. As a result, the growth hormone drug market is growing rapidly in South Korea. According to IQVIA, the domestic growth hormone drug market has increased every year from 126.5 billion won in 2018, doubling over the past five years to 238.5 billion won in 2022. According to the Health Insurance Review, 25,900 received growth hormone therapy in the first half of 2023. This is about double the number in 2020. The popularity of growth plate tests to estimate the expected height of elementary school children has also led to the growth of the market. Growth hormone drugs come with high costs, about 10- 12 million won per year. Treatments are usually conducted for about five to six years. However, due to Korea’s low birthrate and high interest in raising children, parents and grandparents are sparing no expenses for their children’s growth.

A mother with a 9-year-old boy in growth hormone therapy said, “It’s hard to give up now, especially after seeing my second child, a boy, get pushed around and teased for his short stature at school.”

Growth Hormones, what are they?

Growth hormones are secreted from the anterior lobe of the human pituitary gland and have an important influence on the growth and development of the human body. When a growth hormone is secreted from the anterior pituitary lobe, insulin-like growth factor-1 (IGF-1) is produced in the liver, where IGF-1 is transmitted to various tissues, including muscles and bones, to promote growth. It is mainly secreted actively during childhood and adolescence and maintains a certain level in adults but decreases with age.

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Growth hormones play a role in promoting growth. Thus, if it is insufficient, growth will stop leading to a short height. Growth hormone drugs are human growth hormones made by recombining genes and were previously prescribed to patients with genetic diseases that do not grow in height, such as growth hormone deficiency and Turner syndrome. However, in 1981, Genetech launched Somatotropin synthesized from E. coli through gene recombination technology. Mass production of growth hormone treatments became possible, and stability increased significantly.

Therefore, the treatment area has been expanded to not only patients with growth hormone deficiency but also idiopathic (short) patients.

Currently, ‘Eutropin’ from LG Chem is the number one growth hormone product in South Korea. It recorded 120 billion won in sales in 2022. ‘Eutropin’ is followed by ‘Growtropin’ from Dong-A ST Co., with 61.5 billion won in sales. The two companies’ products account for more than half of the Korean growth hormone market.

Growth Hormones, are they safe?

The vice president of Korea Children’s Hospital Association, Choi Yong-jae, said there are many causes where doctors prescribing such treatments do not have the required background knowledge in the area. For a doctor to prescribe GHD therapies, he or she must have profound knowledge on endocrinology and child development. However, when general practitioners, not experts in the field, prescribe GHD therapies, it could cause dangerous side effects.

While growth hormone therapies may help children with deficient growth hormones become taller, they may be detrimental for children with normal growth hormone secretion levels. For example, when children with normal growth hormone levels are administered with growth hormones, they may suffer from transient diabetes, headaches, edema, vomiting, and scoliosis. Prolonged uses of growth hormone therapies may cause swelling, joint pain and excessive growth of the hands, feet, and facial bones.

The Future of Growth Hormones Pharmaceutical companies are also striving to improve growth hormone drugs in numerous ways. For example.

LG Chem launched a mobile app ‘Eudi’ that allows patients to record and manage information about their hormone injections. It includes records of the dosage, place of injection, and the injection date. LG chem’s Eutropin S Pen has a self-administration button. This button allows young patients to easily administer growth hormone drugs to themselves. The S pen also tells the patient how much dose is left in its cartridge and can be stored with hormonal drugs for up to 14 days.

Dong-A ST is developing its Growtropin as an injection with a long-term effect. They are trying to increase the half-life by improving the in-vivo activity of the drug. If growth hormones can reside for a longer time in the body, the number of injections per day can be reduced. Such long-term sustainable growth hormone injections can ease the inconvenience of young patients.

As the two leading companies in this market, LG Chem and Dong-A ST, are expected to continue to compete fiercely, readers should look forward to seeing what new medicines will be developed in the near future. In addition, readers should keep in mind that physical appearances are only a small part of what makes a person truly feel beautiful.

Growth hormones are not the only possible solutions to “heightism”. B

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pharmaceutical branding and marketing Journalist | Ha Neul Roh | skyroh0416@yonsei.ac.kr Designer | J­in Yeong Kim | kimjin02000@yonsei.ac.kr

I

n the ever-evolving world of healthcare, pharmaceutical companies play a pivotal role in improving and saving lives. Behind every breakthrough medication and treatment lies extensive research, development, and a crucial element - pharmaceutical branding and marketing. In this article, we will explore the significance of pharmaceutical branding and marketing, the unique challenges it presents, and the strategies that can make a significant impact in this highly regulated and competitive industry.

The Pharmaceutical Landscape Pharmaceutical companies operate within a complex ecosystem that encompasses healthcare professionals, patients, regulators, and insurers. They face stringent regulations, clinical trials, and fierce competition. Success in this industry not only relies on the quality and efficacy of the drugs but also on how they are perceived in the market. Here's where branding and marketing come into play.

The Power of Branding A strong pharmaceutical brand is synonymous with trust and reliability. Patients and healthcare professionals are more likely to have confidence in a medication if it carries a reputable brand name. Trust is invaluable in an industry where people's lives are at stake. Moreover, effective branding helps differentiate products from thos of etheir competitors. The pharmaceutical market is saturated with similar medications, and branding can be the reason why one medication is prescribed over another, even when both may treat the same condition. Building a solid pharmaceutical brand can lead to long-term success. Companies with established brands often have an advantage when launching new products, as they have already gained credibility and recognition in the market.

Challenges in Pharmaceutical Marketing Pharmaceutical marketing faces a unique set of challenges, including regulatory constraints. Pharmaceutical companies are subject to strict regulations governing marketing practices. They must ensure that their promotional efforts adhere to guidelines set by agencies like the FDA (Food and Drug Administration) in the United States.

This includes accurately representing a drug’s benefits and potential side effects.

Data privacy is another significant challenge in pharmaceutical marketing. In the era of digital marketing, handling patient data is a delicate issue. Striking the right balance between personalized marketing and respecting patient privacy is a constant concern for pharmaceutical marketers. Additionally, pharmaceutical marketing isn’t solely about selling products. It’s also about educating healthcare professionals and patients. Presenting complex medical information in an understandable and unbiased way is a critical aspect of the industry. This cannot be stressed enough because correct use of drugs is crucial for patients’ health. Incorrect use may even lead to death.

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Effective Strategies in Pharmaceutical Marketing Effective strategies in pharmaceutical marketing encompass several approaches. Content marketing, for instance, involves producing informative, engaging, and compliant content that can establish a pharmaceutical company as an authority in its field. Content can be disseminated through websites, blogs, and social media platforms. Collaborating with respected healthcare professionals through Key Opinion Leader (KOL) partnerships can lend credibility to a pharmaceutical brand. KOLs can endorse products and provide valuable insights.

Utilizing digital marketing channels can help brands reach a wider audience and the can provide valuable data for targeting specific demographics. However, it's essential to ensure compliance with data privacy regulations.

A patient-centric approach is crucial as well. Focusing on the patient experience and understanding their needs can shape marketing efforts. Patient testimonials and success stories can be compelling marketing tools. Lastly, transparency and ethical practices are key. Building trust through transparent and ethical marketing practices is crucial. Companies should be honest about their products, their benefits, and potential side effects.

Influence on Physician's Prescription Behavior The target of pharmaceutical marketing should not only be the patients but should also be the physicians as well. Since physicians treat prescribed medicine as well as OTC(over-the-counter)s, giving a good impact to physicians is as important as to patients. Many research has been done in this area, and having good “public relationships” with physicians actually showed more effective than advertising products via print media or digital media. Catching the doctor’s sight is actually quite effective.

In the dynamic and highly regulated world of pharmaceuticals, branding and marketing are essential components for success. Building trust, differentiation, and credibility through effective branding can set a company apart in a crowded marketplace. However, it's crucial for pharmaceutical companies to navigate the unique challenges they face, including stringent regulations and data privacy concerns, with integrity and a patient-centric approach. When done right, pharmaceutical branding and marketing not only contribute to a company's bottom line but also to the well-being of patients worldwide. B

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The Development of New Pharmaceuticals Using AI Journalist | SuYeon Kim | sooyeon0112@yonsei.ac.kr Designer | DaHyun Ryu | dahyunryu17@gmail.com

D

rug development is the process of discovering new medications to treat or cure diseases. Historically, it has improved the quality of people’s lives by providing effective treatments and even saving their lives. However, it usually requires significant time and costs, with generally low success rates. According to KPBMA(Korea Pharmaceutical and Bio-Pharma Manufacturers Association), it takes 15 years to develop new drugs and costs 2.6 trillion won on average. To overcome this, AI technology is transforming the drug development process by enabling more precise targeted therapies with cost and time-saving. Moreover, it advances the field of personalized healthcare and brings about predictive and preventative medical advancements, shaping the future of healthcare.

Recently, several AI-based solutions have emerged which have accelerated drug development. In the case of Pfizer, AI technology is being used to develop new drugs by partnering with CytoReason, an advanced technology company specializing in computer disease model development. This technology is primarily being used in developing the small molecule drugs, but it also shows potential in the development of new biological products, such as antibodies for cancer fibrosis and other disease-related treatments. This article will discuss the five main uses of AI in the drug development process.

Identifying Disease Targets:

In drug development, the first crucial step is identifying specific molecular targets in the body that are associated with a particular disease. These targets can be proteins, genes, enzymes, or other molecules that play a pivotal role in the development or progression of the disease. AI comes into play by analyzing vast amounts of biological data to pinpoint these disease-related targets. It helps researchers understand the underlying mechanisms of the disease, and in doing so, identifies potential drugs that can modulate these molecular targets to treat or mitigate the disease. One of the most significant applications of AI in identifying disease targets is Google DeepMind’s AlphaFold project. AlphaFold is an AI system that predicts the 3D structures of proteins with remarkable accuracy. This AI technology can predict protein structures at a level of accuracy that was previously considered unattainable. It enables scientists to understand the shapes and functions of proteins, which play a fundamental role in the development of diseases.

Drug Discovery and Diseign:

Once potential disease targets are identified, AI becomes a powerful tool for designing new drug molecules or optimizing existing ones. This process involves predicting how different compounds will interact with their target proteins at the molecular level. AI helps in the early stages of drug development by suggesting structural modifications to improve a drug’s efficacy and safety. This not only reduces the time and resources required for experimental testing but also enhances the chances of finding effective treatments.

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Predicting Drug-Drug Interactions:

Given that many patients take multiple medications simultaneously, it is essential to predict potential interactions between these drugs to prevent adverse effects or reduced efficacy. AI plays a critical role in this aspect. By analyzing a patient’s medication list and the known effects of various drugs, AI can predict how these drugs may interact with each other. This predictive capability enables healthcare providers to make more informed decisions about the combinations of drugs prescribed to a patient, ensuring their safety and effectiveness. For instance, IBM Watson is a well-known AI platform that has been applied to various healthcare and pharmaceutical applications, including the prediction of drug-drug interactions. IBM Watson for Drug Discovery uses AI to analyze large datasets and identify potential interactions between drugs.

Clinical Trial Optimization:

Conducting clinical trials is a fundamental part of the drug development process, and AI can be a game-changer here as well. AI optimizes various aspects of clinical trials, including patient selection, dosing regimens, and trial design. By analyzing a wealth of patient data and medical records, AI helps in identifying suitable patient populations for a trial. This not only leads to more accurate and reliable results but also speeds up the drug development process, making potential treatments available sooner. Tempus is a technology company that utilizes AI and data analytics to improve clinical trial design and patient recruitment for cancer research. Also, Pfizer collaborate on cancer drug development by using Tempus’ clinical trial matching program.

Drug Repurposing:

Wegovy should not be used in combination with other Semaglutide-containing products, other GLP-1 recDrug repurposing, or drug repositioning, involves finding new uses for existing drugs that were initially developed for different purposes. AI plays a crucial role in this endeavor by analyzing large datasets of drug and disease information.

By comparing the mechanisms of action of existing drugs with the biological processes involved in other diseases, AI can identify potential matches. This approach significantly accelerates drug development by saving time and resources, compared to the lengthy process of developing entirely new drugs from scratch.

In summary, AI is revolutionizing the pharmaceutical industry by accelerating drug discovery, optimizing drug development processes, and improving the overall efficiency and effectiveness of drug research and development. Its contributions extend to the early stages of target identification, through drug design, clinical trials, and even the creative repurposing of existing medications to benefit patients with a wide range of medical conditions. These AI-driven solutions hold great promise for revolutionizing the drug development process, making it more efficient and effective. By addressing these key challenges, researchers and pharmaceutical companies can bring new treatments to market faster and with greater precision.

However, some ethical issues should be considered when developing new drugs using AI. When developing new drugs using AI, ethical considerations include safeguarding data privacy, addressing bias and fairness, ensuring transparency and accountability, obtaining informed consent from patients, preserving intellectual property while promoting access, complying with regulations, maintaining human oversight, upholding patient safety, promoting equity and access, engaging stakeholders, accepting accountability for outcomes, and monitoring AI systems in the long term. Striking a balance between innovation and ethics is vital to ensure responsible drug development with AI, benefiting patients while maintaining ethical standards. B

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The Trend and Outlook of the Dyslipidemia Market

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Journalist | Grace Park | gracepark02@naver.com Designer | Jinyoo Park | truthfree@yonsei.ac.kr

hen we get older, we can easily suffer from disorders like diabetes, dyslipidemia, dementia, obesity, high blood tension, etc. The individuals who rigorously manage themselves can easily prevent these, but this is not easy to avoid due to a lack of time in their busy daily lives. So, people regularly take nutritional supplements, and those already afflicted with an illness take medication accordingly. According to the Korea Centers for Disease Control and Prevention, the most common chronic diseases among the elderly are hypertension, followed by diabetes, dyslipidemia, and osteoarthritis.

With the start of aging, we have to pay more attention to the disorders of the elderly. My parents are also currently taking medication for dyslipidemia, so I wanted to learn more about dyslipidemia among the various diseases. Thus, we are going to learn about what dyslipidemia is, treatments for dyslipidemia, and the outlook for prospective treatments.

What do you know about Dyslipidemia?

Dyslipidemia is defined as a condition of abnormal blood lipid levels that are too high or low. Blood lipids are fatty substances, such as triglycerides and cholesterol. There are 3 common forms of dyslipidemia.

The first one is high levels of LDL cholesterol (lowdensity lipoproteins), which is considered bad because it causes plaques (hard, fatty deposits) to form in blood vessels. Second is low levels of HDL cholesterol (highdensity lipoproteins) which is good because it helps to remove LDL from the blood. The last one is high levels of triglycerides, which develops when calories are not burned right away and stored in fat cells.

These plaques accumulate in blood vessels, making it difficult for blood to flow. Moreover, this disorder can develop other diseases such as heart attacks and strokes. Dyslipidemia shows symptoms like leg pain, chest pain, shortness of breath, indigestion, exhaustion, fainting, etc.

<Growing plaque>

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What are the Treatments for Dyslipidemia, and How do these Medications Work?

1. Statins

Statins inhibit the enzyme HMG-CoA reductase, which is required for the synthesis of cholesterol in the liver.

However, second compensatory mechanisms induce greater <structure of lovastatin> levels of HMG-CoA reductase and LDL receptors. Thus, statins act by indirectly increasing receptor-mediated absorption of LDL. Due to the higher number of receptors, the overall LDL concentration decreases. Statins are marketed as lovastatin, pravastatin, simvastatin, fluvastatin, and atorvastatin.

2. Fibrates

<structure of fenofibrate>

Fibrates are lipid-lowering drugs which decrease triglyceride levels and increase HDL-C levels. It significantly reduces the levels of highly atherogenic remnant lipoproteins in a more efficient way than statins.

3. Bile Acid Sequestrants Since bile acid sequestrants are not absorbed by digestive enzymes, they bind to the two main biliary acids, thereby removing the bile acids from circulation and decreasing the concentrations of hepatic cholesterol.

The Current Status and Outlook of Medications for Dyslipidemia Currently, statin medications account for approximately 90% of treatments for hyperlipidemia in the market. Among these, Pfizer’s atorvastatin product, known as ‘Lipitor,’ is most widely used. According to data, Lipitor was prescribed for over 140 million units each in 2013 and 2014. Lipitor is currently available in 118 countries worldwide and is the first drug to achieve sales of $10 billion among specialty pharmaceuticals.

Following closely is ‘Crestor,’ which surpassed 100 million units in 2014. Crestor chose the CYP450 2C9 metabolic pathway, unlike most statin medications that opt for the CYP450 3A4 pathway. Some of the medications for chronic conditions are metabolized through CYP450 3A4, which can potentially lead to drug interactions. Thus, Crestor’s metabolic pathway is considered safer for patients who need to take multiple medications.

The third one is ‘Vytorin’, which is a combination of a statin and ezetimibe. This combination can restrain the synthesis of LDL-cholesterol, both in the liver and the intestine where Statins can’t. Thus, only a small dose of Vytorin needs to be taken. This reduces the risk of side effects associated with high-dose statin usage, such as the development of diabetes.

Therefore, there is a current effort to develop combination medications that can surpass the efficacy of single-statins. Combination medications offer the advantage of not only statin benefits but also additional efficacy. Recent developments include combination drugs like atorvastatin and ezetimibe, as well as pravastatin and fenofibrate. Consequently, the outlook for the dyslipidemia treatment market appears promising, with industry experts saying this market is the only one growing at approximately 10% annually.

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Understanding Pharmaceutical Regulations Journalist | Chanyoung Kim | kkimchanyoung@gmail.com Designer | Soyun Kang | soyun525@yonsei.ac.kr

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s Paracelsus once said, ‘Poison is in everything, and nothing is without poison’, every medication has the potential to be hazardous if not used in adequate amounts. Alongside to that, the ideal treatment varies for each individual due to factors such as genetic variations, age, gender, etc. Therefore, to ensure the safety and efficiency of the medication, there ought to be laws and regulations to thoroughly monitor the development and usage of pharmaceuticals. This article focuses on the implications of Pharmaceutical Regulations and how drug regulatory authorities act in the process of drug development.

Pharmaceutical Regulation by definition is a combination of legal, administrative, and technical measures that governments take to ensure the safety, efficacy, and quality of medicines. Drug regulatory authorities such as the FDA (US Food and Drug Administration) or EMA (European Medicines Agency) are responsible for supervising pharmaceutical companies so that their products adhere to these regulatory laws. The regulations play a role in each step of the drug development process: from research, pre-clinical/clinical trials, and ultimately to product approval.

For instance, the FDA regulates each drug development entity through 4 different steps: 1) Preauthorization 2) Clinical Trial 3) Approval and Recommendation 4) Post--approval monitoring.

1) Preauthorization: New medicine must receive preauthorization before conducting clinical trials, and drug developers are obligated to file an IND(Investigational New Drug) application; which includes preclinical data, toxicity data, information on the manufacturing process, clinical trial plans and protocol, information on the investigator, etc. This process aims to confirm the necessity of clinical research and scientific evidence and reduce the possibilities of adverse clinical outcomes.

2) Clinical Trial: The FDA is not responsible for directly conducting clinical trials. Rather, the FDA oversees the people in charge and performs inspections of clinical trial study sites.

3) Approval and Recommendation: After the clinical trials have been successful, the drug-developing entity files either a NDA(New Drug Application) or a BLA(Biologic License Application) depending on whether the drug is composed of small molecules or biologics/biosimilars. Additionally, orphan drugs, and emergency, expedited approval processes have their own measures.

4) Post--approval monitoring: Adverse effects or any unexpected consequences could arise after market approval.

The FDA can recall or alter regulations based on a reporting system called MedWatch where individuals can report adverse reactions.

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Although the general process for new medication is similar for each nation’s agency, there are a few differences.

The EMA, for example, covers only human and veterinary medicine and merely provides drug recommendations based on efficacy and safety information, differing from the FDA covering a broad range of products for which it could make regulatory decisions. Additionally, the preauthorization process in the EU is left to the union’s member state unlike the FDA centralized for the entire nation. The EMA’s role is confined to assessing the data and giving recommendations while the final jurisdiction is made by each state or location.

For Approval and Recommendation, the EMA has 4 different approving pathways: Centralized, National, Mutual Recognition, and Decentralized. It is mostly dependent on the drug for which pathway is taken, but sometimes the applicants decide which pathway they take. After the EMA reviews the product thoroughly, they present an approval recommendation to EU member states, and the EC(European Commission) finalizes the decision for market approval.

Despite the differences, a research study conducted in 2019 states that both agencies have high concordance (91-98%) in decisions on marketing approvals. The results suggest the effect of ongoing robust scientific and technical collaborations by the two entities. Specifically, starting from 2003, both authorities formally started their collaboration by sharing confidential information, holding meetings and forming mutual working groups. This includes sharing scientific evidence, research plans, adverse drug reactions, good manufacturing/clinical practices, etc and currently, the interactions between these entities are now almost daily. Through these efforts, mutual recognition agreements of a standardized, good manufacturing practice were made, along with orphan designations and paediatric investigation plans etc. Even in the era of COVID-19, both entities intensified their collaboration to facilitate a safe, effective, high-quality vaccine.

Notably, it is due to these regulatory authorities that consumers like us could take our daily medications safely, and be provided with adequate care in case problems of ADR(Adverse Drug Reactions) occur. Without the help of these entities, our society would be surrounded with medication that does not have proper evidence of efficacy and safety, and without price management. Therefore regulatory laws aim not to regulate and restrain individuals to choose medication by their own free will, but to allow safety measures and protect them from adverse effects of the medication they face. It is essential that these regulatory authorities be present to make the most out of each individual, confident in their health every day.

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Pharmacologic Management of Parkisonism

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Journalist | Jungwoo Shin | steven1020@yonsei.ac.kr Designer | Seungwoo Lee | seungwu210@yonsei.ac.kr

hat Is Parkinsonism? Parkinsonism is the second most common neurological degenerative disease after Alzheimer’s. Numerically, about 1% of the population worldwide suffer from Parkinsonism. Parkinson’s disease (PD) is accompanied by various movement disorders like rigidity, bradykinesia, tremor, and postural instability. Eventually these symptoms are followed by cognitive decline. Although the symptoms get worse as PD progresses and cannot be cured perfectly, it’s notable that symptoms can be remarkably improved by drug treatment.

Pathogenesis of Parkinson’s Disease Even though there’s no way to describe the exact mechanism by which PD develops, progresses, and either persists or is resolved, it has been revealed that three major factors are related to the onset of PD. 1. Mutation in the 4q21 region of an α-synuclein gene or two/three-fold amplification of the synuclein gene 2. Leucine-rich repeat kinase 2 (LRRK2), Ubiquitin-C-terminal hydrolase L1 (UCHL1), parkin gene 3. Environmental or endogenous toxicants can increase or decrease the possibility of PD. The incidence of PD is higher in people working in health care and agriculture.

Interestingly, coffee, high concentration of vascular uric acid and even smoking have protective effects against PD.

Strategies to Cure Parkinson’s Diseasese Nigrostriatal dopamine, which normally exists in high concentrations in the basal ganglia, is shown to be reduced in PD patients. In other words, there is a collapse in balance between dopamine and acetylcholine (Ach) levels.

Therefore, the basic principle to cure PD patients is to protect against losing dopamine.

1. Levodopa (L-DOPA) A neurogenic factor or drug is effective only when it can enter the brain. As dopamine can’t pass the Blood-Brain Barrier (BBB), it cannot be used directly. Instead, Levodopa, which can pass the BBB through the l-amino acid transporter, is normally used for transporting dopamine. L-DOPA can be turned into dopamine by an enzyme called DOPA decarboxylase (DDC) in the brain. However, DDC can also change levodopa into dopamine, inducing toxicity and adverse reactions like vomiting if it exists in peripheral tissues. Carbidopa, a drug that inhibits DDC in the periphery, is usually prescribed with L-DOPA as it can reduce adverse reactions induced by peripheral dopamine. The combination of L-DOPA and Carbidopa has the advantage of reducing the amount of L-DOPA transferred to peripheral tissues and increasing the amount transferred to the brain, thereby reducing the required dose of L-DOPA.

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2. Catechol-o-methyltransferase (COMT) inhibitor When DDC is suppressed, other pathways are activated instead. The activation of COMT is especially increased, leading to the reduced effectiveness of levodopa treatment. Therefore, COMT inhibitors, such as tolcapone and entacapone are also prescribed in combination with a combination of L-DOPA and Carbidopa.

This drug reduces the required dose of levodopa by moderating drug reactions and prolonging drug on-time. Because of these advantages, Stalevo, which combines all three, L-Dopa, carbidopa, and COMT inhibitor, is widely used.

<Fig.1 Dopaminergic pharmacotherapeutic strategies of Parkinson’s disease>

3. Monoamine oxidase B (MAO-B) inhibitor Dopamine is eliminated from the system in two ways. For one, the presynaptic neuron can re-uptake dopamine, and the second is it being destroyed by an enzyme called MAO. There are two types of MAO, MAO-A and MAO-B. while MAO-A metabolizes NE, Serotonin, and dopamine, MAO-B selectively metabolizes dopamine. This fact suggests that the concentration of dopamine can be effectively maintained if MAO-B is selectively suppressed. In addition, inhibiting MAO-B can be a way to avoid various drug interactions that can occur when MAO-A is inhibited. Therefore, MAO-B inhibitors are used to reduce drug induced motor fluctuation.

Fundamentally, it is meaningful in that all strategies prevent the loss of dopamine and increase the amount of dopamine.

Parkinson’s Treatment Candidate With New Mechanism Glucagon-like peptide-1 (GLP-1) agonist is a glucagon analog that prevents glucagon from playing a role in raising blood sugar levels, thereby lowering glucose. Additionally, dipeptidyl peptidase 4 (DPP-4) feeds on GLP-1. Thus, DPP4 inhibitors are widely used as hypoglycemic agents and improve glucose metabolism by enhancing the bioavailability of active GLP-1. Treatment with DPP4 inhibitors may have beneficial effects on nigrostriatal dopamine and longitudinal motor performance in diabetic patients with Parkinson’s disease. DPP-4 mediated GLP-1 activation has a direct relationship with monoaminergic neurotransmission, and dopamine synthesis and thus may have a major role in PD pathology. Moreover, pre-clinical and randomized controlled clinical trial reports suggest that GLP-1 receptor activation reduces the risk of PD and improves motor functions. Attempts to repurpose existing drugs will lead to the development of treatments for PD. B 2023 VOL.24

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Digital Therapeutics and the role of Pharmacists Journalist | Daeun Jeong | jolly1245@naver.com Designer | Soyun Kang | soyun525@yonsei.ac.kr

What is Digital Therapeutics?

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igital therapy is a combination of ‘digital’ and ‘therapy’, and its components can be divided into digital technology and treatment fields. In other words, digital treatments refer to medical devices that prevent, manage, and treat diseases based on software, not pills or injections taken to treat existing diseases. And digital therapeutics (DTx) is a software medical device to treat or alleviate a disease, disorder, condition, or injury by generating and delivering evidence-based therapeutic interventions that have a demonstrable positive therapeutic impact on a patient’s health. This should be followed by a clinical trial to provide the basis for the effectiveness of the treatment, and a strict approval procedure. It also may require a doctor’s prescription. The difference between digital treatments and conventional treatments is less toxicity, side effects, and relatively low development costs of the former. In addition, medication management is possible in real-time so patient data can be analyzed immediately, and the program can be adjusted and applied again.

The Role of Pharmacists Will pharmacists disappear when digital treatments are used vigorously? The answer is no. In the ever-evolving landscape of healthcare, the role of pharmacists has transformed tremendously with the advent of digital therapeutics.

Digital therapeutics, a groundbreaking field that utilizes software applications to treat and manage various medical conditions, has redefined how we approach healthcare. As a result, pharmacists are no longer just dispensers of medication but have acquired multifaceted roles in this new era. The scope of pharmacists’ ability has become wider than before.

1) Medication Management and Optimization Pharmacists continue to play a crucial role in medication management, ensuring that patients receive the right medications and understand their proper usage. However, in the age of digital therapeutics, they are also responsible for integrating digital therapies into a patient’s treatment plan. This includes overseeing the compatibility of digital therapeutics with conventional medications, ensuring there are no harmful interactions, and educating patients on the benefits of these digital interactions. Because digital therapy is a medical device that must be approved by the FDA, professional pharmacists must be involved. Therefore, pharmacists can participate in the process of evaluating the stability and effectiveness of the treatment. They can also participate in the research process to protect personal information of the patient’s clinical data and to ensure that it can be used correctly in the development of treatments.

Digital treatments can be settled in health care systems based on clinical data in favor of emerging personalized treatments.

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2) Patient Education and Empowerment Pharmacists have become educators in the digital age, guiding patients on how to use digital therapeutics effectively. They help patients navigate mobile apps, wearable devices, and online platforms designed to monitor and improve their health. This educational aspect extends to helping patients understand the data generated by these digital tools and how it correlates with their overall treatment plan. Digital treatments are being used for drug addiction, insomnia, diabetes, and ADHD, where pharmacists play a role in helping patients safely use the prescribed digital treatments. It is because some digital treatments require the expertise of professional pharmacists. One example is the digital game ‘Endeavor Rx’ for the treatment of ADHD in children. During this treatment, pharmacists take part in the patient’s counseling, and this information is delivered to the platform Phil Pharmacy through an EHR (Electronic Health Record, Electronic Health Record) called PhilRx. The platform pharmacy then sends the DTx registration code to the patient. Pharmacists monitor whether patients take drugs appropriately through the app and provides continuous medication counseling based on real-time health data. In this way, pharmacists can play a role in mediating patients to correctly use treatments.

3) Data Analysis and Personalized Care Pharmacists are increasingly being involved in data analysis, utilizing the vast amounts of information generated by digital therapeutics to tailor treatment plans to each patient’s unique needs. They can identify trends, potential issues, and opportunities for individualized care, thus enhancing treatment outcomes. Pharmacists can especially provide immediate feedback because real-time monitoring of continuous patient conditions is possible. Using these advantages, patients’ compliance with medication can also be increased.

In conclusion, the era of digital therapeutics has expanded the role of pharmacists, turning them into versatile healthcare professionals who not only dispense medications but those who also integrate digital solutions into patient care, educate and empower patients, and collaborate with other healthcare providers. As technology advances, the role of pharmacists will continue to evolve, providing patients with more comprehensive and personalized care in the digital age.

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Pharmaceutical Market Dynamics and a Faster Assay Technique for Keeping Up Journalist | Jungyoon Ryu | jungyoon_r@yonsei.ac.kr Designer | Hwan Lee | zkou3859@yonsei.ac.kr

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any prestigious scientists and pharmacists are jumping into the game of drug development, especially that of first-in-class, blockbuster drugs, as the success of one project entails the honor of contributing to global healthcare and, frankly, lavish profits. As the high prospects and profitability of the pharmaceutical industry are becoming more widely recognized, the race for the preoccupation of a market of a new drug is growing intense. While there are several categories of drugs in terms of novelty and effectiveness (e.g., brand-name drugs, generic drugs, first-in-class, best-in-class), in the game of drug development, apparently, the fastest wins the race.

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A Brief Introduction to Organ-on-a-Chip

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Obtaining first-in-class status is the most appealing outcome for drug developers on several levels. According to a recent study on the current market dynamics of the pharmaceutical industry, first-to-launch products exhibit markedly better financial performance in the new market than even second-and-best followers. It shows that this tendency especially stands out in products related to oncology and those that introduce breakthrough therapies or designate orphan drugs.

However, even putting profit aside, it has been shown by a study in public health and social pharmacy that first-in-class drugs are associated with larger incremental QALY gains than next-in-class drugs. (Incremental QALY gains reflect the enhancement in quality and quantity of life induced by therapy or intervention of interest.) This implies that first-in-class drugs confer greater health benefits relative to standard therapies at the time when compared to next-in-class drugs.

Hence, developing first-in-class drugs with new mechanisms of action is mutually beneficial to both patients and financial stakeholders. Likewise, when concerning new drugs of priorly established classes, it is essential to be the first to secure approval of a new drug application (NDA) since drugs with novel aspects (e.g., molecular moieties, drug modalities) are eligible for exclusivity. Exclusivity is a period of time during which an original, brand-name drug is protected from competition via prohibition of market entry by generic drugs. There are two main types of exclusivities: intellectual property exclusivity, which takes the form of a patent, and regulatory exclusivity, controlled by the health authorities.

Intellectual property exclusivity can be approved and expired irrelevant of approval status once a drug’s originality is validated. On the other hand, regulatory exclusivity is granted to NDA holders by the FDA as part of its effort to balance innovative drug introduction and equitable access to drugs. Both exclusivities must be waited out for a generic to get approval. Hence, during this period, the first company to develop a drug earns the exclusive rights to profit from that drug category. After exclusivities expire, the market is flooded with generics, from which point supply drives the price of the original down.

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COLUMN Still, there are instances where best-in-class drugs with therapeutic advantages over their faster counterparts exceed them in terms of commercial success. One illustration of this case would be that of atorvastatin (Lipitor; Pfizer) and lovastatin (Mevacor; Merck): atorvastatin, the fifth but best entrant, achieves greater sales than lovastatin, the first entrant in the class of statins. However, a more systematic review of the pharmaceutical market revealed that fast-followers must enter the market not long after (statistically in less than two years) the launch of the first entrant. Plus, there must be exceptional benefits over drugs launched first or be part of a unique mechanistic class of drugs, namely, one that necessitates the provision of secondary options to surmount the handicap of being a follower. Therefore, although effectiveness and beneficial modifications are relevant to promoting preferences exhibited in the market, such findings additionally corroborate the fact that speed is a non-negligible and chief factor in drug development for financially successful drugs.

Since entering a new drug market first is strikingly important for procuring a prominent stand in it, speed is a crucial factor to consider when initiating a pipeline for a novel drug. Therefore, the incorporation of efficient and precise tools in the developmental procedure is vital. The process of drug development can be categorized largely into 5 major stages: 1) early drug discovery, 2) preclinical research, 3) investigational new drug (IND) application, 4) clinical research, and 5) regulatory review, approval, and post-marketing safety surveillance. Strategies for accelerating developmental procedures include exploiting regulatory detours such as fast track or minimizing the time needed for drug discovery.

One option for employing the latter of the two said strategies for expediting the drug development process is to invent faster and more convenient assays for testing probable drug ingredients. In this respect, organs-on-chips are gaining interest as an alternative to and enhancement in conventional testing methods.

The organ-on-a-chip (OoC) is a microfluidic device containing three-dimensional miniature tissue cultures that serves as an in-vitro platform for biochemical and physiological research. It consists of 3D cell cultures immersed in pico- to milli-scale volumes of solution deliberately delivered through very fine microchannels. These solutions are designed so as to imitate the microenvironment of native organs or tissues and reproduce tissue-specific functions. The threedimensionality of the tissue cultures facilitates in-vivo-like interplay between cells and the microfluidics element allows for chemical time gradients to be applied to the cultures, thereby mimicking the dynamical alterations in microenvironments under physiological conditions. Yet more, mechanical pressure can be exerted on the cells in order to mimic movements of live organs. Due to these aspects, OoCs are a more precise means of in-vitro testing of physiological responses to drugs over two-dimensional and three-dimensional cell cultures. While the more biologically complex animal model holds greater physiological relevance, it has the drawback of having unpredictable discrepancies from human physiology and difficulties in experimental assessment of physiological processes.

OoCs will not only serve as potential alternatives to animal testing, which bear controversy regarding ethical issues and are financially consuming, but also will step up drug development processes, owing to their convenience and reliability in testing and ease of mass production due to low-costs and technological availability.

Therefore, implementing OoC technology in assays for drug discovery and pre-clinical research will speed up drug development by allowing multiple tests to be run concurrently and minimizing failure rates of clinical trials via precise predictions of physiological responses to drug candidates. Faster assays devised in integration with innovative bioengineering technology such as OoCs can be key to surviving in the speed-oriented industry of pharmaceuticals. B

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Data Science in Pharmaceutical Industry Journalist | Chaerin Oh | cherin02@naver.com Designer | Jini Jeong

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| 6265mmm@naver.com

ne of the most high-profile academic areas in modern society is data science. It simplifies human decisionmaking processes and helps to produce optimized results. From the available data, we not only draw information to predict patterns, but we also look further at new growth opportunities.

Data scientists are sometimes called the most attractive profession of the century, as these data sciences are highly likely to be applied in convergence with different industries. The three components of data science are computer science, major knowledge, and statistics. Depending on which discipline enters the major knowledge at this time, the method of using data science is completely different.

So, how is data science used in pharmaceuticals? Some argue that pharmacies in the future will be transformed by digital healthcare. Companies have jumped on the flow of digital healthcare through the development of wearable and AI-based counseling algorithms. United States, the pioneer country of digital health care, is providing various medical innovation policies divided into build of big data and reformation of regulation. For example, United States is working on the ‘All of Us’ project collecting medical records of millions. Their ‘Pre-Cert’ project had changed the target of pharmaceutical regulation from product to the manufacturer. However, going further beyond these technologies, the current pharmaceutical industry is agonizing over which technologies to pay attention to and which movements to take.

The increased interest in data science in the pharmaceutical field is also largely due to the COVID-19 outbreak.

This is because data science has helped to manage the COVID-19 crisis. Moreover, the change of society such as the spread of contactless economy and increase of chronic disease patients is also raising interest in data science. In Korea, a program was developed to analyze several data such as the impact of drug use on infection rates and the probability of death, and an analysis program that could utilize hospital data was provided.

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In the field of bio-research, an algorithm is being developed to select customized anticancer drugs from identifying drug mechanisms based on advanced genome analysis technology. Big data is used in the development stage of new drugs. The development period, cost, and low success probability, which are obstacles to new drug development, can be solved by using big data and future AI technology. Genomes containing vast amounts of data are not easy to analyze.

However, AI can lay the foundation for the development of new drugs by grasping the relationship between genetic mutations and diseases.

However, in the Republic of Korea, the usage of data in the pharmaceutical field is limited. In the domestic pharmaceutical industry, unlike overseas pharmaceutical industries, there are restrictions on the use of Real World data (RWD) and Real World evidence (RWE). RWD means practical data from various references such as surveys, medical records, and health insurance reports. RWE refers to ordinary evidence obtained by analyzing RWD which can be used to check the safety and efficiency of drugs. In the Republic of Korea, there is data that will help the production of drugs by the National Health Insurance registered to the entire citizens.

Nevertheless, in the usage of data, data analysis is possible only with the approval of the research plan after a strict deliberation process. This kind of restriction limits the liquidity of research and makes it impossible to cope with reflected or unexpected results because researchers cannot expect every single possibilities during the planning stage. In fact, most domestic pharmaceutical companies say they have no experience using RWD during their production of drugs. Amid the spread of RWD use in the previous period of drugs mainly in advanced countries, the problems mentioned above can be seen as restrictions and policies that do not fit in the trend of the times.

Even though such regulations exists in domestic pharmaceuticals, they are getting ready for the future pharmaceutical industry. Many pharmacy schools in Korea are providing classes on drug data. Leading future pharmacists from big data analysis to AI utilization seems to be a step in line with the trend of pharmaceuticals in modern society. The ability to produce, process, and utilize pharmaceutical data will become a factor in evaluating the capabilities of future pharmacists and a quality that the pharmaceutical industry should seek. B

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Unmasking the Threat of Counterfeit Medicine Journalist | Siyun Hwang | siyun8097@naver.com Designer | Youngseo Park | selly4577@yonsei.ac.kr

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n today’s interconnected world, the availability of medicines has never been greater. However, lurking beneath the surface of this pharmaceutical abundance is a shadowy menace – counterfeit medicine. Counterfeit drugs are a global health crisis that not only jeopardises patient safety but also undermines the integrity of the healthcare system. This article will delve into the perilous world of counterfeit medicine, shedding light on its causes, consequences, and the measures being taken to combat this growing threat.

The Counterfeit Medicine Epidemic Counterfeit medicine refers to fraudulent pharmaceuticals that mimic legitimate drugs but lack the active ingredients necessary for therapeutic efficacy or, even worse, contain harmful substances. These fake medicines are often indistinguishable from their genuine counterparts, making it exceedingly difficult for consumers and healthcare professionals to detect them. The World Health Organization (WHO) estimates that up to 10% of drugs available worldwide are counterfeit, a figure that rises dramatically in certain regions, particularly in low- and middle-income countries.

Recent examples of counterfeit medicines include vaccines, including those for COVID-19, as well as weight loss supplements, which contained undisclosed or dangerous ingredients that can harm consumers.

Causes of Counterfeit Medicine Several factors contribute to the proliferation of counterfeit medicine including lucrative weak regulatory profits, systems, and globalization. Counterfeit drugs are a highly profitable criminal enterprise, with estimated annual earnings exceeding $75 billion. The allure of such financial gain incentivizes organized crime groups and unscrupulous individuals to engage in counterfeit drug production. Also, inadequate regulatory systems in some countries create loopholes that counterfeiters exploit. Insufficient oversight, lax law enforcement, and corruption enable the illicit trade of counterfeit medicines to thrive. Furthermore, the globalization of pharmaceutical supply chains has made it easier for counterfeit drugs to infiltrate legitimate distribution networks. These products often pass through multiple hands before reaching patients, making it challenging to trace the source of contamination.

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Consequences of Counterfeit Medicine The consequences of counterfeit medicine are far-reaching and dire. Patients who unknowingly consume counterfeit drugs are exposed to severe health risks. Ineffective or substandard medications can exacerbate illnesses, lead to treatment failure, or even cause fatal outcomes. Additionally, counterfeit drugs may contain toxic substances, allergens, or incorrect dosages, further endangering patients’ lives. Counterfeit antibiotics and antimalarials, in particular, contribute to the development of drug-resistant pathogens. When patients receive suboptimal treatment, surviving pathogens can become more resilient and resistant to genuine medications.

The economic impact of counterfeit medicine extends beyond healthcare costs. It erodes trust in healthcare systems, discouraging individuals from seeking medical treatment when needed, and driving up overall healthcare expenses due to complications arising from counterfeit drugs.

The prevalence of counterfeit drugs erodes public confidence in the pharmaceutical industry and regulatory bodies. Patients may become sceptical of the drugs prescribed by healthcare professionals, potentially leading to non-compliance with prescribed treatments.

Combating Counterfeit Medicine Efforts to combat counterfeit medicine are being undertaken on multiple fronts: 1. Regulatory Enhancements: Many countries are strengthening their regulatory frameworks to better monitor and control pharmaceutical supply chains. Stricter regulations, improved tracking, and serialization systems are being implemented to trace drugs from production to distribution.

2. Technological Solutions: Emerging technologies such as blockchain and QR codes are being leveraged to provide transparency in the supply chain. These innovations allow consumers to verify the authenticity of medications before purchase.

3. International Cooperation: International collaboration is essential to tackle the global nature of counterfeit medicine. Organizations like WHO, Interpol, and pharmaceutical companies are working together to share intelligence and coordinate efforts to combat this problem.

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Public Awareness: Educating the public about the risks of counterfeit medicine is crucial. Awareness campaigns, both at the national and international levels, aim to empower consumers to make informed choices and report suspicious products.

Counterfeit medicine poses a significant and growing threat to global public health. Its far-reaching consequences, including health risks, economic burdens, and the erosion of trust, necessitate concerted efforts to combat this menace. Enhanced regulatory measures, technological innovations, international cooperation, and public awareness campaigns are steps in the right direction. As individuals, healthcare professionals, and policymakers, it is our collective responsibility to unmask the hidden peril of counterfeit medicine and safeguard the health and well-being of individuals worldwide . B

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telemedicine and nonreimbursable high-risk medication Journalist | Da Won Lee | dalee5451@yonsei.ac.kr Designer | J­in Yeong Kim | kimjin02000@yonsei.ac.kr

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he Korean Pharmaceutical Association warned of the risk of non-reimbursable high-risk medications being prescribed by non-contact medical care in the ‘Public Hearing on Telemedicine Pilot Project” held on September 14. A vice-chairman of the Korean Pharmaceutical Association said, “non-face-to-face treatment of non-benefit medications may result in the absence of a management system as those medications are not reported to the Public Health Center. Also, he is concerned about the danger of undiscerned distribution of nonreimbursable high-risk medications via trading sites.

Before delving into the topics, let's first learn about how telemedicine has been implemented in South Korea. In the past, patients inevitably had to visit a pharmacy in person to get their prescriptions. However, with the advancement of technology, it has become possible to receive medications remotely. Consequently, many countries gradually allow patients to obtain their medications non-face-to-face. For instance, Phone consultation or prescription (PhoneTx) was temporarily allowed in Korea during the COVID-19, due to the risk of infection. This unexpected accident provoked the necessity for non-face-to-face care, “Telemedicine”, the remote delivery of healthcare services using technology, is also known as e-medicine.

In South Korea, the pilot project for remote medical consultations was implemented on June 1st this year, limited to follow-up patients and those requiring essential medications. In this respect, remote delivery of medications was allowed but under restricted conditions. Telemedicine has both advantages and disadvantages, leading to ongoing debates regarding its full-scale implementation, as shown in the discussion ‘Public Hearing on Telemedicine Pilot Project’.

Telemedicine has some great advantages for patients. Telemedicine offers patients the convenience of sending medicines to their homes. This benefits those in remote or underserved areas with limited access to medical services. Patients also can avoid the danger of infection by visiting the pharmacy, and even, patients with chronic illnesses can easily have revisits remotely.

However, telemedicine also comes with drawbacks. One of these is the security risk, as there is an increased possibility of patient information being exposed, jeopardizing confidentiality. Additionally, patients who are not proficient in using technology, known as ‘technologically illiterate’, may find it demanding to navigate telemedicine platforms. Moreover, diagnosing accurately might be challenging in cases where a physical examination is necessary. Finally, as mentioned earlier, there is a pervasive risk of the misuse of non-reimbursable high-risk medications.

Examples of Restricted Prescription Drugs in Foreign Telemedicine Then, how are other countries implementing telemedicine restrictions on prescription drugs?

Japan: Prescription of narcotics and psychotropic substances is prohibited. Medications requiring safety management for patients with incomplete information on basic conditions cannot be prescribed for more than 8 days. Diuretics and diabetes medications for weight loss purposes are also restricted. Especially, medications such as erectile dysfunction drugs are not prescribed through online consultations if information for safety precautions is not fully obtained Germany: Electronic prescriptions are not yet permitted for narcotics, dosing devices, and T-prescriptions (medications containing active ingredients like lenalidomide, pomalidomide, or thalidomide).

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United Kingdom: Certain types of medications cannot be prescribed without safety measures. Clinical practitioners can prescribe regulated drugs, when necessary, but verification of identity must occur.

Australia: Prescriptions for narcotics under 'Schedule 8' and medications like painkillers, sleeping pills, and steroids under 'Schedule 4 Appendix D' are restricted in New South Wales.

United States: Electronic prescribing is mandatory for all narcotics and psychotropic drugs in Schedule 2, 3, 4, and 5. EPCS (Electronic Prescribing of Controlled Substances) has been implemented in Medicare Part D and Medicare Advantage rx insurance plans, starting January 1, 2023. This means healthcare providers prescribing medications to patients must adhere to ‘electronic prescribing’ for narcotics and psychotropic substances. Many state governments within the United States, not just the federal government, have either mandated or are planning to mandate electronic prescriptions for narcotics and psychotropic drugs.

France: Some drugs with the risk of narcotic addiction cannot be prescribed after remote consultations.

Additionally, painkillers are categorized by pain intensity. The strongest Grade 3 painkillers are not allowed to be prescribed after remote consultations.

What are the non-reimbursable high-risk medications referred by the Korean Pharmaceutical Association?

The Korean Pharmaceutical Association referred to 14 different non-reimbursable high-risk medications. The 14 medications are as follows: 1. Epilatiorium(hair loss treatment) including five ingredients - minoxidil, finasteride, dutasteride, dutasteride combined with tamsulosin hydrochloride, and finasteride combined with minoxidil 2. Acne and wrinkle-reducing medications including five ingredients - isotretinoin, tretinoin, hydrocortisone combined with tretinoin and hydroquinone, erythromycin combined with tretinoin, and fluocinolone acetonide combined with hydroquinone and tretinoin 3. Obesity medications including two ingredients - sibutramine sulfate and orlistat 4. Emergency contraceptives(morning-after pills) including two ingredients - levonorgestrel and ulipristal acetate Hair loss treatments, acne medications, obesity drugs, emergency contraceptives, and others can be teratogenic and have serious side effects. These include abnormal blood pressure, pyknocardia(frequent pulse), and increased risk of heart attacks and strokes for cardiovascular patients. Furthermore, medications like ‘finasteride’ or ‘dutasteride’ can be absorbed through the skin even if touched, emphasizing the urgent need for proper administration guidance and supervision. However, due to the shortcomings of telemedicine, these medications can pose some significant risks.

The Future of Telemedicine

Although the positive aspects of telemedicine discussed during the public hearing were not elaborated upon in detail in this article, opinions about telemedicine are divided. It is crucial to weigh both the convenience telemedicine offers and the risks it poses. Telemedicine should be implemented in the most appropriate way, considering both its advantages and drawbacks. B

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Pathbreaking Anti-Obesity Drug: KDS2010, a Brain’s WeightControl Switch Introduction | jennylee_525@yonsei.ac.kr Journalist | Hyunjin Lee Designer | Youngseo Park | selly4577@yonsei.ac.kr

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new infectious disease of the 21st century has emerged: “obesity”, and its global population reached 988.8 million in 2020 and will increase to 1.91 billion in 2035. Just as the obese population is expected to continue to increase, the obesity treatment market is also expected to grow steadily. And finally, good news has been delivered to as many as 1 billion obese patients worldwide: KDS2010, a novel drug that regulates fat metabolism in astrocytes. Existing drugs related to body fat reduction control appetite to some extent, but there were several problems causing other complications, such as depression. This is because the drugs suppress the patient’s appetite through nerve cells. However, by finding a “weight control switch” in the brain, researchers solved the relationship between non-neural cells and obesity, not the nerve cells. This pathbreaking anti-obesity drug, KDS2010, is significant in which shows no side effects and has a better weight loss effect than the existing one.

What is KDS2010?

A newly developed drug, KDS2010 is a selective and reversible MAO-B inhibitor that plays a key role in regulating fat metabolism and obesity. It successfully facilitated weight loss in obese mice without resorting to dietary restrictions. Previous obesity treatments, such as phentermine, mazindol, and fluoxetine, mainly target the hypothalamus and focus on neuronal mechanisms related to appetite regulation. To overcome the problem of oppressing the appetite, the researchers focused on the non-neuronal ‘astrocytes’ and discovered that clusters that specifically express the receptor of the inhibitory neurotransmitter ‘GABA (Gamma-Aminobutyric Acid)’ of reactive astrocytes cause obesity. In fact, this cluster has been found to be associated with the α5 subunit of the GABA A receptor and was hence named the GABRA5.

Under obesity conditions, astrocytes show reactivity, increasing the production of MAO-B enzymes. This increase in MAO-B overproduction of astrocytic GABA inhibits the activity of surrounding GABRA5 neurons, resulting in suppressed fat combustion and leading to fat accumulation. Therefore, the MAO-B enzyme in reactive astrocytes can be an effective target for obesity treatment without comprising appetite. KDS2010 will be groundbreaking as it inhibits increased MAO-B enzymes to prevent GABA overproduction and restores GABRA5 neuron activity to restore normal fat metabolism. Simply put, KDS2010 is a candidate for innovative obesity treatment with a new mechanism that can be “free from side effects such as eating” and “free from regaining weight”.

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KDS2010 and Weight Loss Hunger and energy balance in the body are controlled by the brain’s lateral hypothalamus (LH) and the lateral hypothalamic area (LHA). One of its main functions is to stimulate feeding behavior and cause the sensation of hunger. These neurons in the LH are connected to fat tissue which regulates fat metabolism with the astrocytes.

GABA helps ensure the body has the energy to function by controlling when people feel hungry and letting them know when they are satiated by blocking the hunger signal and thereby avoiding overeating.

The nerve cell cluster “GABRA5 (GABRA51)”, specifically expresses the receptor of GABA, an inhibitory nerve substance, was discovered in the lower part of the lateral vision. The activity of GABRA5 was suppressed by chemogenomic methods, heat generation and energy exhaustion of adipose tissue was reduced, fat was accumulated, and weight was increased. On the other hand, when GABRA5 in the lower part of the lateral vision was activated, weight was decreased, and showed a significant decrease in the obese mouse model. In other words, GABRA5 nerve cells are a “weight control switch”. Thus, the key to weight control is restoring GABRA5 neurons, which are regulated by the reactive astrocytes in the LH, and by KDS2010, a selective and reversible MAO-B inhibitor.

Future of anti-obesity drug, KDS2010 Obesity has various patterns in the progression of causes and symptoms and as responsiveness to therapeutic drugs is different, it is crucial to develop obesity treatments with various mechanisms of action. Targeting astrocytes in the hypothalamus was the groundbreaking of anti-obesity drug treatment: KDS2010. Additionally, the development of KDS2010 is not limited to the academic realm and advancing its potential as a game changer in obesity treatment as it involves the collaboration with the biotech company Neurobiogen, which is currently spearheading Phase 2 clinical trials. Furthermore, since astrocytes are associated with nerve cells, they can also be extended to research on the treatment of various diseases such as Amyotrophic Lateral Sclerosis disease and rheumatoid disease, thus various spinoffs will be possible. Therefore, KDS2010, which is differentiated from existing obesity drugs that pre-block energy absorption from outside, is highly likely to be a first-in-class drug. B

Conclusion Obesity is seriously threatening the health of modern people to the extent that it is classified as a “novel infectious disease in the 21st century” and designated as one of the world’s top 10 health risk factors. Effective obesity treatment can be hopefully achieved by KDS2010 with no appetite suppression, and it will emerge as a next-generation obesity treatment. B

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Advancements in Drug Development aim to tackle the obesity epidemic Journalist | YoonAh Jung | nyoonah@yonsei.ac.kr Designer | DaHyun Ryu | dahyunryu17@gmail.com

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besity is recognized as a major pandemic of the 21st century, contributing to increased morbidity, mortality, and the burden of healthcare costs. Internationally, one in five adults now have obesity. The Global Burden of Disease study reports that overweight and obesity are the fourth leading risk for global deaths, and more than 4.7 million adults die each year as a result of overweight or obesity. Therefore, the development of treatments to treat obesity has been steadily attracting attention in the pharmaceutical industry for more than 60 years.

Why is it difficult to develop an Anti-Obesity drug?

Early anti-obesity drug studies targeted molecular mechanisms that control appetite, but most of them showed side effects such as cardiovascular side effects, increased suicide risk, or increased drug dependence and abuse. Penfluramine, a leading anti-obesity drug, was approved by the FDA in 1996 but banned for its side effect, and Sibutramine was approved in 1997 but withdrawn due to increased cardiovascular risk.

Among the obesity treatments currently in use, certain drugs are recommended for short-term use due to the possibility of addiction and faster heart rate. Because of the inadequate efficacy, side effects, and drug resistance that often appear, long-term drug therapy for obesity remains as a challenging task.

https://themedicalbiochemistrypage.org/obesity-metabolic-and-clinical-consequences/

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GLP-1 analogue drugs used as a treatment for obesity

GLP-1(Glucagon-Like Peptide 1) is one of the Incretin hormones, secreted by L cells in the small intestine when food is consumed or blood sugar rises. GLP-1 binds to the pancreatic GLP-1 receptor to increase insulin secretion and suppress glucagon secretion, lowering blood sugar, which is effective in treating type 2 diabetes. In addition, GLP-1 has a weight loss effect by inhibiting NPY/AgRP, a neuron that acts on the hypothalamus to induce satiety and promote appetite. This mechanism allows GLP-1 analogs to act as obesity treatments.

“Saxenda (component name: Liraglutide)” is a GLP-1 analog obesity treatment that acts as the same mechanism as the hormone GLP-1. Using the mechanism of the above GLP-1 hormone, 9.2% of the patient’s weight was reduced one year after administration, and the effect of maintaining weight loss was also proved. Saxenda was also safer than other drugs that was used for obesity treatment, and it was ranked first in the obesity treatment market market share.

https://www.medpagetoday.com/special-reports/features/102773

Research Trends in Future GLP-1-analogue Treatments

As the obesity rate of people around the world increases, the obesity treatment market is greatly increasing. In the seven largest markets (US, France, Germany, Italy, Spain, the UK, and Japan), the obesity treatment market is expected to grow rapidly to $37.1 billion in 2031, according to ‘Global Data’. Currently, GLP-1 analogue drugs with better effects are being developed, led by ‘Wegovy’ and ‘Mounjaro’, which have the best effects among current obesity treatments.

In addition, drugs developed by improving the side effects of existing obesity treatments are being released. The ‘Olix’ company announced the results of clinical trials of ‘OLX702A’, which is being developed as a treatment for obesity.

Unlike existing drugs that cause yo-yo effect when stop taking the obesity treatment, a drug called ‘OLX 702A’ attracted attention because it did not cause a yo-yo effect. In addition, efforts are actively underway to change the existing obesity treatment to oral medication because current injection method has the disadvantage of using it.

There are still many challenges to be solved in obesity treatment technology. Korea Bio Association presented problems such as duration of use, drug response rate, expensive drug prices, and controversy over overweight-health causality. Obesity drugs are certainly effective drugs, but they should be accompanied by individual efforts to maintain proper habits with medication. This is because only drug administration cannot be a solution to obesity. There are still many challenges to be solved in the development of obesity treatments. The pharmaceutical industry should make efforts to develop practical and safe obesity treatments through continuous research and innovative approaches. B

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Cancer Therapy: Heavy Ion Therapy Journalist | Seoyeon Choi | sy_iloveu@naver.com Designer | Jini Jeong | 6265mmm@naver.com

Implementation of Heavy Ion Cancer Therapy

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t the end of 2022, Yonsei medical center introduced the first Heavy ion treatment device in Korea. Heavy ion therapy requires specialized facilities and is only operated in about 10 facilities in 16 countries around the world. The heavy ion therapy device installed at Yonsei Medical Center is the world’s 16th facility and started operating for the first time in April 2023 after test operation. 1200 cancer patients are expected to receive treatment each year.

About 70% of cancer patients receive radiation therapy alone or in combination. Radiation therapy mostly uses x-rays or gamma rays, which can be less effective in treating the cancer as the radiation dose decreases dramatically. Japan’s Institute of Radiology (NIRS) started treatment at Heavy Ion Medical Accelerator in Chiba (HIMAC) for the first time in the world in 1994, and has now treated more than 11,000 cancer patients. The technology itself first began to be investigated in the United States, but there is still no baryon accelerator in the United States. In addition, most hospitals and institutions cannot establish baryon accelerator centers because baryon accelerator centers have high construction and maintenance costs.

Radio therapy- What is Heavy Ion Therapy?

Heavy ion cancer therapy, also known as heavy ion therapy or particle therapy, is an advanced form of radiation therapy used to treat certain types of cancer. Traditional radiation therapy uses X-rays or photons to target and destroy cancer cells. Heavy ion therapy, on the other hand, uses charged particles, typically protons or carbon ions, to deliver radiation to the tumor. It deposits ionizing radiation in cancer cells via accelerated charged particles that are heavier than protons. First, a narrow beam of heavy ions is accelerated in a particle accelerator to give enough energy to the ions to penetrate to the depth of the cancer within the human body and kill cancer cells. In general, the speed of the ion correlates with the energy it carries. For example, a speed of approximately 2/3 to ¾ the speed of light is needed for the ions to achieve the energy needed to reach a deeply located tumor (30 cm) in a large patient. After the ions reach the desired speed and energy, they are extracted from the accelerator and are magnetically guided to patient treatment rooms. The ions leave the magnetic transport system and are focused on cancers. They enter through the patient’s skin and travel to the cancer to deposit the therapeutic dose of ionizing radiation. The narrow incident beam is magnetically scanned, and its energy changed to effectively form a broad beam to “paint” the entire volume of the tumor target with ionizing radiation.

Typically, multiple such broad beams, incident from different directions, are used to lower the dose outside the tumor and to optimally spare the surrounding normal tissues. There are some key aspects of heavy ion cancer therapy:

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1 Process of heavy ion therapy

Pros and Cons of Heavy Ion Therapy 1. Precise targeting - Heavy ion therapy can precisely target tumors with complex shapes or those located near critical organs. With conventional radiation therapy That use x-rays and r-rays, a large radiation dose is inevitably deposited near the surface of the body and the dose diminishes in strength thereafter. Deep seated tumors will not receive sufficient damage and healthy tissues will also be irradiated. On the other hand, heavy ion irradiation therapy can pinpoint the target with accurate irradiation according to their Bragg Peak, and deliver sufficient damage to target cancer while minimizing damage to healthy tissue. Heavy ion and proton beams have characteristic that called “bragg peak” which enables high dose to be administered to the tumor while limiting the dose to the surface of the patient’s body. The high precision helps minimize damage to healthy tissues and reduces side effects.

2. Increased biological effectiveness- Heavy ions have a higher linear energy transfer (LET) than x-rays. This high LET results in a greater biological effectiveness, meaning they cause more damage to cancer cells per unit of radiation dose. This is particularly beneficial for tumors that are resistant to conventional radiation therapy. Especially, it is said to have a particularly good effect on prostate cancer in Japan which has a lot of experience in heavy ion treatment. Also, without incision or pain, it is a gentle treatment even friendly to the elderly. According to the currently accumulated data, it is more effective than conventional photon treatment, but it is difficult to directly compare and analyze with radiation therapy due to a lack of heavy ion facilities.

3. Limitations and considerations- Heavy ion therapy is not suitable for all types of cancer. The decision to use this treatment is made based on the specific characteristics of the tumor, its location, and the patient’s overall health. Also, it is a costly and resource-intensive treatment, and its availability may be limited to certain specialized medical centers.

Due to the lack of facilities and insufficient research data, it remains uncertain how future cancer treatments will evolve, once proton therapy becomes more widespread treatment. However, the ability to treat areas where surgical method can’t be used and reduced side effects (minimal impact on surrounding cells) can become significant advantages.

With Yonsei medical center’s introduction of this technology, we might be able to look forward to our future without cancer. B 2023 VOL.24

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LIFE ISSUES

Proper and Exact Ways of Taking Medication For Elders Journalist | Hoyeon Dam | sjk28ho@gmail.com Designer | Youngseo Park | selly4577@yonsei.ac.kr

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n most Asian countries, the proportion of elderly people is getting larger and larger. Many industries thereupon have invented something helpful for these people such as silver towns which residential complexes with a collection of facilities and residences designed to comfortably suit the elderly over the age of 60 and help them live a wholesome life. By receiving the supports they need, they can live a longer life.

People tend to get sick when they age. However, medical technology has improved significantly, and accordingly, people’s average age has increased too. Therefore, the desire to live a healthy life has reached the highest point. To resolve this phenomenon, lots of specialists in the pharmaceutical industry invented new medication for these people. Since medications only work when they are used correctly, people must take medications as they were instructed to. They should never take drugs more or less than recommended by pharmacists.

The elderly often forget the instructions and try to take medications based on their own judgements. This is very harmful because the medication may cause side effects if they are not treated properly, especially in elders. The high risk of drug side effects in the elderly can lead to complex interactions between the various medications they take. Also, as the body gets older, the treatment effect and side effects can appear at the same time because due to the deterioration of liver or kidney functions it becomes difficult to metabolize normal medications in the body. Fortunately, there are some ways to prevent these risky circumstances, which are stated beneath.

First, patients should tell their doctors or pharmacists what medication they are currently taking in detail so that the doctors and pharmacists can provide their patients with the right medications.

Second, patients must alert their doctors or pharmacists if they have new symptoms when they take their new medications since it may be a side effect from the medicine. The common side effects for the elderly are indigestion, heartburn, kidney dysfunction, fatigue, dizziness, edema, and so on. They should tell these symptoms to their doctors or pharmacists as soon as possible.

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Third, patients should adhere to medication guidelines. If a product doesn’t have to be refrigerated, they should store it in a dry and cool place. They should not arbitrarily split or grind medications. In addition, patients should take their medicine with water, if they take medicine with coffee, dairy products, juice, etc. the effect of the medicine may decrease.

Fourth, Take the medicine at a fixed time.

Medicine which is taken before meals: It is a medicine whose absorption is interfered with by food, or one that should be taken before meals depending on its mechanism of action of the medicine. Some digestive and stomach acid inhibitors are taken before meals so that it can help smooth the digestive process and relieve stomach stress.

Some mineral supplements can also be taken before meals to help increase absorption or maximize effectiveness.

Medicine which is taken between meals: Minimizes possible interactions with food; to let the therapeutic effect appear quickly, take between meals. It is important to take medicine on an empty stomach. An acid agent that neutralizes gastric acid is a good example of this kind of medicine. If you take it for 1 to 2 hours after a meal with high acidity in the stomach, it can effectively reduce the pain caused by stomach acid.

Medicine which is taken after meals: It is a medicine that shows increased effects when taken with food, or one where the food ingested can protect the gastric mucosa and reduce side effects such as heartburn.

Medicine which is taken before bedtime: If drowsiness occurs after administration, it is recommended to take it before bed to reduce side effects since it can cause accidents while driving, operating a machine, etc.

The solutions stated above are what patients can do by themselves. However, there might be possibilities that they forget these easily due to amnesia, which is a common condition among the elders. For these cases, there is a mobile application that provides a mobile prescription inquiry service that allows users to view and manage information about prescribed drugs. Through this service, people can easily view and manage the efficacy and precautions for the prescribed drug by scanning the QR code included in the prescription. It also provides a medication notification function so that elders can take the medicine on time, and it is configured so that guardians can also view and manage prescriptions. If you are curious about your medication information, you can check it again at any time, so it shows high satisfaction rates in patients and patient experience management. The medication notification is composed of medicine names, efficacy, and medication information, as well as an easy-to-understand picture of the medicine, medication methods, and precautions, helping patients take medication correctly.

In the future, for patients with chronic diseases or allergies, it will provide customized health information of prescribed medications. B

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Excellence in Technology of KIST Doping Control Center

Journalist | Jaeeun Park | ong114164@naver.com Designer | Hwan Lee | zkou3859@yonsei.ac.kr

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he 2022 Hangzhou Asian Games was held from September to October this year. When global sports events such as the Asian Games and the Olympics are held, the problem which always emerges is ‘drug doping’. To maintain the integrity of sports and safeguard the health of athletes, rigorous doping control measures are important. The World Anti-Doping Agency(WADA) is an international organization that aims to promote, coordinate and monitor all kinds of anti-doping in sports, and actively encourages anti-doping movements. There are only 27 doping analysis institutions around the world certified by WADA, and the Doping Control Center(DCC) in KIST is the only one in South Korea. The Technology of KIST DCC has been recognized worldwide, and according to the 2020 World Doping Center Technology report released by WADA, Korea was evaluated as one of the TOP3 countries with growth hormone promotion factors and biomarker detection methods, along with the United States and Brazil. The year before last, the center was asked to cooperate with Japan in the 2020 Tokyo Olympics and received attention from people within Korea.

Advanced Testing Methods The KIST DCC conducts a comprehensive range of tests, and its ‘Biomarking Factor Detection’ technology is one of the latest breakthroughs in this field. It is a cutting-edge method designed to uncover the subtle traces of growth hormone manipulation in athletes’ bodies. In the meantime, detecting performance enhancing substances like growth hormones has been a challenging task due to their rapid metabolism. Growth hormones are used to strengthen athletes’ muscles, prevent them from injuries and enhance their recoveries from injuries at an abnormal rate. However, the ‘Biomarking Factor Dectection’ analyzes intermediate substances that mediate the effects of growth hormones. These intermediate substances are called biomarkers, and they can be identified and quantified using mass spectrometry and chromatography. Mass spectrometry allows scientists to accurately measure the mass and infer the structure of biomarkers. Chromatography separates complex mixtures into individual components, enabling precise analysis. By targeting specific biomarkers associated with growth hormone manipulation, researchers can now detect even the slightest traces of doping substances in athletes’ urine samples reducing the likelihood of false positives. The mass spectrometry and chromatography capabilities of KIST DCC are among the best in the world because of the accuracy and reliability of their test results.

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In addition, there are more advantages to KIST DCC. It has increased sensitivity than the existing methods by improving sensitivity of detecting drugs using fluoride ions, so that scientists can detect even the most sophisticated doping attempts. Also, this technology enables the early detection of doping, so it prevents athletes from benefiting from illegal substances during training and competition. This is important because it preserves the integrity of sports, upholding the spirit of fair competition and safeguarding the health of athletes. Lastly, the existence of ‘Biomarking Factor Detection’ serves as a powerful deterrent, dissuading athletes from attempting to use inhibited drugs due to the high risk of detection.

Furthermore, there are some substances that naturally occur, so analysis methods of high sensitivity and efficiency for prohibited drugs were developed using the ‘Isotope Ratio Mass Spectrometry(IRMS)’ method to differentiate between prohibited substances of endogenous and exogenous sources. IRMS can reveal the origin of exogenous steroids found in the athletes’ body by measuring the ratios of stable isotopes of carbon (C-12 and C-13) in the steroids. These ratios are different in naturally occurring steroids compared to many synthetic ones.

Collaboration with other countries The center, KIST DCC, actively collaborates with international anti-doping organizations and laboratories to stay at the forefront of anti-doping science. Starting this year, they are launching doping tests and sample analysis support projects in Asia and Oceania with the Korea Anti-Doping Commission(KADA). The purpose of this supporting project is to strengthen doping management capabilities in developing countries in Asia and Oceania. This collaboration ensures that the center remains updated on the latest developments, and adapts its methods and techniques accordingly.

Conclusion KIST DCC is an example of excellence in technology within the world of anti-doping. Its advanced testing methods and sophisticated data management all contribute to its status as a global leader against doping in sports. It not only serves as a beacon of hope for clean athletes, but also inspires others in the field to strive for excellence in technology and push the boundaries of what is possible in the pursuit of clean and fair competition. B

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Members

Editor in chief

Daeun Choi

12th, 4th semester 2, 8, 9p

VICE Editor in chief

COPY MANAGER

Design MANAGER

Hyunjin Lee

Jungyoon Ryu

Youngseo Park

12th, 4th semester 30, 31p

12th, 4th semester 22, 23p

12th, 4th semester

2, 3, 26, 27, 30, 31, 36, 37, 42, 43p

Journalist

Chanyoung Kim 12th, 2nd semester 16, 17p

Haneul Roh

12th, 4th semester 10, 11p

Suyeon Kim

13th, 2nd semester 12, 13p

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Jeongwoo Shin 12th, 2nd semester 18, 19p

Jaeeun Park

13th, 2nd semester 38, 39p

Jinyoo Park

12th, 4th semester 4, 5, 6, 7p

Daeun Jeong

13th, 2nd semester 20, 21p

Yoonah Jung

13th, 2nd semester 32, 33p

Seoyeon Choi 13th, 2nd semester 34, 35p

Siyun Park

15th, 2nd semester 14, 15p

Dawon Lee

14th, 2nd semester 28, 29p

Chaerin Oh

15th, 2nd semester 24, 25p

Haoyen Tan

15th, 2nd semester 36, 37p

Siyun Hwang

15th, 2nd semester 26, 27p

Designer

Hwan Lee

12th, 4th semester 1, 22, 23, 38, 39, 44p

Jinyoo Park

12th, 4th semester

4, 5, 6, 7, 14, 15, 40, 41p

Seungwoo Lee 12th, 2nd semester 8, 9, 18, 19p

Soyun Kang

12th, 2nd semester 20, 21p

Dahyun Ryu

15th, 2nd semester 12, 13, 32, 33p

Jinyeong Kim 12th, 2nd semester 10, 11, 28, 29p

Jini Jeong

15th, 2nd semester 24, 25, 34, 35p 2023 VOL.24

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It was a great pleasure to be a vice editor of Blue Vanguard and to get to know all of you, and it will be greatly missed! It was an outstanding motivation to me with amazing editors through sharing diverse and unique insights. I truly appreciate all and I will continually cherish and desire good fortune for you all.

Good Bye!! :)

Hwan Lee

I started The Blue Vangaurd for learning design programs and trying out design myself. I did everything that I wanted to and I had a lot of fun during the designing. It was so grateful to be able to work with the other designers. Adios!

Youngseo Park

I was happy to be a member of the designer for one year and design manager for one year in Blue Vanguard! I learned a lot and it was a time to get to know each other. I’ll always support Blue Vanguard from behind! Goodbye!

Jungyoon Ryu

Thank you all for making my experience at Blue Vanguard so fruitful. It was an invaluable experience sharing and expressing our mutual interest in pharmacy through writing. I wish you all the best. Good bye!

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Farewell Haneul Roh

Being a part of Blue Vanguard was a meaningful experience. I was able to learn alot by communicating with other editors. It was a great pleasure to be a member of Blue Vanguard!

Jinyoo Park

“As the time to leave Blue Vanguard comes, it’s so sad.

Perhaps, during the unprecedented dual role in the journalism and design departments, I feel like I’ve learned so much!

It’s been such a joyful and rewarding time! Goodbye, everyone!”

Daeun Choi

I remember when I first joined Blue Vanguard. I was so excited to meet the upper classman and my peers.

I learned a lot from the past 2 years as a Blue Vanguardian. I also made many valuable relationships with people. I will always remember the fun times we had in this club. Thank you everyone, I wish you all the best :)

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Yonsei Student Pharmacist Magazine