The Pharma World

ENDORSED BY

DGDA





04 THE PHARMA WORLD Bangladesh Representative
51, Kalabagan 1st Lane, Dhaka

Cell: 01729294721
[email protected]

CONTENTS

News Face to Face Technology 86

New Arrivals 4, News 19, FIP News 26 Bhupati Kumar Roy 28 Global Market Survey 89
72
Guest Column API Market 91

Interview Dr Lim Chun Sen FAQ 92

Prof. Dr. Faruque Ahmed 33 Red Alert 93

Prof. Dr. Mobin Khan 37 Drug Safety 94

Prof. Dr. Salimur Rahman 41 Feature 27 Regulatory Affairs 95
Medical Myth 31
Prof. Dr. Mamun-Al-Mahtab (Shwapnil) 45 Gastroliver Update 35 In Depth 96
Vaccine 47
Prof. Dr. Md. Anwarul Kabir 49 Worth Knowing About 61 Concern 97
Gleanings From The Local Press 66
Prof. Dr. M. S. Arfin 55 Corona Update 77 FDA Update 98
Research Update 82
Prof. Dr. Md. Ashraful Islam 59 What’s New 85 AMR 99

Prof. Dr. Shahinul Alam 63 FDA Approval 102

Prof. Dr. A H M Rowshon 69 Globe Scan 103

Prof. Dr. Hafeza Aftab Rosy 75

Dr. Faroque Ahmed 79 Appointments And Promotions 104

Al Emran Chowdhury 101 Doctor’s Diary 107

board of Advisors Prof. Dr. Harun-Ur-Rashid Prof. Dr. Mohammod Shahidullah
National Prof. Brig. (Rtd.) Abdul Malik Founder & Chief Consultant Department of Neonatology
Founder & President Kidney Fundation Hospital & Bangabandhu Sheikh Mujib Medical
National Heart Foundation Research Institute, Dhaka University, Dhaka
Dhaka Prof. Dr. ABM Abdullah Professor Dr. Abdul Ghani
National Professor Dr. A K Azad Khan UGC Professor, BSMMU Ex-Chairman
President Personal Physician to Department of Pharmacy
Diabetic Association of Bangladesh & Hon’ble Prime Minister University of Dhaka
Chairman Board of Trustees
Bangladesh University of Health
Sciences (BUHS), Dhaka

Advisor, International Affairs Editor head of marketing
Prof. Dr. Moshe Szyf Muhammad Masud Faisal Ahmmed
GlaxoSmithKline & James McGill Professor
Dept. of Pharmacology & Therapeutics Executive Editor Marketing
McGill University Medical School S A Nadeem Sanat Saha
Montreal, Quebec Canada
managing editor Circulation
Pharmaceutical Advisor Sandip Kumar Saha Md. Sikander
Abu Nayeem Saifur Rahman Md. Bashar
Associate Editor
Medical Advisor Humayera Kabir Hana Computer Graphics
Dr. R. M. Samiul Hasan Md. Aftabul Islam
Business Editor
Media Advisor Md. Shahjahan Production
Dr. Sajal Ashfaque Mati Ar Manush
Dr. SMG Saklayen Russel Research Editor
Dr. Saleh Mahmood Tusher Prof. Dr. Md. Moklesur Rahman Sarker Editorial/Business Office
51, Kalabagan 1st Lane (Ground floor)
Dhaka-1205, Bangladesh
E-mail: [email protected]

Volume 12 n No. 7 n july-august 2021 Published by Muhammad Masud. 51, Kalabagan 1st Lane (Ground floor) Dhaka-1205,
Bangladesh, Tel/Fax: +88 02 58155677 n Printing: Image Printing & Packaging
3 Purana Paltan, Dhaka.
IMPORTANT: Every care is taken to ensure the accuracy of the information given in
this journal but no responsibility is accepted for any error and/or omissions. Editor/
publisher is not responsible in any way for views/comments expressed herein.

THE PHARMA WORLD 05

NEW ARRIVALS

ACME Brand Name: Terbikill
Generic Name: Terbinafine USP
Brand Name: Balovir 40 Strength: 250 mg, Cream 1%
Generic Name: Baloxavir Marboxil INN Dosage Form: Tablet & Cream
Strength: 40 mg Indications: Onychomycosis, Tinea
Dosage Form: Tablet Pedis, Tinea Corporis, Tinea Cruris,
Indications: For the treatment of Cutaneous Candiasis & Pityriasis
acute uncomplicated influenza for Versicolor.
those who have been symptomatic
for no more than 48 hours. Post- ARISTOPHARMA
exposure prophylaxis (PEP) of
influenza in persons 12 years of age Brand Name: Aristobet
and older following contact with an Generic Name: Betamethasone (as
individual who has influenza. Valerate)
Strength: 0.1%
Brand Name: Cetisoft Dosage Form: Cream & Ointment
Generic Name: Cetirizine Indications: Severe inflammatory
Hydrochloride BP skin disorders such as eczema,
Strength: 10 mg psoriasis and contact dermatitis etc.
Dosage Form: Soft Gel Capsule
Indications: Seasonal rhinitis, Brand Name: Aristobet - CL
perennial rhinitis, conjunctivitis, Generic Name: Betamethasone (as
pruritus & urticaria. Valerate) + Clotrimazole
Strength: 0.1% + 1%
Brand Name: Ertaco Dosage Form: Ointment
Generic Name: Sertaconazole Indications: Versatile fungal skin
Nitrate USP infections.
Strength: 20 gm
Dosage Form: Cream Brand Name: Ipralin Nebuliser
Indications: Superficial Fungal Solution
infection (Tenia Corporis, Tenia Generic Name: Ipratropium Bromide
Cruris, Tenia Pedis, Tenia Capitis) + Salbutamol
Strength: 0.5 mg + 2.5 mg
Brand Name: Sematid Dosage Form: Nebuliser Solution
Generic Name: Semaglutide INN Indications: COPD & Asthma.
Strength: 3 mg & 7 mg
Dosage Form: Tablet Brand Name: Nibalap
Indications: Indicated as an adjunct Generic Name: Lapatinib INN
to diet and exercise to improve Strength: 250 mg
glycemic control in adults with type Dosage Form: Tablet
2 diabetes. Indications: HER2 positive
metastatic breast cancer.

06 THE PHARMA WORLD

NEW ARRIVALS

Beximco Brand Name: Aeronid®
Generic Name: Budesonide
Brand Name: Barri® Strength: 200 mcg
Generic Name: Baricitinib Dosage Form: HFA inhaler
Strength: 4 mg Indication: For speed up recovery
Dosage Form: Tablet from COVID-19.
Indications: For the treatment of
COVID-19 in hospitalized adults Brand Name: Billi®
requiring supplemental oxygen, Generic Name: Bilastine
non-invasive or invasive mechanical Strength: Bilastine 20 mg, 10 mg
ventilation, extracorporeal meltab, oral solution 2.5 mg/ml
membrane oxygenation (ECMO). Dosage Form: Tablet, orally
dissolving tablet and Oral Solution
Brand Name: Apixa® Indications: Bilastine is indicated for
Generic Name: Apixaban symptomatic treatment of allergic
Strength: 2.5 mg & 5 mg rhino-conjunctivitis (seasonal and
Dosage Form: Tablet perennial) and urticaria.
Indications: For Superior Stroke
prevention in Nonvalvular Atrial Brand Name: Lulexa®
Fibrillation (NVAF), Treatment Generic Name: Luliconazole
of Deep Vein Thrombosis (DVT) Strength: Luliconazole 1% w/w
or Pulmonary Embolism (PE), Dosage Form: Cream
Prevention of recurrence. Indications: Superficial fungal
infections.
Brand Name: Bizoran®
Generic Name: Amlodipine + BIOPHARMA
Olmesartan
Strength: 10 mg + 20 mg, 10 mg + 40 Brand Name: Moxif 400
mg Generic Name: Moxifloxacin
Dosage Form: Tablet Strength: 400 mg
Indications: In uncontrolled Dosage Form: Tablet
hypertension when up-titration is Indications: Adjuvant therapy of
needed. Covid-19, COVID-19 associated
pneumonia, acute chronic
Brand Name: Semglee® bronchitis & Typhoid fever.
Generic Name: Biosimilar Insulin
Glargine Brand Name: Rixoban
Strength: Biosimilar Insulin Glargine Generic Name: Rivaroxaban
100 Units/ml Strength: 2.5 mg & 10 mg
Dosage Form: Solution for Injection Dosage Form: Tablet
in pre-filled pen Indications: Thromboprophylaxis
Indications: Treatment of Diabetes during COVID-19, stroke, deep vein
Mellitus in adults, adolescents and thrombosis (DVT) & pulmonary
children aged 2 years and above. embolism (PE).

THE PHARMA WORLD 07



NEW ARRIVALS

Brand Name: Napgin Plus Brand Name: Formet-L
Generic Name: Naproxen + Generic Name: Metformin
Esomeprazole Hydrochloride + Linagliptin
Strength: 500 mg + 20 mg Strength: 500 mg + 2.5 mg
Dosage Form: Tablet Dosage Form: Tablet
Indications: Osteoarthritic Indication: Type 2 diabetes.
joint pain, acute gout & acute
musculoskeletal disorder, low back Brand Name: Famoloc
pain & rheumatoid arthritis. Generic Name: Famotidine
Strength: 20 mg & 40 mg
Brand Name: Aceta One Dosage Form: Tablet
Generic Name: Paracetamol Indications: Heartburn, peptic ulcer,
Strength: 1000 mg dyspepsia & urticaria.
Dosage Form: Tablet
Indications: Fever, mild to Brand Name: Vcand
moderate pain, fever and pain after Generic Name: Voriconazole
vaccination, headache, migraine & Strength: 200 mg
muscle ache. Dosage Form: Tablet
Indications: Dermatophytosis,
Brand Name: Amotid CL invasive aspergillosis, deep tissue
Generic Name: Amoxicillin + infections & esophageal candidiasis.
Clavulanic Acid
Strength: 625 mg & 100 ml PFS Brand Name: Cloma 1
Dosage Form: Tablet & PFS Generic Name: Clonazepam
Indications: Community-acquired Strength: 1 mg
pneumonia, acute bacterial Dosage Form: Tablet
rhinosinusitis, UTI, acute otitis Indications: Panic disorder, rapid eye
media & SSTI. movement, burning mouth syndrome,
tardive dyskinesia & seizures.
Brand Name: Ortho-D3
Generic Name: Cholecalciferol Brand Name: Olvance-AM
Strength: 40000 IU, 2000 IU, 1000 IU Generic Name: Olmesartan
& 100 ml Medoxomil + Amlodipine
Dosage Form: Capsule & Oral solution Strength: 20 mg + 5 mg
Indications: Cholecalciferol (Vitamin Dosage Form: Tablet
D3) deficiency states & inadequate Indication: Hypertension.
absorption of calcium
Brand Name: Lasocon D
Brand Name: Formet-V Generic Name: Dexlansoprazole
Generic Name: Metformin Strength: 30 mg
Hydrochloride + Vildagliptin Dosage Form: Capsule
Strength: 500 mg + 50 mg Indications: Gastric ulcer, duodenal
Dosage Form: Tablet ulcer & Gastro-Esophageal Reflux
Indication: Type 2 diabetes. Disease (GERD).

THE PHARMA WORLD 09



NEW ARRIVALS

Eskayef Brand Name: Maxfer 1 gm
Generic Name: Ferric
Brand Name: Esoral Carboxymaltose
Generic Name: Esomeprazole Strength: 1 gm
Magnesium Trihydrate Dosage Form: IV Injection
Strength: 20mg Indications: Iron deficiency anemia,
Dosage Form: Powder for post-partum bleeding, chronic
Suspension kidney disease (CKD), post-surgical
Indications: Heartburn, acid related anemia, inflammatory bowel
dyspepsia, peptic ulcer disease, syndrome (IBS).
gastroesophageal reflux disease
(GERD). Brand Name: Biltin
Generic Name: Bilastine
Brand Name: Levetam Strength: 2.5 mg/mL
Generic Name: Levetiracetam Dosage Form: Oral Solution
Strength: 250mg, 500mg & 500mg Indications: Allergic rhino-
XR conjunctivitis, urticaria & other
Dosage Form: XR Tablet allergic conditions.
Indication: Epilepsy.
Brand Name: Mycofin
Brand Name: Voltagel Generic Name: Terbinafine
Generic Name: Diclofenac Sodium Hydrochloride
Strength: 10gm & 50gm Strength: 1% w/w
Dosage Form: Gel Dosage Form: Cream
Indications: Back Pain, knee pain, Indications: Tinea pedis, Tinea
joint pain, sprain, headache & other cruris, Tinea Corporis & fungal skin
physical pain. infection.

Brand Name: Caridol EVEREST
Generic Name: Carisoprodol USP
Strength: 250mg Brand Name: CALCIXEN
Dosage Form: Tablet Generic Name: Calcium (Coral
Indications: Low back pain, neck Source) + Vitamin D3
pain, knee pain, osteoarthritis pain, Strength: 500 mg + 200 mg
rheumatoid arthritis pain, sprained Dosage Form: Tablet
muscle, fracture, shoulder pain and Indications: Indicated for the
other pain. treatment & prevention of
osteoporosis, osteomalacia, rickets,
Brand Name: Aglip tetany, pseudohypoparathyroidism
Generic Name: Alogliptin and as dietary supplement where
Strength: 12.5mg & 25mg calcium intake may be inadequate
Dosage Form: Tablet (during pregnancy, lactation,
Indication: Type 2 diabetes. postmenopausal women and the
aged).

THE PHARMA WORLD 011

NEW ARRIVALS

Brand Name: Favirest hypertension, sudden and excess
Generic Name: Favipiravir INN spasm in muscle (tetani), spasm
Strength: 200 mg formation in muscle, stomach-
Dosage Form: Tablet intestine cramps, increased
Indications: Treatment of novel or stimulability of muscle and nerves,
re-emerging pandemic influenza calf cramps, cases with cramps
virus infections. and stress in new-born or small
children, preterm spasms, cervical
Brand Name: Lyroxen 25 failure, early membrane rupture,
Generic Name: Pregabalin BP spasm in pregnancy (eclampsia/pre-
Strength: 25 mg eclampsia, tocolysis necessary to use
Dosage Form: Capsule beta mimetic), menstrual period with
Indications: Neuropathic pain, calcification and ossifications,
pain associated with diabetic prevention of renal calculus
peripheral neuropathy, post- formation, prevention of repetition
herpetic neuralgia, fibromyalgia, of calcium oxalate urolithiasis,
neuropathic pain associated with treatment of diabetes and migraine.
spinal cord injury, adjunctive
therapy for adult patients with Brand Name: Pico Plus
partial onset seizures. Generic Name: Sodium Picosulfate
Strength: 5 mg/ 5 ml
Brand Name: Lyroxen 50 Dosage Form: Oral Solution
Generic Name: Pregabalin BP Indications: Constipation of any
Strength: 50 mg etiology, relief from prolonged
Dosage Form: Capsule & recurrent constipation, bowel
Indications: Neuropathic clearance before surgery, childbirth
pain associated with diabetic or radiological investigations.
peripheral neuropathy, post-
herpetic neuralgia, fibromyalgia, Brand Name: Pico Plus 10
neuropathic pain associated with Generic Name: Sodium Picosulfate
spinal cord injury, adjunctive Strength: 10 mg
therapy for adult patients with Dosage Form: Tablet
partial onset seizures. Indications: Constipation of any
etiology, relief from prolonged
Brand Name: Magnito & recurrent constipation, bowel
Generic Name: Magnesium clearance before surgery, childbirth
Strength: Magnesium Oxide USP or radiological investigations.
equivalent to Magnesium 365 mg.
Dosage Form: Tablet Brand Name: Sinlair
Indications: Relieving the symptoms Generic Name: Montelukast
of magnesium deficiency, Strength: Montelukast Sodium USP
heartbeat acceleration, heartbeat equivalent to Montelukast 10 mg
irregularities, heart attack, Dosage Form: Tablet
angina pectoris, mild to severe Indications: Prophylaxis and

12 THE PHARMA WORLD

NEW ARRIVALS

chronic treatment of Asthma, Brand Name: Ambromax
prevention of Exercise-Induced Generic Name: Ambroxol
Bronchoconstriction (EIB) & relief hydrochloride BP
of symptoms of Allergic Rhinitis. Strength: 15 mg/ 5 ml
Dosage Form: Syrup
GOODMAN Indications: Productive cough,
acute and chronic inflammatory
Brand Name: D-Coral DX disorders of RTIs, bronchitis,
Generic Name: Coral Calcium BP + laryngitis, pharyngitis, sinusitis
Vitamin D3 USP and rhinitis associated with
Strength: 600 mg + 400 IU viscid mucus, bronchial
Dosage Form: Tablet asthma, bronchiectasis, chronic
Indications: Osteopenia, pneumonia.
osteoporosis, calcium deficiency,
osteomalacia, calcium deficiencies KUMUDINI
during pregnancy & lactation.
Brand Name: Prenavo DR
Brand Name: Fevimol Generic Name: Doxylamine +
Generic Name: Paracetamol BP Pyridoxine
Strength: 500 mg Strength: 10 mg + 10 mg
Dosage Form: Tablet Dosage Form: Tablet
Indications: Fever, mild to moderate Indications: Nausea & Vomiting of
pain, fever & pain after vaccination, Pregnancy
headache, migraine, muscle ache.
Brand Name: Naftifun
Brand Name: Tyfinor Generic Name: Naftifine
Generic Name: Ciprofloxacin USP Strength: 2gm/100 gm
Strength: 500 mg Dosage Form: Cream
Dosage Form: Tablet Indications: Treatment of
Indications: RTIs, UTIs, SSTIs, interdigital tinea pedis, tinea cruris,
infectious diarrhea, typhoid fever, and tinea corporis caused by the
surgical prophylaxis, bone and organism Trichophyton rubrum.
joint infections, intra-abdominal
infections. Brand Name: Jointcare
Generic Name: Glucosamine
Brand Name: Moxihil Sulfate + Diacerein
Generic Name: Moxifloxacin USP Strength: 750 mg + 50 mg
Strength: 400 mg Dosage Form: Tablet
Dosage Form: Tablet Indications: Osteoarthritis,
Indications: Acute bacterial sinusitis, rheumatoid arthritis, bone and
acute bacterial exacerbation of joint injuries
chronic bronchitis, community
acquired pneumonia, uncomplica- Brand Name: Supreno
ted & complicated SSTIs, Generic Name: Butamirate Citrate
complicated intra-abdominal INN
infections. Strength: 7.5mg/5ml
Dosage Form: Syrup
Brand Name: Vitanerv Indications: Relieve dry (non-
Generic Name: Vitamin B1 USP + productive) cough. Dry cough
Vitamin B6 USP + Vitamin B12 USP may be caused by a recent viral
Strength: 100 mg + 200 mg + 200 mcg infection. Also used for pre &
Dosage Form: Tablet post-operative cough sedation in
Indications: Diabetic neuropathy, patients who will undergo surgical
peripheral neuropathy, lumbago, procedures and bronchoscopy.
sciatica, intercostal neuralgia,
myalgia, trigeminal neuralgia. THE PHARMA WORLD 13



NEW ARRIVALS

It can be used in the acute Brand Name: Rafcon
cough of any etiology, whooping Generic Name: Sodium Alginate
cough and cough due to acute + Sodium Bicarbonate + Calcium
lower respiratory tract infections Carbonate
(tracheitis, laryngitis, bronchitis) etc. Strength: 500 mg + 267 mg + 160 mg
Dosage Form: Suspension
Navana Indications: Gastric reflux,
heartburn, flatulence associated
Brand Name: Aloglip with gastric reflux, heartburn of
Generic Name: Alogliptin Benzoate pregnancy, all cases of epigastric
INN and retrosternal distress where the
Strength: 6.25mg, 12.5 mg & 25 mg. underlying cause is gastric reflux.
Dosage Form: Tablet
Indications: As an adjunct to diet Pharmasia
and exercise to improve glycaemic
control in adults with type-2 Brand Name: Retrovir
diabetes mellitus. Generic Name: Tenofovir Disoproxil
Fumarate
Brand Name: Osmina Strength: 300 mg
Generic Name: Ospemifene INN Dosage Form: Tablet
Strength: 60 mg Indication: Chronic Hepatitis B.
Dosage Form: Tablet
Indications: An estrogen agonist/ POPULAR
antagonist indicated for the
treatment of moderate to severe Brand: Candicon
dyspareunia & vaginal dryness, Generic: Voriconazole
a symptom of vulvar and vaginal Strength: 200 mg
atrophy, due to menopause. Dosage Form: Tablet
Indications: Oropharyngeal
NIPRO JMI candidiasis, esophageal candidiasis,
intestinal candidiasis, vaginal
Brand Name: Citrux-C candidiasis, Candida Auris infection,
Generic name: Vitamin C invasive candidiasis, onychomycosis,
Strength: 250 mg Tinea cruris, Ringworm (Tinea
Dosage form: Chewable Tablet corporis), Tinea pedis (Athlete’s
Indication: Prevention and foot), Tinea capitis (Ringworm of
treatment of scurvy. the hair), otomycosis, aspergillosis
& invasive aspergillosis, invasive
ORGANIC fusariosis, fungal eye infections.

Brand Name: Urifine Brand: Bilastin
Generic Name: Potassium Citrate + Generic: Bilastine
Citric Acid Monohydrate Strength: 12.5 mg/5ml
Strength: 1500 mg + 250 mg Dosage Form: Syrup
Dosage Form: Oral Solution Indications: Allergic rhinitis, allergic
Indications: To relieve discomfort rhinoconjunctivitis and urticaria.
in urinary tract infections, to
prevent kidney stones, with Brand: HCG 10000 IU
uricosuric agents to prevent Generic: Human Chorionic
gout, acidosis caused by kidney Gonadotrophin
diseases. Strength: 10000 IU
Dosage Form: IM/SC Injection
Indications: For Female: Ovulation
induction in infertility due to

THE PHARMA WORLD 15

NEW ARRIVALS

anovulation or impaired follicle- RADIANT
ripening, Preparation of follicles
for puncture in controlled ovarian Brand Name: Radivit-D
hyperstimulation programs (ART), Generic Name: Cholecalciferol USP
llutael phase support, threatened & Strength: 2000 IU, 20000 IU, 40000
habitual abortion. IU, 50000 IU
For Male: Hypogonadotropic Dosage Form: Tablet & Capsule
hypogonadism (also cases of Indications: Treatment &
idiopathic dyspermias have prevention of Vitamin D3 deficiency
shown a positive response to & insufficiency
gonadotrophins), oligospermia,
delayed puberty associated with Brand Name: Radivit-C
insufficient gonadotropic pituitary Generic Name: Ascorbic Acid USP
function. Strength: 1000 mg
Dosage Form: Tablet
Brand: Iroject Indications: Prevention and
Generic: Ferric carboxymaltose treatment of scurvy. It may be
Strength: 500 mg indicated in pregnancy, lactation,
Dosage Form: IV injection infection, trauma, burns, cold
Indications: Iron deficiency exposure, following surgery,
anemia, general weakness, any fever, stress, peptic ulcer, cancer,
type of iron deficiency. methaemoglobinaemia. 

Brand: Skinobac Brand Name: Coralcal-Kit
Generic: Mupirocin Generic Name: Ibandronic Acid +
Strength: 2% Calcium Carbonate + Vitamin D3
Dosage Form: Ointment Strength: 150 mg+600 mg+400 IU
Indications: Primary bacterial Dosage Form: Tablet
skin infections (Impetigo) and Indications: Treatment and
secondary bacterial skin infections prevention of Osteoporosis. It
(trips and falls, cuts, lesions, increases Bone Mineral Density
punctures, burns etc.) (BMD) and reduces the incidence of
vertebral fractures.
Brand: Telmivas AM 40/5
Generic: Telmisartan USP + Brand Name: Zinc-R
Amlodipine BP Generic Name: Zinc Sulfate
Strength: 40 mg + 5 mg Monohydrate
Dosage Form: Tablet Strength: 20 mg
Indications: Treatment of mild to Dosage Form: Tablet
moderate essential hypertension Indications: Zinc deficiency and/or
or uncontrolled hypertension for zinc losing conditions
whom combination therapy is
appropriate. Brand Name: Dolceta
Generic Name: Paracetamol +
Brand: Telmivas 40 Tramadol Hydrochloride
Generic: Telmisartan USP Strength: 325 mg+37.5 mg
Strength: 40 mg Dosage Form: Tablet
Dosage Form: Tablet Indications: The management of
Indications: Initial therapy of high moderate to severe pain in adults
blood pressure, cardiovascular & short-term (five days or less)
prevention: to decrease the management of acute pain
chance of heart attack, stroke, or
cardiovascular death, treatment of
heart failure (patients intolerant to
ACE inhibitors).

16 THE PHARMA WORLD

NEW ARRIVALS

Brand Name: Lanplus Brand Name: TOFE
Generic Name: Dexlansoprazole Generic Name: Tolfenamic Acid BP
Strength: 30 mg, 60 mg Strength: 200 mg
Dosage Form: Capsule Dosage Form: Tablet
Indications: Healing of erosive Indications: Acute Migraine pain
esophagitis, maintenance of & mild to moderate pain disorder
healed erosive esophagitis, like dysmenorrhoea, rheumatoid
symptomatic non-erosive arthritis or osteoarthritis
Gastroesophageal Reflux Disease
(GERD). Brand Name: Vitamin BZ
Generic Name: Vitamin B-Complex
Brand Name: Pidogrel & Zinc
Generic Name: Clopidogrel Strength: 100 & 200 ml
Bisulphate USP Dosage Form: Syrup
Strength: 75 mg Indications: Deficiency of Vitamin
Dosage Form: Tablet B & Zinc.
Indications: Acute Coronary
Syndrome (ACS), Recent MI, recent Square
Stroke, or established Peripheral
Arterial Disease Brand Name: Livacol
Generic Name: Obeticholic Acid
Brand Name: Pidogrel Plus Strength: 10 mg
Generic Name: Clopidogrel Dosage Form: Tablet
Bisulphate USP + Aspirin USP Indications: Primary biliary
Strength: 75 mg + 75 mg cholangitis (PBC) in combination
Dosage Form: Tablet with Ursodeoxycholic acid (UDCA)
Indications: Acute Coronary in adults with an inadequate
Syndrome (ACS), Recent MI, recent response to UDCA or as
Stroke, or established Peripheral monotherapy in adults unable to
Arterial Disease. tolerate UDCA.

Sharif Brand Name: Toco Soft
Generic Name: Tocotrienol +
Brand Name: Picaso Tocopherol
Generic Name: Sodium Picosulfate Strength: 50 mg (74.5 IU) + 13.5 mg
BP (20 IU)
Strength: 10 mg & 100 ml Dosage Form: Soft Gelatin Capsule
Dosage Form: Tablet & Syrup Indications: Supports healthy
Indications: Short term relief hair & skin, Supports brain health
of prolonged and recurrent & cognitive function, powerful
constipation and for the antioxidant, helps to maintain
management of constipation of healthy blood vessels.
any etiology.
Brand Name: Mevin SR
Brand Name: Ultra D Generic Name: Mebeverine
Generic Name: Vitamin D3 Hydrochloride
Strength: 1000 IU Strength: 200 mg
Dosage Form: Tablet Dosage Form: Sustained Release
Indications: Deficiency of Vitamin Capsule
D3 and to boost up immunity Indications: For the symptomatic
treatment of Irritable Bowel
Syndrome (IBS) and other

THE PHARMA WORLD 17



NEW ARRIVALS

conditions include: Chronic Brand Name: Minibet
irritable colon, spastic Generic Name: Ciprofibrate
constipation, mucous colitis, Strength: 100 mg
colicky abdominal pain, persistent Dosage Form: Tablet
non-specific diarrhea. Indications: Treatment of severe
hypertriglyceridemia with or
Brand Name: Xpos without low HDL-Cholesterol,
Generic Name: Posaconazole mixed hyperlipidemia when a
Strength: 100 mg statin is contraindicated or not
Dosage Form: Delayed Release tolerated.
Tablet
Indications: Indicated in patients Brand Name: Beviprex
aged 13 years and above for the Generic Name: Glycopyrronium
treatment of following fungal Bromide + Formoterol Fumarate
infections (as salvage therapy): Strength: 9 mcg + 4.8 mcg
Invasive aspergillosis, Fusariosis, Dosage Form: Metered Dose Inhaler
Chromoblastomycosis and (MDI)
mycetoma, Coccidioidomycosis, Indications: For the maintenance
Mucormycosis. treatment of patients with
Chronic Obstructive Pulmonary
Brand Name: Calbotol Disease (COPD), including chronic
Generic Name: Calcium Citrate + bronchitis and/or emphysema.
Calcitriol
Strength: Calcium Citrate 1200 mg Brand Name: Probio R
equivalent to Calcium 252 mg + Generic Name: Lactobacillus and
Calcitriol 0.25 mcg Bifidobacterium species
Dosage Form: Tablet Strength: 20 Billion CFUs
Indications: Osteoporosis, Dosage Form: Capsule
weak bones (osteomalacia, Indications: Restoration of
rickets), decreased activity intestinal flora after antibiotic
of the parathyroid gland or other harmful medications,
(hypoparathyroidism), certain reduction of diarrhea associated
muscle disease (latent tetany), in abdominal discomfort, reduction
certain patients to make sure they of the duration of diarrhea.
are getting enough calcium (e.g.
postmenopausal). WHITE HORSE

Brand Name: Camlotel Brand Name: Asozit®
Generic Name: Amlodipine + Generic Name: Esomeprazole
Telmisartan Magnesium Trihydrate USP
Strength: 5 mg + 80 mg Strength: 20 mg & 40 mg
Dosage Form: Tablet Dosage Form: Capsule
Indications: Treatment of Indications: Gastro esophageal
hypertension, alone or with other reflux disease, erosive esophagitis,
antihypertensive agents. It may duodenal & gastric ulcer, acid
also be used as initial therapy in related dyspepsia, Zollinger-Ellison
patients who are likely to need Syndrome.
multiple drugs to achieve their
blood pressure goals. THE PHARMA WORLD 19

NEW ARRIVALS

Brand Name: Nexopan®Plus 51, Kalabagan 1st Lane
Generic Name: Naproxen USP Tel: 88-02-58155677
+ Esomeprazole Magnesium
Trihydrate USP 677395919
Strength: 500 mg + 20 mg
Dosage Form: Tablet
Indications: Osteoarthritis,
rheumatoid arthritis, ankylosing
spondylitis, NSAID associated
gastric ulcer.

Brand Name: D-Care®
Generic Name: Cholecalciferol USP
Strength: 2000 IU, 20000 IU &
40000IU
Dosage Form: Tablet & Capsule
Indications: Treatment &
prevention of Vitamin D3 deficiency,
osteoporosis.

Brand Name: Bio-7®
Generic Name: Biotin BP
Strength: 1000 mcg
Dosage Form: Tablet
Indications: Hair loss, brittle nails
(Onychoschizia), weak splitting or
soft nails, eczema & dermatitis.

Brand Name: Nerfid®
Generic Name: Pregabalin USP
Strength: 25 mg, 50 mg & 75 mg
Dosage Form: Capsule
Indications: Management of
neuropathic pain associated with
diabetic peripheral neuropathy, post-
herpetic neuralgia and fibromyalgia.

Brand Name: Diastat®
Generic Name: Empagliflozin INN
Strength: 10 mg & 25 mg
Dosage Form: Tablet
Indication: Diabetes Mellitus Type-II.

Brand Name: Winfax®
Generic Name: Cefuroxime Auxetil USP
Strength: 250mg, 500mg & 125mg/5ml
Dosage Form: Tablet & Powder for
Suspension
Indication: Pharyngitis/tonsillitis,
otitis media, lower respiratory tract
infections, skin and skin-structure
infections, urinary tract infections,
bone and joint infections,
gonorrhoea.

20 THE PHARMA WORLD

NEWS

Congrats

Firdausi Qadri honoured
with Magsaysay Award

Dr Firdausi Qadri, a Bangladeshi sci- Research, Bangladesh (icddr,b). She DR FIRDAUSI QADRI
entist instrumental in the develop- completed her doctorate in bio-
ment of vaccines that have saved chemistry at Liverpool University in lion people in six high-risk districts
millions of lives, has been honoured the United Kingdom after obtaining of Dhaka. Under the World Health
with the Ramon Magsaysay Award. a postgraduate degree in the sub- Organization and United Nations
She will be conferred with the award ject. She joined the icddr,b in 1988. International Children’s Emergency
at a ceremony on November 28 at Fund (UNICEF), she led a team of
the Ramon Magsaysay Center in Ma- Her biggest challenges came in experts in the 2017-2020 OCV mass
nila, said a press release of the Ra- the fight against cholera and ty- vaccination of Rohingya refugees
mon Magsaysay Award Foundation. phoid -- major diseases in Bangla- from Myanmar in Cox’s Bazar in
The award is given every year to desh and other Asian and African Bangladesh and prevented a mass
individuals who have made extraor- countries with poor access to safe cholera outbreak.
dinary contributions to the eradi- water, sanitation, education, and
cation of poverty and the develop- medical care. She played a key role
ment of the society in Asia. in the development of a more af-
fordable oral cholera vaccine (OCV)
Dr Qadri, 70, is an emeritus scien- and the typhoid conjugate vac-
tist at the Mucosal Immunology and cine (ViTCV) for adults, children,
Vaccinology Unit at the Infectious and even infants as young as nine
Diseases Division of International months. Last year, she helped facil-
Centre for Diarrhoeal Disease and itate the OCV vaccination of 1.2 mil-

Prof. ABM Abdullah and Prof. Manilal Aich
Litu receive Rotary appreciation

Rotary International has tional Zone 1B, Region 10
proudly presented certifi-
cates of appreciation to handed over the certifi-
Professor Dr. ABM Abdul-
lah and Professor Dr. Ma- cates at a city hotel.
nilal Aich Litu as “COVID
Hero” as a recognition Professor ABM Abdul-
of their overall activi-
ties including prevention lah, an acclaimed medi-
of COVID-19, continuing
medical activities from PROF. DR. ABM ABDULLAH cine specialist and an ac-
the front, creating public
awareness and providing online medical services. ademic, is Prime Minister

According to a press release, Rotary International Sheikh Hasina’s personal
Zone 1B, region 10 handed over the certificates of ap-
preciation and Gold Award to them for commendable physician. He was a pro-
and selfless work at the time of COVID-19 crisis. Presi-
dent of Rotary International and RPIC, Rotary Interna- PROF. DR. MANILAL AICH LITU fessor in the Department
of Internal Medicine and

the dean of the Faculty of

Medicine at  Bangabandhu Sheikh Mujib Medical Uni-

versity.  He was awarded the Ekushey Padak in 2016 by

the Government of Bangladesh.

Professor Manilal Aich Litu is the Head of the

Department of ENT at Sylhet MAG Osmani Medical

College.

THE PHARMA WORLD 21



NEWS

MOU between Sinopharm, Ministry of Health
and Family Welfare and Incepta Vaccine Ltd for
joint production of Sinopharm Covid Vaccine

An agreement has recently been Rahman, Director General, Directo- come speech on behalf of Sinopharm.
signed between the Sinopharm of rate General of Drug Administration Aiming to co-produce the China’s
China, Ministry of Health and Family (DGDA), and Mr Abdul Muktadir, Chair-
Welfare, People’s Republic of Bang- man of Incepta Vaccine Ltd and In- Sinopharm vaccine in Bangladesh, the
ladesh and Incepta Vaccine Ltd, re- cepta Pharmaceuticals Ltd were also Memorandum of Understanding was
nowned vaccine manufacturing com- present in the program as Special signed by Honorable Minister Mr. Za-
pany of the country, at the auditorium guests. Prof. Dr. Abul Bashar Moham- hid Malek MP, His Excellency, Ambas-
of Bangladesh College of Physicians mad Khurshid Alam, Director General, sador of People’s Republic of China to
and Surgeons (BCPS), Mohakhali Dha- Directorate General of Health Services Bangladesh Li Jiming and Abdul Muk-
ka in order to produce the Sinopharm (DGHS) gave a welcome speech. Mr. tadir, Chairman of Incepta Vaccine Ltd
covid vaccine in Bangladesh. Lokman Hossain Miah, Senior Secre- and Incepta Pharmaceuticals Ltd on
tary, Health Service Division, Ministry behalf of Ministry of Health and Fam-
Honorable Minister of Health and of Health and Family Welfare presided ily Welfare, Sinopharm and Incepta
Family Welfare Mr. Zahid Maleque MP over the function. Vaccine Ltd respectively.
was the Chief Guest at the signing cer-
emony. Honorable Foreign Minister In addition, Counselor of the De- Speakers at the event said that a
Dr. A. K. Abdul Momen MP was pre- partment of Asia Affairs of the Minis- new direction has been unveiled with
sent as the guest of honor. try of Foreign Affairs of China Ji Rong this agreement in the production of
and the Chairman of Sinopharm Mr covid vaccine in Bangladesh in this
Mr. Masud Bin Momen, Senior Sec- Liu Jingzhen were connected online Mourning August. It was expected
retary, Ministry of Foreign Affairs, His from Beijing and delivered speech that through this agreement, Incepta
Excellency, Ambassador of People’s as special guests. Mr. Fu Qiang, Chief Vaccine Ltd, would produce the Sin-
Republic of China to Bangladesh Li Engineer of Sinopharm gave the wel- opharm Vaccine very soon, says the
Jiming, Major General Md, Mahbubur company press release.

THE PHARMA WORLD 23



NEWS

ONE PHARMA BEGINS DEVELOPMENT Beximco Pharma
OF STERILE BIOTECH PROJECT receives USFDA
approval for
Baclofen

KSM Mostafizur Rahman, Managing Director, One Pharma welcomes DGDA Major Beximco Pharmaceuticals Limited
General Md. Mahbubur Rahman during the latters visit to its plant at Bogura. received USFDA approval for Ba-
clofen, 10 and 20 mg tablets.
One Pharma Ltd., a sister concern of the company to flourish since then.
the renowned and established Na- One Pharma Limited became the The muscle relaxant drug indi-
tional AgriCare Group, has started its cated for the treatment of muscle
journey towards the development of sole distributor of vaccines produced pain, spasms, and stiffness in peo-
its new sterile dedicated biotech fa- by the ‘Institute of Medical Biology of ple with multiple sclerosis or spinal
cility. The plant would be a landmark the Chinese Academy of Medical Sci- cord injury or disease.
project for the company which has es- ences (IMBCAMS)’ which has already
tablished and expanded its business been approved by BMRC for Phase- This is the ninth Abbreviated
over the last two decades based on III clinical trial by ICDDR,B, under the New Drug Application of the phar-
the trust of its clients. The new facil- guidance of renowned scientist Dr. maceuticals fully developed in-
ity located at BSCIC, Bogura under the Firdausi Qadri in Bangladesh. house and successfully approved
regulation of DGDA, Bangladesh will for the US market since the com-
also be manufacturing biosimilars & Earlier this year, One Pharma Ltd. pany’s oral solid dosage facility
vaccines (both human & animal) in had made it into the famous Guin- was approved by the US FDA in
the future. This plant has been set up ness World Records by creating the June 2015, said a press release.
to meet the standard of WHO cGMP, World’s Largest Crop Field Mosaic (Im-
UK MHRA & US FDA. With a fine-tuned age) “Shashyachitre Bangabandhu” The Company expects to launch
layout, world-class machineries, honouring the father of the Nation the product through its US distribu-
state-of-the-art Effluent Treatment Bangabandhu Sheikh Mujibur Rah- tion partner in due course.
Plant (ETP) and experienced & highly man. According to the Guinness World
skilled manpower, this plant is going Records’ website, One Pharma Ltds’ According to IQVIA audited mar-
to be one of the best of its kind in the record-breaking crop field has over an ket data, there are currently nine
country. area of 119,430.273 m² (1,285,536.75 ft²) active players for Baclofen in the
width. The unique feat was achieved US market, which generated sales of
One Pharma Limited started its by AFM Bahauddin Nasim and KSM more than US$ 110 million in 2020.
journey in November 2015 with the Mostafizur Rahman in one attempt
core vision of providing innovative & which was organized by the National Nazmul Hassan, Managing Di-
modern manufacturing technologies AgriCare Group in Bangladesh on rector of Beximco Pharmaceuti-
by professional expertise for produc- March 9, 2021. cals, said, ‘We are pleased to have
ing world-class medicines for domes- received FDA approval of Baclofen,
tic & overseas markets. One Pharma Managing Director of One Pharma a commonly prescribed medicine
Limited has proudly been working Ltd, KSM Mostafizur Rahman became in the US, as we continue to lever-
hand in hand with the agricultural a Member of the Executive Commit- age our core strengths in R&D and
sector since 2002 which has helped tee of the Bangladesh Association of manufacturing to develop and de-
Pharmaceutical Industries (BAPI) for liver important generic products to
the period of 2021-2022. patients.

This approval strengthens our
product offering in the US and we
look forward to the launch of ge-
neric Baclofen in due course.’

THE PHARMA WORLD 25



NEWS

ROP Centre launched at BSMMU

A Retinopathy of Prematurity (ROP) at the inauguration ceremony. Dr Mu- and facilities across the country to
Centre has started its journey on the nir Ahmed, Country Director of Orbis ensure access and coverage of qual-
premises of Bangabandhu Sheikh International, was the guest of honor ity ROP screening and treatment ser-
Mujib Medical University (BSMMU) to while Prof Dr Zafar Khaled, Chairman vices.
contribute to the reduction of pre- of Department of Ophthalmology of
ventable blindness caused by ROP BSMMU, chaired and Dr Tariq Reza Ali The director general of Directorate
among neonates. Prof Dr Md Sharfud- of BSMMU moderated the event. Dr. of Medical Education advised BSMMU
din Ahmed, Vice Chancellor of BSMMU, Nuzhat Choudhury, Professor, Depart- to conduct pilot and research onROP
has inaugurated the centre recently. ment of Opthalmology, BSMMU was issue by involving upazila health com-
also present at the evernt. plexes, especially the SCANUs/NICUs
Retinopathy of Prematurity is a as part of integrated intervention, and
potentially blinding eye disease that The centre has been established develop a sustainable model for rep-
affects premature infants and is the with support of Orbis International lication. Orbis International country
leading cause of blindness among and Peter Gilgan Foundation. Orbis director said the organization’s prior-
children. More premature babies are International, Bangladesh has already ity is newborn and children and tech-
being saved, but few hospitals have established seven ROP centers -- two nology-based innovative approach to
the skills and resources to deliver the in Dhaka and five in Chattogram, My- transform the center at BSMMU into a
care needed. Ophthalmologists say if mensingh, Rangpur, Chandpur and ‘center excellence; so that the coun-
a baby is affected with ROP, his/her Dinajpur districts. The BSMMU centre try as a whole can serve as a national
eyes must be screened and its neces- will work as a hub for all the centers level hub for ROP in the country.
sary treatment must begin within 30
days of birth, otherwise the baby can
be blind.

The long-term objectives of the
ROP centre are offering quality train-
ing, standardization of screening and
treatment guidelines, tele-consulta-
tion and referral services, networking
with other centers, supporting re-
search and acting as a national hub for
ROP activities in Bangladesh. Prof Dr
Mohammad Shahidullah, President of
Bangladesh Medical and Dental Coun-
cil (BMDC), Prof AHM Enayet Hussain,
Director General of Directorate Gen-
eral of Medical Education, and Prof Dr
Saif Uddin Ahmed, Pro-Vice Chancel-
lor of BSMMU, were the special guests

Beacon Pharma to export drugs to Syria

Beacon Pharmaceuticals Limited has has visited our factory in this regard.” has not been finalised yet.”
received a good manufacturing practice Beacon Pharmaceuticals wants to ex- Currently, the company is exporting
(GMP) certificate from the Syrian Arab port drugs for Covid, cancer, and general
Republic for the purpose of registering treatment to the Syrian Arab Republic drugs to 116 countries. Earlier, he said
the company for medicine exports. Now, through the private sector, he added. the sales of the antiviral drug Remde-
the company will be able to register its Khalilur Rahman said, “We expect that sivir have increased significantly. It has
products for exporting to that country. they will take medicines worth $10 mil- been in high demand since the spread
lion yearly. But how many items will be of Covid-19 around the world. The com-
Company Secretary Khalilur Rahman exported to  the Syrian Arab Republic pany introduced two items for Covid-19
said, “Recently, a Syrian technical team patients – Remdesivir and Favipiravir.

THE PHARMA WORLD 27

FIP NEWS

New handbook from FIP to help
pharmacists maximise disease
prevention role through vaccination

“Make every contact

count” is the key mes-

sage from FIP as it

launches a new  vac-

cination handbook for

pharmacists. The

handbook details the

many ways in which pharmacists can

contribute to improving vaccination

coverage, such as supply chain and

stock management, storage, record

keeping, facilitation of appointments

and administration of vaccines, but it

also gives emphasis to their important

educational and advisory role. The

handbook provides guidance on the

implementation of a range of phar- “Not all of the roles described in resources in this programme of work
the handbook are currently open to by FIP to ensure pharmacy’s contribu-
macy vaccination services, guidelines pharmacists in every country — but tion to the World Health Organization
with this handbook FIP aims to sup- Immunisation Agenda 2030 and the
on safety, and answers to frequently port the expansion and development Global Vaccine Action Plan 2011–2020
of the roles of pharmacists in order to include a collection of evidence and
asked questions about vaccines. increase vaccination coverage across guidelines for the development of
the globe,” he added. vaccination services, a report on the
At this time of increasing levels of roles of pharmacy in vaccination, and
The handbook is the latest addi- a regulatory self-evaluation assess-
vaccine hesitancy, pharmacists should tion to a range of resources devel- ment tool for advancing pharmacy
oped by FIP to transform vaccina- services in this area.
be equipped with proper training and tion through pharmacy. Other recent

tools to effectively communicate and

provide evidence-based recommen-

dations to populations in order to

support vaccine uptake,” said Gonçalo

Sousa Pinto, editor of the handbook.

impact of young A new report to showcase the impact of group initiatives together with case
pharmacists and young pharmacists and pharmaceuti- studies from early-career pharmaceu-
pharmaceutical cal scientists on global health has been tical groups in Indonesia, Lebanon,
scientists on published by the Young Pharmacists Nigeria, Malaysia and Portugal on
global health Group of FIP. The publication, entitled emergency, advocacy and COVID-19
“Role of early-career pharmaceuti- response. “We hope this report will
28 THE PHARMA WORLD cal groups in global health”, aims to inspire individuals to create their own
highlight how youth engagement can early-career groups in their countries
contribute to the achievement of the or regions and we also hope that oth-
FIP Development Goals and United Na- er groups learn from this report and
tions Sustainable Development Goals. be influenced to develop their ini-
tiatives and share their outcomes and
The report presents the results of a knowledge,” FIP President Dominique
survey on the involvement of individ- Jordan says in the foreword.
ual and early-career pharmaceutical

FEATURE

Transforming the Pharma
Industry: RACE framework

The pharmaceutical industry is Prof. Dr. Reza Bin Zaid your conversion funnels in analytics. A
one of the sectors that will see Advisor , ITmedicus and eReps Digital nice way to think of this is ‘How do you
the largest change from digital Marketing Team open the conversation and encourage
transformation in the coming years. them to give you their time’. In simple
Technologies like business intelli- REACH terms, we call ‘inbound marketing’, the
gence (BI), big data analytics, and dig- method of attracting doctors by creat-
ital marketing technology are already This is the awareness stage of brand- ing valuable content and experiencing
helping pharma companies to im- ing where you focus on activities that products in their clinical practice.
prove efficiency, speed up processes, will drive reach to your target doctors
and make data-driven decisions. online and therefore traffic to landing CONVERT
pages (microsites where your brands
Pharmaceutical products are showcased). You may not need to This means getting your doctors to
on digital marketing have your own media, it can be ac- take that final next step which turns
quired from third parties and traffic them into considering a product for
Not only to achieve business goals, driving objectives can be set there for prescribing. This is the final goal in
digital marketing helps to stand out optimal business results. your conversion funnel that ultimate-
from competitors by 24/7 product ly improves the ROI.
promotion, without engaging extra ACT
market force and even changing an ENGAGE
existing marketing plan. On the top ‘Act is short for Interact’. This stage
it allows a low budget and uncover of the RACE framework is where you This is where you focus on develop-
new marketing opportunities, these need to encourage your doctors to ing a long-term relationship with a
all lists can serve as the foundation interact with your product, already first-time prescriber of a brand to
of a powerful marketing tool, called in the showcase; doctors will take an build up doctor’s loyalty. This should
‘pharmaceutical product digital mar- action when they land on your brand ultimately drive repeat prescriptions
keting’. showcase page. It’s the first stage of and potentially advocacy. A range of
engagement before moving them to communications can be used by in
R - A - C - E- framework final conversion. This microsite will person visit and delivering a claimed
of digital marketing allow doctors to interact with product item. The measures that link to doc-
information (product detailing) and tor’s willingness scores.
The RACE framework provides solid, interact with e-samples and/or e-gifts-
practical support in your digital mar- that personalized promotional ma- In Summary
keting planning within both objective terials you will plan to deliver. These
setting and tactical development. actions are all top-level goals within The RACE framework provides a simple
RACE consists of four steps designed approach that can be used across dif-
to help brands engage their tar- ferent levels within a digital market-
get doctors. These steps reflect the ing plan. It can help define objectives,
stages in the doctor’s online journey: strategy and tactics as well enabling an
starting with Awareness through to organization to touch achievable goals.
Conversion and then considering your
brand by Engagement (an area where If you would like to find out more
Digital Marketing can really drive per- about the RACE framework and how
sonalized success). you can use it to create a successful
digital marketing plan, our eReps digi-
Let’s look at each stage of the RACE tal marketing tool could be of interest
framework in more detail and how it to you. To find out more, get in touch
can be used practically when plan- with one of our team today by calling
ning digital activities. (+880-1794724653) or email ereps@it-
medicus.com

THE PHARMA WORLD 29

FACE TO FACE

Pharmaceutical marketing ethics are
best demonstrated through acts of
fairness, integrity and responsibility

Bhupati Kumar Roy Please tell us about the and reverse engineered generic but
Executive Director, Marketing overall scenario of the Pharma some companies are producing API.
Healthcare Pharmaceuticals Limited Market in Bangladesh. Government and large companies
Dhaka are taking initiatives to develop API
Bangladesh pharma market size is production facilities to reduce the
approximately 27,000 Crore BDT ac- dependency on import. Export poten-
cording to the IQVIA MAT 3Q. There are tial of our pharma market is gradually
275 local companies, and 8 multina- increasing. Bangladeshi pharmaceu-
tional companies are licensed to pro- ticals companies are exporting medi-
duce medicines. Around 100 compa- cines to 150 countries. Now-a-days
nies are actively producing medicines. some companies are highly focused
DGDA (Directorate General of Drug Ad- on developing their capabilities to
ministration) is the regulatory author- export their products in highly regu-
ity for Bangladesh Pharma market for lated markets. (like USA, UK, Australia
Health Ministry. Around 16,000 gener- EU etc).
ic drugs are listed for the production.
The market is moderately regulated, “Complacency” is the enemy of ex-
polarized and oligopolistic. Around cellence…the company that is never
80% value of the market are with top quite satisfied is the company that
15 companies. The local pharmaceuti- satisfies.” This is a quote by Robert
cal companies are capable of meeting Zell, founder of JD Edward
the local demand with its versatile
product in an extent of 98%. Day-by- How do you evaluate the
day this industry is introducing com- performance of the pharma
plicated therapeutic molecules like industries during the pandemic?
Vaccines and Biologics. We must have
clinical trial capable facilities or insti- Alike of Global Pandemic, Bangla-
tutes in Bangladesh (particularly for desh is also experiencing the surge
biologists). Our academic institutes of COVID-19. I personally think the
(universities) are lagging in develop- contribution and performance of the
ing skilled manpower in pharma R&D. pharmaceutical companies is phe-
Universities must give more attention nomenal amidst the COVID hit time.
on this in future for R&D. Let me explain categorically. When
COVID striked in our country in mid
Government should give more in- February of 2020, Government de-
centive & focus to pharma sector, and clared a lock-down except emergen-
I believe pharma industry can bring cies. As a result, many important
more foreign currency than that of sector had to stop their production
RMG for the country in next few years’ except Pharmaceuticals, Foods and
time. emergencies. No single pharma com-
pany shut down their production &
Though Bangladesh graduated to distribution for a single day during
middle income country, but under this pandemic. You know, pharma-
the TRIPS agreement of WTO, Bang- ceutical manufacturing is somewhat a
ladesh is still enjoying the facilities complex process in terms of raw ma-
of introducing new generic drugs in terials, excipients, reagent collection;
local market. This market is heav- and every step needs a stringent pre-
ily depending on import based API

30 THE PHARMA WORLD

FACE TO FACE

cision and quality assurance to deliver The positive attitude of being present be successful in pharma industry in
a finished product. We performed and in field clicked. Later on, when I per- the long run.
maintained all the steps as normal sonally went in field to meet HCPs,
as regular time, though there were they applauded our positive nature What are the challenges before
international freight issues and lo- of being with them even in crisis. Healthcare Pharmaceutical Limited?
cal distribution challenges. We don’t Secondly, we increased the spectrum
have any data or news that our local of our portfolio. We immediately ar- Well, it is difficult to illustrate the
medicine demand faced any crisis for ranged to follow the algorithm of in- challenges as a whole. Every day new
a single day. Rather, we brought new ternational treatment protocol for challenges are popping up and we try
therapeutic solution with emergency COVID-19 and launched a number of to solve it at our extent. But as an or-
approval from DGDA to combat COV- products and ensured the availabil- ganization, every company has some
ID-19, e.g. Favipiravir, Remdesivir, Bev- ity. All these simple strategies helped objectives so it has to face some chal-
acizumab. For the first time, we ob- us to keep the momentum of growth. lenges. We really want to grow in in-
served the macro-economic behavior Along with this, we introduced zoom ternational market and more specifi-
of the pharmaceutical market and as and Microsoft team platform to con- cally in highly regulated markets. Our
expected, even in the pandemic, this nect HCPs with the patients, to meet Technical and International Market-
industry grew 10-12% by volume. emergency crisis. ing team are working on this mission.
Globally treatment guidelines are dy-
I always believe in remaining purposeful, meaningful, namic. Every year, there comes some
and how much I have contributed to organization, to changes in the treatment protocols
society. I am always passionate about my work and in advancing portfolios like oncol-
enjoy my time and work with my team without caring ogy, virology or autoimmune disease
about the position I belong to. market. We as a team, work hard to
cope-up with these changes. Another
What changes did you make What is the secret of your point is that, we have a rich portfolio
in the marketing strategies to success in getting the berth in in our pipeline. But due to some ob-
suit the pandemic norms? the Top Ten of Pharma sector? vious reason, some molecules or new
therapeutic options are very expen-
Pandemic provided us a lot of [Laughed], there is no Aladeen’s sive, which majority of people can-
learning especially in hygiene aspect. Genie for success. As  Benjamin Dis- not afford. If there was any integrated
From the very first time of pandemic raeli  said, ‘The secret of success is health insurance coverage for all peo-
we ensured the safety of our field constancy to purpose’. …be posi- ple from the government, we believe
representatives, office and factory tive, ready to learn from others, keep more people will be benefited with
colleagues. We ensured abundant yourself motivated and give the best recent innovation or therapy.
quantity of hand gloves, masks, PPE, of yourself for the organization. I
goggles and every other protective found this company as a newbie in From the marketing point of
gear for our field representative. Then the market. Within 16 years of its view, do you stress on quality
we encompass them under insur- journey, it climbed up the ranking or selling technique for more
ance policy so that we can address table and gained the trust of coun- prescription generation?
any sickness or casualties. This strat- try leading HCPs and consumers. If I
egy provided enormous confidence to look back, I can see the dedication Selling in the pharmaceutical in-
our field colleagues to meet with the of our employees, team work, loyalty dustry is very different to other indus-
HCPs. Our strategies were primarily to to the company, quality & people fo- tries due to the nature of the product
be with our HCPs so that they can rely cus of our top management. On the offered. There are a number of key
on us during any emergency necessi- top of all these, I would say “qual- factors to consider, including heavy
ties like supply information or scien- ity practice” in every step of opera- regulation, ethical issues, key influ-
tific information about our product. tions, and “compliance” are vital to encers (key opinion leaders) and the
overall selling process.

My honest opinion, “selling tech-
nique” for prescription generation in
pharma industry is a myth. In pharma
industry, there is no selling tech-
niques, it is all about quality, science
and knowledge and how the organiza-
tion communicates with HCP. If you do

THE PHARMA WORLD 31

FACE TO FACE

not have quality medicine (or prod- activities will build more trust with tive Director, Marketing respectively.
ucts) , it is almost impossible to con- those it seeks out for its products, I think my early career grooming in
vince the key opinion leaders (HCP) communication and services. direct sales operation helped me a
of our country. Another vital factor lot to understand the philosophy of
is quality operation. For any pharma On my view there is two corner- personal marketing & relationship
company to perform well (with sus- stone of the word “competition”. First, marketing. I also motivate my junior
tainability), it must focus on quality competition to grow more than others fellows of department to go to field
practice in every step of its operation and second, competition is required more frequently in the early phase
(like people recruitment, developing for further excellence. One important of their career. Regarding your ques-
people, sourcing of API, manufactur- benefit of competition is  a boost to tion about success, I personally don’t
ing, distribution, and communication innovation. Competition among com- like the word “SUCCESS”. For example,
with HCP). “Good marketing practice” panies can spur the spirit of invention Mark Zukerberg (of FACEBOOK) is a
is a must and knowledge are the only of new or better products, or more very successful entrepreneur in the
tools in pharma business. efficient processes. ... Innovation also world , but how much positive contri-
benefits consumers with new and bution he made for the world & hu-
Which of your brands are market better product. man being ..? that is a big question??.
leaders? Do you think that I always believe in remaining pur-
sometimes brand craze stands in the I am explaining the first. Every poseful, meaningful, and how much
way of choosing the best quality? company wants to grow more than I have contributed to organization, to
others. The objective is obvious. Un- society. I am always passionate about
Sergel is our number one brand less you grow more, you will be no- my work and enjoy my time and work
among all brands in Bangladesh where in rank in the future. Globally it with my team without caring about
pharma market. Apart from Sergel, we is accepted. But the question is, with the position I belong to.
have 12 more brands that are market what we are competing? The products
leaders in their respective generic we are dealing with is considered life- What are your growth plans
class. Personally I do not fully agree saving. for the company?
that brand craze is a factor. Brand
craziness is a marketing gimmick, These are not something we are We are number 4 company in the
commonly used for commodity (or dealing with like an iphone or Android pharma industry and since last cou-
consumer) marketing. For exam- phone, that most Business school use ple of years, we are growing more
ple, a young lad is very fond of Nike to exemplify as a case study. May be than the market. We will grow year
shoes. He will buy only Nike shoes, there is some isolated cases of uneth- to year more than the market growth.
even though New-balance is offering ical practices globally or locally, but
far good product in the same price we do believe most companies has In every therapeutic sector, we
category. The term should be brand the fundamentals on operating the want to build up one or two brand
loyalty. Let see, a HCP is prescribing company based on ethics and com- leaders in future. We want to build
a product since his intern time for pliances. up top class R&D facilities in the
a particular indication. His mentor country, which will meet our lo-
wrote this product and insisted him Personally what are the secrets cal and global objectives. We have
to write this product. When this young of your success in your career our ongoing project for Hormone,
HCP enter in his professional life, in reaching the very high bio-generics and Vaccine facilities.
more likely he will write this product position where are you now? Hopefully these projects will help us
because this product is proven to him. to grow further in future. We want to
When an HCP gains confidence on a My career is like an open book that expand our business in Highly Regu-
pharma product, he likes to prescribe everyone can read, and there is noth- lated Markets (like USA, Canada, EU
that medicine to his patients. ing to be personal on that. In 1988, I etc) within next few years. We look
graduated (M. Pharm) from Pharmacy forward to grow our business in ex-
Can we say the competition in the Department of Dhaka University. Next port market in such fashion, so that
local market is healthy and ethical? year I joined F. Hoffmann-La Roche, over 70% of total companies revenue
Bangladesh as a sales associate. As a will come from export to HRM (highly
Pharmaceutical marketing ethics sales associate I worked in the direct regulated markets).
are best demonstrated through  acts field operation. In 1995, I joined as a
of fairness, integrity, and responsibil- marketing manager in F. Hoffmann- Moreover, we are much ahead
ity. ... a pharmaceutical company that La Roche. Nine years later, in 2004 I of producing API of our own (DMF
acts responsibly with its marketing joined Healthcare Pharmaceuticals grade) and reduce the dependency
Limited. In 2013 & 2015, I got promot- on import.
ed as Director marketing and Execu-

32 THE PHARMA WORLD

Medical Myths

All about
hepatitis

All types of hepatitis People with hepatitis C surface and had enough infectivity
are equally serious cannot breastfeed to infect someone.

Some types of hepatitis are self-lim- Hepatitis C virus does not spread All people with hepatitis
iting, which means that they clear up through breast milk. However, moth- have jaundice
on their own. Others can cause liver ers with cracked or bleeding nipples
cancer or permanent liver damage. should temporarily stop breastfeed- Jaundice is a sign of liver problems,
Hepatitis A  often makes people feel ing until there has been healing. but not all hepatitis viruses cause
very sick for a short time, but it is liver problems right away. About
very rare to have any kind of serious People can contract hepatitis half of people living with hepatitis
complications or long lasting illness. by kissing and holding hands C have no symptoms at all until,
Hepatitis B  can be very serious sometimes decades down the line,
if a person’s initial viral infection Although this myth is widespread, when the virus has damaged their
becomes a chronic infection, but it is still a myth. People cannot liver severely enough for jaundice
that happens in only 2–6% of adults, contract hepatitis C virus by kiss- or other symptoms to appear.
and some people never have symp- ing, holding hands, sharing eating
toms during their initial infection utensils, mosquitoes, coughing, or People cannot contract
(though the majority do). Hepatitis sneezing. Hepatitis C virus spreads hepatitis C twice
C  often doesn’t cause symptoms at when someone encounters blood
first, but around 60–80%  of people from someone who has contracted This is also a myth. Once someone
with a hepatitis C infection go on the virus through shared drug injec- is treated and cured of hepatitis C,
to develop chronic infection, which tion equipment, non-sterile tattoo they can contract it again — antibod-
eventually can lead to liver cancer, equipment, birth, or rarely, sex. ies from the original infection don’t
liver cirrhosis, and death if left un- protect you like a vaccine might (if
treated. This is why it’s important to There is a vaccine for we had one). This is why it remains
be vaccinated for hepatitis A and B all types of hepatitis important to take precautions
and screened for hepatitis C at least against reinfection once someone’s
once, even if you feel well. This is not true. Currently, there initial infection has cleared up.
are vaccines for hepatitis A and
Hepatitis C is rare B, which require multiple shots to Hepatitis C medications
complete the series. As it stands, have bad side effects
According to the World Health Or- there is no vaccine for hepatitis C.
ganization, 325 million people have This is not true. Current treat-
hepatitis B, C, or both. In 2016, the Hepatitis C cannot survive ments for hepatitis C virus usually
WHO estimated that 399,000 people outside of the human body involve 8–12 weeks of oral therapy
died from hepatitis C globally. with pills. Cure rates are now over
Together, hepatitis B and C are the In 2014, researchers at Yale Univer- 90%. These new medications have
most common causes of cirrhosis sity found that hepatitis C remained very few side effects and are very
and liver cancer. They also cause the alive a full 6 weeks after drying on a well tolerated.
most viral hepatitis-related deaths.

THE PHARMA WORLD 33



INTERVIEW

Not only in Bangladesh, Sheikh
Russel Institute is the only institute
of its kind in south Asia

Prof. Dr. Faruque Ahmed our hospital. Among the cancers, GI Bowel Syndrome (IBS)? Is it
Director cancers is the 4th most-common type preventable? What changes in
Sheikh Russell Gastro Liver Institute & of cancer and the 2nd highest cause diet can help the patients?
Hospital, Dhaka of cancer death globally. Other ma-
lignancies such as liver cancer, car- There are many factors which may
As an eminent Gastroenterologist cinoma stomach, carcinoma colon, trigger IBS like diet, stress, various
of the country, would you please carcinoma esophagus, carcinoma gall drugs or medications etc. Fried foods,
let us know about the common bladder, carcinoma pancreas etc. are junk foods, excessively fatty food
pancreato-biliary and oncologic also common in our country. can trigger IBS. Milk and milk prod-
disorders of the gastrointestinal ucts also trigger IBS symptoms. Dairy
(GI) tract in our country? In light of the recent COVID-19 products contain lactose and many
pandemic, does pre-existing GI people develop lactose intolerance.
Common disorders in the biliary disorders pose a greater risk for So, we advise people with IBS to avoid
system are gall stones, gall-bladder COVID-19 complications? What milk and milk products as these will
carcinoma, different bile-duct injuries are the GI symptoms to look exacerbate the symptoms. Leafy veg-
etc. If we talk about pancreas, there out for? What measures do you etables should also be avoided.
are acute pancreatitis, chronic pan- recommend for its management?
creatitis and different types of pan- Mental stress also plays a huge role
creatic tumors like solid tumors, cystic Definitely, people with pre-existing in IBS. Mental illnesses like anxiety,
tumors and pancreatic cancers, which GI disorders will have more complica- depression, tension, or even euphoria
are very common. Pancreatic divisum tions due to COVID-19, in comparison may trigger symptoms in IBS. GI infec-
is one of the most common congeni- with healthy individuals. They’ll also tions also exacerbate IBS symptoms.
tal pancreatic anomalies we see in have worse prognosis. Most com-
mon GI symptoms to look out for are, Recommended diet for IBS patients
nausea, vomiting, diarrhoea-mostly is FODMAPs diet. Studies have shown
bloody diarrhoea, abdominal pain that a low FODMAP diet improves IBS
which may sometimes result from symptoms.
acute pancreatitis due to COVID. On
the other hand, there will inevitably IBS is not preventable; there are no
be some biochemical liver abnor- such measures that can be taken to
malities. 5% to 30% people may show prevent IBS. We have to keep in mind
signs of jaundice which, when severe, that IBS is a chronic illness. Once an
may lead to liver failure, especially IBS, always remains an IBS. So, the
when the patients have pre- existing patients should be very aware and
liver disease. Other symptoms which mindful of their diet and avoid all the
may occur are anorexia or loss of ap- trigger factors mentioned above.
petite, loss of taste, loss of smell etc.
Please tell us in brief about peptic
There are no specific management ulcer disease (PUD)? How do we
for COVID GI symptoms. We generally go treat and prevent recurrence of PUD?
for the usual management. The main
target should be avoiding getting COVID Peptic ulcer disease is very common
at all costs by adopting all the neces- worldwide. It is also a very common dis-
sary precautions to prevent COVID. ease in our country. Once upon a time
Bangladesh had the highest prevalence
What are the trigger factors of PUD in the world. Back in the 80’s, the
and symptoms for Irritable prevalence was found to be 15%. Today,
the prevalence dropped down to 3% to
4%. The scenario of PUD has improved

THE PHARMA WORLD 35

INTERVIEW

in our country. Peptic ulcer disease is How common is GERD in our country? kinds of GI interventions. So, we are
the ulcerous openings or sores devel- Can it lead to malignancy? How can developing and patients are getting
oped in the lining of the stomach, oe- we prevent such complications? interventions they require.
sophagus  or intestine, especially the
duodenum.  Duodenum is the most GERD is also a common GI problem. Gastroenterology started as a dedi-
common site for peptic ulcer to occur We have field level studies reveal that cated specialty in Bangladesh in 1977
as it is the beginning of the small in- the prevalence of GERD in our society and was initiated by Prof. AK Azad
testine. Peptic ulcer is an  acid–peptic is around 20%. Among the GI diseases, Khan. Subsequently, Prof. Mahmud
disorder. It develops due to an imbal- GERD is one of the costliest diseases, Hasan joined in 1982 with Prof. Azad.
ance in the acid-pepsin cycle, both of because to manage GERD, you have During these last few decades, our
which are secreted in the stomach. On to take medications for a long time. If gastroenterology has reached to a
top of that, there’s infection by Helico- GERD is left untreated for a long time, world-class standard. Now we have a
bacter Pylori. Most patients experience especially for over 5 years, it proceeds good number of trained and certified
symptoms like upper abdominal pain, to develop oesophageal cancer. So, gastroenterologists in our country;
abdominal discomfort, abdominal dis- we can consider GERD as a precancer- we also have a good number of gas-
tension, early satiety, burning in upper ous condition. troenterology centres in our country.
abdomen during empty stomach etc. In Sheikh Russell, we have all the to-
The treatment of PUD is not at all com- GERD is preventable. GERD is re- pnotch facilities for GI and Liver pa-
plex. All the medications are excellent lated to extra body weight. If we can tients. We also have a dream to start
in our country and available at an af- maintain the standard body-weight, Liver-Transplant, but due to COVID, we
fordable price. We usually recommend we can prevent the problem. We must have not been able to start it yet. We
treatment for 4-8 weeks. If the patient avoid foods which may trigger GERD started a structured training of endos-
is found to be infected with H. pylori, like junk foods, fried foods, and in copy using different models including
we give anti- H. pylori treatment which some cases, full-fat milk or milk prod- animal models. We have collaborated
is very effective in treating PUD and to ucts. There are some etiquettes we with UK and Indian experts of the
eradicate the bacteria. Once fully eradi- also need to follow i.e. avoid eating field. They have trained us and worked
cated, we can prevent the recurrence of full stomach meals, avoid over-eat- with us; thus we have developed many
peptic ulcer disease. ing, keeping one-third of our stomach trained qualified gastroenterologists.
empty, avoid eating junk foods, avoid This institute is also another great
Being available over-the counter, taking water immediately after meal, achievement of the country for pro-
patients now-a-days are self- avoid going to bed right after eating viding modern treatment of the GI
prescribing and overusing anti- and waiting at least two hours after and Liver diseases, and for training
ulcerant drugs i.e. PPIs. What meal to go to sleep. Some drugs like and developing skilled manpower in
are the consequences of such antihypertensive agents or anti-anx- this field. We are doing some regular
irrational use in long term? iety drugs may also precipitate this public health works in media such as
illness. posters, talk shows to increase aware-
PPIs are excellent drugs in general ness about the preventable diseases.
for management of acid related dis- With proper treatment we can cure I was the key person to prepare the
orders. These are very affordable as GERD and if we can control this ill- DPP, implementation of it as Project
well. But there are some limitations in ness, we can definitely prevent fur- Director. I am now working as Director
long term use of the PPIs. There is a ther complications. of this Institute. Within the short pe-
global alert against the long term use riod of time the institute has gained
of PPIs. So, under any circumstances, How has Gastroenterology the faith of people of this country as a
long term use of PPIs is strongly dis- developed since you started, in dependable health care institute. We
couraged. And of course, using this terms of diagnosis and clinical rendered tremendous services to COV-
drug as OTC, without indication is nev- approach in Bangladesh? Please ID-19 patients including vaccination.
er advocated. The drug should only tell us about the role of Sheikh
be purchased when prescribed by the Russel Gastro Liver Institute & This is a world-class GI centre. Our
physicians and should not be contin- Hospital in the field of Interventional Prime Minister is the key Patron of this
ued for more than 4-8 weeks. Long gastroenterology in our country? institute and with her help we were
term use of PPIs may lead to some se- able to create such first–class centre.
rious consequences like development The field of Interventional Gastro- Not only in Bangladesh, Sheikh Rus-
of tumors or polyps in the stomach, GI enterology is already booming in our sel Institute is the only institute of its
infections, kidney complications and country. In many centres we have in- kind in this south Asian part of the
bone-mineral complications. terventional gastroenterology. If we world. So, we are doing GI practices
talk about Sheikh Russel Gastro Liver at a world-class level.
Institute & Hospital, we provide all

36 THE PHARMA WORLD

GASTROLIVER UPDATE

Hepatic encephalopathy related fection, kidney dysfunction, or death). The albumin group
to transjugular intrahepatic had higher rates of pulmonary edema (4 versus 1 percent),
portosystemic shunt although statistical analysis was not provided. Additional
data on efficacy and safety are needed before albumin is
Patients with a transjugular intrahepatic portosystemic used routinely for treating decompensated cirrhosis.
shunt (TIPS; a nonsurgical procedure for managing com-
plications of portal hypertension) may develop hepatic Lactated Ringer’s solution
encephalopathy, and pharmacologic prophylaxis may in acute pancreatitis
reduce this risk. In a trial including 197 patients with cir-
rhosis undergoing TIPS and followed for six months, rifaxi- There are conflicting data on the benefits of Lactated
min prophylaxis resulted in lower rates of post-TIPS hepatic Ringer’s (LR) solution in reducing systemic inflammation.
encephalopathy compared with no prophylaxis (34 versus In a trial that randomly assigned 121 patients with acute
53 percent). We believe rifaximin prophylaxis may be rea- pancreatitis to treatment with Lactated Ringer’s solution
sonable for patients with risk factors for post-TIPS hepatic or normal saline, the use of LR did not impact the primary
encephalopathy (eg, alcohol-related cirrhosis, sarcopenia), outcome of systemic inflammatory response syndrome
but additional trials are needed to determine if rifaximin is prevalence at any time point, but appeared to reduce hos-
beneficial for most patients undergoing TIPS. Potential bar- pital stay and intensive care unit admissions. Given the ab-
riers to rifaximin use include duration of therapy and cost. sence of clear evidence of superiority, hydration with either
normal saline or Lactated Ringer’s solution is acceptable.
Semaglutide for treating
nonalcohol-associated Transglutaminase 2 inhibitor
steatohepatitis for celiac disease

Data on glucagon-like peptide-1 (GLP-1) agonists (an A gluten-free diet is central to the management of celiac
antidiabetic therapy) for treating nonalcohol-associated disease, but new therapies are under investigation. In a
steatohepatitis (NASH) are emerging. In a 72-week trial randomized trial, 159 adults with well-controlled celiac
including 320 patients with NASH, semaglutide (0.4 mg disease were assigned to one of three dose levels of an
daily) resulted in higher rates of histologic resolution investigational selective oral transglutaminase 2 inhibitor
of NASH compared with placebo (59 versus 17 percent). or placebo for six weeks while on a daily gluten challenge
Lower doses (0.1 or 0.2 mg daily) were less effective but (3 grams/day). All three dose levels significantly attenuat-
also more likely to result in histologic resolution (40 and ed gluten-induced duodenal mucosal damage compared
36 percent, respectively) compared with placebo. How- with placebo. Further studies are needed to validate these
ever, rates of improvement in liver fibrosis stage were results before considering an oral transglutaminase 2
not significantly different between the treatment groups inhibitor as an alternative to a gluten-free diet.
and placebo. Gastrointestinal side effects were more
frequently reported with semaglutide, but statistical Risk of late postoperative
analysis was not provided. Additional data on outcomes recurrence of Crohn disease
and side effects are needed before semaglutide is used
routinely for patients with NASH in the absence of other For patients with endoscopic remission after surgery
indications. for Crohn disease (CD), the risk of disease recurrence
beyond one year (ie, late recurrence) is uncertain. In a
Albumin infusion for patients with study including 86 patients with ileocecal resection for
decompensated cirrhosis CD and no recurrence at initial postoperative colonos-
copy, 35 patients (41 percent) had late recurrence with a
Patients with decompensated cirrhosis are administered median time to recurrence after baseline colonoscopy of
albumin for established indications (eg, spontaneous 14 months (interquartile range 6 to 25 months). Disease
bacterial peritonitis), whereas the benefit of routine infu- recurrence was defined as a composite endpoint of at
sion is uncertain. In a trial of 777 hospitalized patients least one of the following: clinical recurrence, CD-related
with decompensated cirrhosis and serum albumin level hospitalization, bowel complication, balloon dilation of
<3.0 g/dL (30 g/L), compared with standard care, albumin the anastomosis, or repeat surgery. This study supports
infusion to achieve a level ≥3.0 g/dL (30 g/L) for 14 days or continuing endoscopic surveillance of patients with ini-
until discharge did not reduce the composite endpoint (in- tial endoscopic remission after surgery for CD.

THE PHARMA WORLD 37



INTERVIEW

Hepatology Society of Bangladesh is
playing an important role in developing the
capacity of prevention and management
of liver diseases in Bangladesh

Prof. Dr. Mobin Khan As an eminent Hepatologist of with underlying cirrhosis of the liver,
Ex-Professor and Founder Chairman the country, would you please particularly those who are older than
Department of Hepatology let us know about the liver 65 years, are at a higher risk of devel-
BSMMU & Director diseases in our country? oping severe COVID-19 illness and/or
The Liver Centre, Dhaka more problems from their existing liv-
Liver diseases are going through er disease if they get a COVID-19 infec-
a transition from once predominant tion, with prolonged hospitalization
hepatitis to non-alcoholic fatty liver and increased mortality. COVID-19
disease (NAFLD) in Bangladesh. Like may affect the processes and proce-
that of the developed part of the world, dures for screening, diagnosis, and
a rise in the prevalence of NAFLD and a treatment of liver cirrhosis. Therefore,
fall in the hepatitis B and C is evident. these patients need to take all neces-
Currently the prevalence of hepatitis B sary precautions to avoid COVID-19
is approximated to be near about 4% infection. Primarily they should avoid
or below. While the prevalence of hep- social gathering, keep themselves
atitis C is only 0.2%. As the hepatitis B isolated in a safe and clean room, use
vaccine was scheduled in the current masks, and practice hand hygiene. If
EPI program since 2003, the number of such patients develop any new symp-
patients is going to fall in the coming toms, they should contact their liver
days. However, hepatitis C doesn’t have specialist immediately.
any vaccine which could be taken to
prevent it. If the main routes of trans- Please tell us, in brief, about
mission like blood transfusion, sexual the prevalence of viral hepatitis
intercourse, drug abuse are controlled, in Bangladesh, what can
infection rates would decline. On be done to eliminate viral
the other hand, NAFLD is hiking rap- hepatitis from the country?
idly in the country. A cross-sectional
study conducted in a large sample of We know that mainly four hepatitis
participants revealed that the overall viruses cause significant viral hepati-
prevalence of NAFLD in Bangladesh tis, namely- hepatitis A, hepatitis B,
would be roughly in between 32.12% to hepatitis C and hepatitis E. Among
35.64%. Hence, it is time that the fatty them hepatitis A and hepatitis E are
liver disease is taken seriously. waterborne diseases and causes
acute inflammation of the liver. Hepa-
In light of the recent COVID-19 titis A predominantly occurs in chil-
pandemic, does pre-existing dren and hepatitis E occurs in adults.
liver disease (chronic liver These are self-limiting disease which
disease, cirrhosis, or related require adequate rest and support-
complications) pose a greater ing care through hydration and nu-
risk of COVID-19 complications? trition. These diseases continue to
What measures should be taken occur sporadically, and therefore no
to address this phenomenon? prevalence estimates are possible. As
these viruses are transmitted through
According to the American Asso- fecal-oral route, maintenance of hy-
ciation for the Study of Liver, people

THE PHARMA WORLD 39

INTERVIEW

giene and drinking safe and clean A direct quantitative comparison of advancement in
water is essential to prevent catching liver disease prevention, diagnosis and management
the hepatitis A and E virus. Hepati- with the developed countries is not possible. However,
tis B and C on the other hand cause our subjective assessment shows that substantial
chronic inflammation of the liver improvement has taken place regarding liver disease in
(chronic hepatitis). The current preva- the country over last two decades.
lence of hepatitis B is around 4% and
hepatitis C is around 0.2%. A very ef- HCV infection, 15 to 30 out of 100 peo- triglyceride and some medications
fective and low-cost vaccine for hepa- ple can develop liver cirrhosis within (e.g., amiodarone, diltiazem, tamox-
titis B is available in the market. The 20 years. The overall annual risk of ifen). However, lean patients are not-
vaccine is also incorporated in the cancer in hepatitis C patients is 1 to risk free either. Some environmental
expanded program on immunization. 5%. Which 1 to 5 out of 100 chronic and genetic factors play important
Therefore, ensuring EPI vaccination hepatitis C patients might develop role in the development of NAFLD
of children can prevent hepatitis B cancer each year. Co-infection with in lean patients. They include – high
in the children. Whereas, adults who HBV virus, alcohol intake, and co- fructose diet, high fat diet, metaboli-
were born before 2003 should take existence of hemochromatosis and cally obese normal weight physique,
the vaccine, to prevent the disease. biliary cirrhosis increases the risk of presence of PNPLA3 mutation, con-
Hepatitis C doesn’t have any vaccine developing cancer in HCV patients. genital defects in metabolism, endo-
for prevention. However, both B and C Some other risk factors include older crine disorders (like polycystic ovary
viruses could be prevented from entry age (>55 years), male sex, decreased syndrome, hypothyroidism, growth
if routes of transmissions are blocked. platelet count and increased alfa- hormone deficiency), starvation, and
WHO recommends following inter- fetoprotein. Since novel directly act- total parenteral nutrition.
ventions of primary prevention of the ing antiviral drugs are 95% effective
hepatitis B and C, in reducing hepatitis C loads in HCV Up to 30% NAFLD patients can
patients, not taking the treatment develop NASH. In order to prevent
l safe and appropriate use of would be the most important risk fac- NASH, NAFLD patients must take in-
health care injections; tor for developing cancer during the terventions to stop the progression
present times. of NAFLD. These interventions in-
l safe handling and disposal of clude – weight reduction, increased
sharps and waste; What are the risk factors of physical exercise and drugs. Diet and
developing non-alcoholic fatty liver lifestyle modification, with weight
l provision of comprehensive disease (NAFLD)? How often can loss, remain the mainstay of treat-
harm-reduction services to NAFLD progress to nonalcoholic ment for NAFLD. A reduction of 5 to
people who inject drugs; steatohepatitis (NASH)? What 10% weight substantially improves
can be done to prevent it? NAFLD associated liver changes in
l testing of donated blood for patients. Weekly 150 minutes exercise
HBV and HCV (as well as HIV A wide range of conditions can in- is recommended for reduction of fat
and syphilis); crease the risk of developing NAFLD in in the liver. Drugs alone cannot halt
an individual. The most important fac- the course of NAFLD. However, it can
l training of health personnel; and tor is increased body mass index (BMI). work as an adjunct in the treatment
l prevention of exposure to Being overweight and obesity sig- of NASH. Vitamin E and pioglitazone
nificantly increased the risk of NAFLD. offer some benefit in selected cases
blood during sex. Other important risk factors are – type (must be taken with advice from
2 diabetes, insulin resistance, high Hepatologists). Obetacholic acid may
What are the chances of someone blood pressure, high cholesterol and provide the first liver-targeted thera-
with HCV infection developing py for NASH.
cirrhosis or liver cancer?
What are the risk factors?

Globally, an estimated 58 million
people have chronic hepatitis C virus
infection. Every year 1.5 million new
infections are added to this number.
In 2019, nearly 300,000 people died
to due to hepatitis C. Around 30% of
those who are infected spontaneous-
ly clear the disease within 6 months
and doesn’t require treatment. But
the remaining 70% develop chronic
HCV infection. Of those with chronic

40 THE PHARMA WORLD

INTERVIEW

As a pioneer hepatologist of our are frequently used for both diagnosis ment of liver diseases in Bangladesh.
country, where does Bangladesh and management. RT-PCR based am- For prevention, it is working relentlessly
stand as far as prevention, plification of the hepatitis B and C virus for increasing awareness about liver
diagnosis and treatment of liver and viral load calculation are available diseases among the people through
disease are concerned, compared in many centers. Many antibodies as- press conferences, comprehensive
to the advanced countries? sociated with autoimmune diseases of newspaper and social media articles in
liver could now be detected in Bangla- both Bangla and English, and publish-
A direct quantitative comparison of desh. Regarding management, almost ing books for lay people. Every year on
advancement in liver disease preven- all drugs are now available at reason- 12th June and 28th July press conferenc-
tion, diagnosis and management with able cost in the country. Endoscopic es and/or virtual meetings are arranged
the developed countries is not possible. and percutaneous interventions are on the occasion of International NASH
However, our subjective assessment regularly done. Liver transplantation day and world hepatitis day respective-
shows that substantial improvement are now being tried in Bangladesh. ly. The aim is to raise awareness about
has taken place regarding liver disease viral hepatitis and nonalcoholic fatty
in the country over last two decades. As the Founder President of liver disease. We try to disseminate the
Availability of HBV vaccine and its incor- “Hepatology Society of Bangladesh”, updated information on this disease
poration in EPI has remarkably reduced would you please tell us about the through this program. Besides, we are
the prevalence of HBV in Bangladesh. role of you organization regarding arranging biannual international hepa-
Almost all the advance diagnostic tools hepatic disorders in Bangladesh? tology conference to update knowledge
and techniques with relevant experts of specialist physicians and surgeons of
are now available in the country. For ex- ‘Hepatology Society of Bangladesh’ is Bangladesh on the latest development
ample, Fibroscan, CT abdomen, MRI of playing an important role in developing in the field of hepatology.
HBS is regularly done. ERCP and MRCP the capacity of prevention and manage-

HEPATITIS C

DEFINITION GLOBAL HEALTH BURDEN MAIN ROUTES OF
TRANSMISSION
Hepatitis C is a liver disease Viral hepatitis is found worldwide. However, there is a higher
caused by the hepatitis C prevalence in North Africa and Eastern & Central Asia. Unsafe Injections
virus (HCV), the virus can
cause both acute and 3 to 4 350 000 to 180 Inadequate Sterilization of
Chronic hepatitis infection, million 500 000 million Medical Equipment
ranging in severity to a mild people infected
illness lasting a few weeks new cases worldwide. Blood Transfusion
to chronic liver diseases, each year. die each year
liver cancer and in some from Hepatitis C. Sexual Transmission
cases death.
TREATMENT INNOVATION
THE SILENT EPIDEMIC: EVOLUTION OF THE DISEASE 60 to 90%

Due to the large number of people unaware that they are chronically infected with HCV the of HCV infections can be cured. New treatments o er
identification of new advanced liver diseases will continue to increase as people progress in better cure rates, reduced treatment duration and fewer
their disease and more screening is undertaken. side e ects.

Infection Chronic Disease Cirrhosis Liver Cancer FROM SCREENING TO CARE

80% of people do 60-85% of people 15-30% of 1 HCV is the n°1 Too often, patients who test positive are not referred to
appropriate treatment and care.
not exhibit any infected with HCV will people with chronic cause of Liver
symptoms following develop chronic HCV infection will Only 3-5%
initial infection. infection. develop Cirrhosis Cancer.
of patients receive treatments even in high income
0 5 YEARS 10 YEARS 20 YEARS countries.

PATH TO HCV MANAGEMENT INCREASE AWARENESS IMPROVE SCREENING DEVELOP POLICIES &
AND PREVENTION AVAILABILITY ALLOCATE RESOURCES
SUPPORT RESEARCH
& DEVELOPMENT 3 out of 4 persons are unaware Only 1 in 3 countries provides Only 1 in 3 countries has a
There are currently 20 candidate
products in the pipeline. they are infected with HCV. testing accessible to all. national strategy to combat HCV.

THE PHARMA WORLD 41



INTERVIEW

COVID-19 vaccination of liver patients should
be prioritized over any other patients

Prof. Dr. Salimur Rahman burden of Hepatitis B is decreas- Please tell us, in brief, about the
Consultant, Hepatology & Internal ing gradually as our government has prevalence of Viral Hepatitis
Medicine started mass vaccination against hep- in Bangladesh. what can be
Labaid Specialized Hospital atitis B since 2005. And we are seeing done to Eliminate Hepatitis
Professor, Dept. of Hepatology, the results now. If we talk about the B from the country?
BSMMU (Former) acute liver diseases presented with
President, Association for The Study jaundice, most adults are suffering In our country the prevalence of vi-
of Liver Diseases Bangladesh from Hepatitis E, while most cases in ral hepatitis is higher than the West-
children are due to Hepatitis A. This is ern countries as they have success-
As an eminent Hepatologist because majority of adult population fully eliminated the disease through
of the country, how do you achieve lifelong immunity against preventive measures and mass vac-
evaluate the status of liver hepatitis A once they become infect- cination. On the contrary there are
diseases in our country? ed in childhood. In some cases, hepa- higher prevalence of chronic hepatitis
titis B can also cause acute infection. due to alcohol in the West. Chronic
There is a huge burden of liver hepatitis in our country is due to hep-
diseases in Bangladesh. According A liver disease which is increasing atitis B and hepatitis C. As I said be-
to a study, 10-12% of patients admit- in prevalence is fatty liver, mainly due fore, around 5% people are suffering
ted in the general medical wards of to the changes in diet and lifestyle, from hepatitis B and around 1% peo-
our medical colleges in our country especially in the urban areas. Other ple are suffering from hepatitis C in
suffer from liver diseases. If we talk causes of liver diseases can be auto- Bangladesh. These numbers would go
about the prevalence of liver diseases immune, drug induced or malignancy. down in the future, as we have started
in our country, most are due to viral Other rare causes are hemochroma- mass vaccination against hepatitis B.
hepatitis, especially hepatitis B and C. tosis and Wilson disease. The treatment of hepatitis C is also
Hepatitis B and C cause chronic liver available in our country at a very af-
diseases. In a study done around 5 In light of the recent COVID-19 fordable price. So, we are on the path
years ago, the carrier rate of Hepati- pandemic, does pre-existing liver to eliminate both hepatitis B & C in
tis B was around 5-6% in Bangladesh, disease (chronic liver disease, the future from our country.
while Hepatitis C was around 1%. The cirrhosis, or related complications)
pose a greater risk for COVID-19 What are the chances of someone
complications? what do you with Hepatitis C infection
recommend for its management? developing cirrhosis or liver
cancer? What are the risk factors?
We know that when a person with
any comorbidity gets infected by COV- This is a very interesting question.
ID-19, the complications are much more In case of acute viral hepatitis B in-
than a person without any comorbidity. fection, around 95% of the patients
Same goes for the patients with liver gets cleared of the virus and only 5%
diseases; the morbidity and mortality develop chronic hepatitis B. among
are much higher than patients without them only those who have active dis-
liver disease. So, the liver disease pa- ease, require treatment. On the other
tients should be very careful and must hand, in case of hepatitis C, 80 to
be vaccinated to protect themselves 90% of the patients become chroni-
from COVID-19. Their vaccination should cally infected. The virus remains in
be prioritized over any other group of the body for the rest of their lives. So,
patients. My advice to the patients of the disease progresses to cirrhosis
liver diseases would be, they must con- of the liver, decompensated liver cir-
tinue taking their medicines during the rhosis and hepatocellular carcinoma.
COVID period and if they are unable to Obviously, it’ll take 15 to 20 years for
come to hospital, they should consult this progression. Around 5 to 10% of
physicians over telemedicine. the patients develop liver cirrhosis

THE PHARMA WORLD 43



INTERVIEW

and liver cancer. If patients do not for hepatitis B & C in our country is able in our country except liver trans-
have the access to proper treatment, just 1% of that in the western coun- plantation. We actually did start liver
especially liver transplantation, they tries. The price for a single tablet for transplantation, but due to COVID
will eventually die. The risk is much hepatitis C in the Western countries is situation and many other circum-
higher in patients who are suffering around $1000, while Bangladesh can stances, we temporarily stopped liver
from both hepatitis B & C, hepatitis C provide a full course of treatment in transplantation. Hopefully in the fu-
patients who have fatty liver and pa- $1000. But of course, this is still very ture when the COVID situation im-
tients who are alcoholic. expensive for our poor people. Due to proves, we will be able to resume the
the availability of generic products in facility again. Other interventional
How effective is stem cell therapy our country, the cost of treatment in procedures like resection, radiofre-
for end stage liver disease? is it our country has come down to just a quency ablation, microwave ablation,
compatible with the socio-economic fraction of 1/100th of that in the west- endoscopic procedures like argon
demographic of our country? ern countries. You’ll be happy to know plasma coagulation and endoscopic
that many patients from the Western variceal ligation, and transarterial
This is also a very good question. countries, as well as China come to chemoembolization (TACE) are avail-
Stem cell therapy has been started our country for treatment of hepa- able and are regularly being done
in Bangladesh for quite a few years. titis after getting diagnosed in their even in this COVID situation.
We have done stem cell therapy on respective countries. They come to
a number of patients. You know that Bangladesh, get the prescription and For prevention, we must create
stem cell therapy is a mode of treat- buy their whole course of treatment awareness. We should provide vac-
ment which is still in a research level from our country. I myself have pro- cination for hepatitis B. We should
in many countries. So, we should not vided telemedicine services to many treat patients with hepatitis C so that
take it as the alternative for liver such patients. I have treated many they cannot transmit the disease to
transplant. Liver transplant is the patients from UK, USA and China. others. Sterile surgical equipment
ideal treatment for end stage liver and disposable needles should be
disease. We can think of stem cell To help the people in our country, used for any surgery including cir-
therapy as a bridge to liver transplan- our government has been providing cumcision and nose and ear pierc-
tation. If patients do not have access some free drugs or subsidised treat- ing. During dental surgery and other
to liver transplantation or cannot af- ment in bigger medical colleges and dental procedures, use of sterile
ford liver transplantation, they may in BSMMU also. Bangladesh has a tar- equipment and needle should be
try stem cell therapy. I have seen the get to achieve the target of Sustain- practiced. Tattooing is also a major
prognosis is not good in decompen- able Development Goal to eliminate area of transmission in the Western
sated liver cirrhosis, but it may give viral hepatitis by the year 2030. countries. In the villages of our coun-
good results in compensated liver cir- try, there is still practice of traditional
rhosis. Many of our patients who have I also think that the insurance com- medicine and people still go to illit-
been treated by stem cell therapy are panies should come forward to provide erate quacks for treatment. This is a
in good condition. health care insurance to poor people very dangerous practice. It should be
in our country who cannot afford the avoided and we should create aware-
The socio-economic condition is treatment otherwise. Family support is ness among people to take proper
not a factor. If scientifically it becomes another thing we should focus on. For treatment and advice from qualified
very effective and the advancement example, the affluent members of the physicians.
of the stem cell therapy in the future family or relatives can come forward
becomes much more beneficial, then to help lessen the burden of the un- For diagnosis, we can approach
it should be practiced to save the pa- derprivileged family members who are the government to fix up a rate of all
tients’ lives. So, let us see what the suffering from liver diseases. the investigations. Thus the cost of
future holds. diagnosis may come down.
As one of the leading Interventional
Treatment of Liver diseases is quite Hepatologist of our country, I have said before, all the
expensive. How can we make it where does Bangladesh stand procedures and surgery needed
affordable for the common people? as far as prevention, diagnosis for the treatments and also all the
and treatment of liver diseases medications, as well as the expertise
Yes, I do agree that the treatment are concerned, compared to is available in our country. But, yes,
of liver diseases is quite expensive. the advanced countries? the cost of treatment can be reduced
The investigative procedures are ex- further by the help of the government
pensive, and treatments are also ex- I would say all the components of to help the needy patients who
pensive. But, the cost of treatment intervention in hepatology is avail- discontinue their treatment due to
poverty.

THE PHARMA WORLD 45



INTERVIEW

We have introduced PLEX in Bangladesh and
dedicated this therapy to the sacred memory
of Bangabandhu & named it Mujib Protocol

Prof. Dr. Mamun-Al-Mahtab (Shwapnil) As an eminent Hepatologist of acute hepatitis due to SARS-CoV-2
Division Head the country, would you please infection, which is usually self-limit-
Interventional Hepatology Division let us know about the liver ing. However, those with pre-existing
Department of Hepatology diseases in our country? advanced liver diseases may not be
BSMMU, Dhaka that lucky. It has been revealed from
If we talk of liver diseases in Bang- a large Asian Pacific multi-center col-
ladesh, the one name that comes to laborative study conducted in several
mind is hepatitis B virus. This particu- countries of the region including
lar virus is responsible for more than Bangladesh, that in patients with
30% cases of acute hepatitis in Bang- pre-existing liver cirrhosis, COVID-19
ladesh. However, the fact remains is associated with up to 43% mortal-
that hepatitis E and A viruses are the ity. Besides some of the drugs used
main culprits behind acute hepatitis in COVID-19 management including
in Bangladesh, being responsible Remdesivir, Favipiravir, Tocilizumab
for majority of such cases in adults etc. are hepatotoxic. Not only that,
and children respectively. On the even steroids may lead to flair of
contrary, hepatitis B virus dominates hepatitis B virus.
the scenario of chronic liver diseases
in Bangladesh, being responsible However I am not advocating that
for more than 60% cases of chronic people with pre-existing liver disease
hepatitis, liver cirrhosis and liver if contracted with COVID-19 need not
cancer in Bangladesh. The next most be treated. Rather COVID-19 manage-
important causes of chronic liver ment is important for these patients.
diseases in the country are fatty liver What I recommend is that COVID-19
and hepatitis C virus respectively. patients with co-existing underlying
liver disease should be considered
It has been estimated that more for hospitalization and preferably co-
than 22 thousand people die in Bang- managed with a Hepatologist for best
ladesh annually from liver disease possible outcome.
related etiologies. Liver diseases
are responsible for more than 10% Please tell us, in brief, about the
deaths in the medicine wards of pub- prevalence of Viral Hepatitis
lic medical colleges in Bangladesh, in Bangladesh. what can be
being the 3rd commonest cause of done to Eliminate Hepatitis
deaths in the country. B from the country?

In light of the recent COVID-19 According to published litera-
pandemic, does pre-existing ture, 5.4% Bangladeshis are infected
liver disease (chronic liver with hepatitis B, while 0.84% have
disease, cirrhosis, or related hepatitis C virus infection. The first
complications) pose a greater step to eliminate hepatitis B would
risk for COVID-19 complications? be to raise public awareness, so
what measures do you recommend that people volunteer to be tested.
for its management? We have to keep in mind that these
patients remain asymptomatic. Most
Patients, even without any pre- get diagnosed at routine testing for
existing liver disease, can develop

THE PHARMA WORLD 47

INTERVIEW

health check or screening before is ongoing in Japan involving several liver disease suffers from sudden
overseas employment, vaccination or Japanese public universities. Had liver failure due to wide range of eti-
blood donation. COVID-19 pandemic not upset our ologies like in our perspective, reac-
regular lives, NASVAC was expected to tivation of hepatitis B, acute hepatitis
Therefore unless people become be available in Bangladesh by now. A or E infection, drugs etc.
aware and get tested voluntarily in We are expecting that as COVID-19
large numbers, we won’t be able to pandemic is eventually contained, we The curative treatment for ACLF is
attain our SDG goal of elimination of shall have NASVAC for prescribing to liver transplantation, which unfortu-
hepatitis B and C by 2030. Besides our patients sometime soon. nately is not available in Bangladesh.
at the same time, we also have to Besides, it is also expensive and
ensure easy and affordable delivery One more information that’s worth finding a donor liver remains a chal-
of investigations, vaccine and drugs mentioning here is that we are now lenge. Here, a promising treatment
and specialized treatment facilities working with our Cuban and Euro- option is plasma exchange or PLEX. It
and specialists for catering to the pean research collaborators to re- is a simple technique which involves
increased demand. Finally we have to purpose NASVAC for use in COVID-19 replacing the patient’s plasma in
implement at birth as well as catch patients. We have already published three sessions. PLEX is highly effec-
up vaccination for those who have our first article in this regard. The tive in ACLF. We have introduced PLEX
missed vaccination under the EPI second article from our Cuban col- in Bangladesh in collaboration with
programme. leagues on NASVAC in COVID-19 is Department of Hepatology, Christian
expected to be published very soon. Medical Mission Hospital, Vellore,
As the principal investigator in India during ‘Mujib Borsho’. We have
the clinical trials on NASVAC, What is Nonalcoholic dedicated this therapy to the sacred
please tell us about this novel steatohepatitis (NASH)? How do memory of Bangabandhu and have
generic for chronic hepatitis B. we prevent and treat NASH? named it ‘Mujib Protocol.’

NASVAC is a novel therapeutic NASH is chronic or persistent liver BSMMU has opened Interventional
vaccine that was invented by a inflammation or hepatitis in liver as Hepatology Division recently.
Bangladeshi Hepatologist Dr. Sheikh a consequence of fat accumulation What advancements can we
Mohammad Fazle Akbar, now working in the liver commonly referred to as anticipate in the clinical hepatology
in Japan. The molecule was synthe- fatty liver. The most effective means scenario in the future?
sized in Cuba, who are well renowned to prevent and treat fatty liver and
globally for their Biotechnological NASH is life style modification. In a We are doing ground breaking
advancements. I was the Principal nut shell, we have to avoid excess procedures in Bangladesh for last
Investigator of phase I, II and III clini- carbohydrate intake like rice, sugar several years namely autologous
cal trials of NASVAC in Bangladesh. etc. and excess fatty food as well. We haematopoietic stem cell trans-
This is still the only phase III clini- should also adapt to brisk walking plantation or stem cell therapy and
cal trial to have been conducted in for at least 30 minutes per day, at hepatic venous pressure gradient
Bangladesh. least 5 days a week. (HVPG) measurement for liver cirrho-
sis, transarterial chemoembolization
Our findings were published in Besides the diseases that are (TACE) and radiofrequency ablation
leading scientific journals namely, responsible for fatty liver namely (RFA) for liver cancer to name a few.
Hepatology International and PLOS diabetes mellitus, dyslipidemia, hy-
One. Our clinical trial was audited pothyroidism, hepatitis C, polycystic We shall now introduce these pro-
by the Cuban and Bangladesh drug ovary etc. should also be looked for cedures in BSMMU. In fact we have
authorities and found to be of GCP and treated. already started stem cell therapy
standard. Subsequently the recipe of and PLEX in our newly established
NASVAC was approved in Bangladesh What is the role of Plasma exchange Interventional Hepatology Division.
by our drug administration. In addi- (PLEX) in Acute on chronic liver This will make these advanced thera-
tion, Cuba and several other coun- failure (ACLF)? What can be done to pies more easily accessible to our
tries have also approved NASVAC for reduce the mortality rate in ACLF? patients. Besides we are introduc-
commercial use in their respective ing an Advanced Fellowship Training
countries. ACLF is serious liver disease with Programme in this division shortly.
extremely poor outcome associated Once that is accomplished, these
A multi-centre Asian Pacific with up to 40% mortality. It occurs advanced treatment modalities will
clinical trial has been concluded when a patient with pre-existing become available in the periphery of
subsequently and currently another diagnosed or undiagnosed chronic Bangladesh too.
multi-centre clinical trial of NASVAC

48 THE PHARMA WORLD

VACCINE

Mix-and-match COVID vaccines had an allergic reaction to your first with other vaccines both as the first
trigger a potent immune response dose of the Pfizer or Moderna  COV- injection (primer) and the second
ID-19  vaccines, here›s reassuring one (booster shot). The data dem-
With safety concerns around the As- news: It›s safe for you to get that nec- onstrates that both the combination
traZeneca COVID-19 vaccine, several essary second dose. That›s according of Sputnik Light with other vaccines
European countries have already to a team of allergists. They exam- and vaccination with two injections of
started recommending people who ined second-dose vaccine reactions only Sputnik Light shows high safety
received a first dose of the AstraZen- among patients who, after their first profile with no serious adverse events
eca ‘adenovirus’ vaccine get an mRNA shot, had symptoms that appeared related to vaccination. All of the com-
vaccine for their second dose (Pfizer to be an allergic reaction. All the pa- binations studied were safe.
or Moderna). Preliminary results from tients participating in the study, had
a trial in Spain show the benefits of experienced some form of allergic re- Chinese CoronaVac Vaccine
combining AstraZeneca and Pfizer action after their first shot of an mR- 83.5% effective against
vaccines. Of the 663 participants who NA-based COVID vaccine. Many reac- symptomatic COVID Vaccine
received the first dose of AstraZeneca, tions were mild, but in some cases the
two-thirds were randomly selected to reaction involved anaphylaxis, a life- A double dose of China’s CoronaVac
receive a Pfizer booster eight weeks threatening, whole-body allergic re- vaccine is 83.5% effective against
after their first shot. Those in the action. Among them, 17% experienced symptomatic  COVID-19, researchers
control group (n=232) were not yet to full-blown anaphylaxis after their say. An immune response analysis
receive a booster. Participants who first dose of the vaccine. However, of 981 participants who got the vac-
received the Pfizer booster seemed to everyone tolerated the second dose, cine found that it triggered a strong
have more robust immune responses according to the study. The new find- immune response in 90%, the study
than people who receive two Astra- ings suggest it’s safe for most people authors said. In the trial, there were
Zeneca shots, while antibody levels of to receive a second dose of the mRNA no severe adverse events associated
control participants did not change, COVID-19 vaccine. with the vaccine, and most adverse
indicating that mixing of different events (90%) were mild. They included
vaccines, a strategy known as ‘heter- Combination of the Sputnik fatigue, injection site pain and muscle
ologous prime and boost’ could trig- Light with other vaccines aches. The researchers said further
ger a potent immune response. demonstrates high safety profile study is needed to confirm the vac-
cine’s long-term effectiveness. That’s
Pfizer Says 3rd shot of Vaccine The heterogeneous boosting ap- because this trial had a short follow-
Boosts COVID protection proach (“vaccine cocktail” using hu- up period, relatively young and low-
man adenovirus serotype 26 as the risk participants, and it took place
New data show that protection from first component and human adeno- before variants of concern appeared.
both doses of the Pfizer COVID-19 vac- virus serotype 5 as the second com-
cine decreases slightly over time, but ponent) was at the core of Sputnik V. China has provided over 480 million
that a third dose significantly boosts With this approach proving successful doses of COVID-19 vaccines to world
levels of antibodies against sev- in creating a longer and more dura-
eral variants of the virus, including ble immunity against the coronavi- China has provided more than 480
the highly contagious Delta variant . rus, RDIF took the lead in initiating million doses of COVID-19 vaccines to
The study of 42,000 volunteers in six partnerships with other vaccine pro- the world, a Chinese Foreign Ministry
countries found that the vaccine had ducers to conduct joint studies of a spokesperson said. He said China so
an efficacy rate of about 96% against combination of the first component far has provided vaccines to nearly
symptomatic COVID-19 for the first two of Sputnik V with foreign vaccines. To 100 countries, and announced that it
months following the second dose, date, the data of 121 volunteers cor- has pledged to provide the first batch
but that declined by about 6% every responding to the Sputnik V combi- of 10 million doses of vaccines to
two months after that, reaching 83.7% nation groups were analyzed in the COVAX. Chinese vaccines are the first
after six months. However, Pfizer dis- following regimens: Sputnik Light/ batch of vaccines obtained by many
closed that a third dose of its vaccine AstraZeneca, Sputnik Light/Moderna, developing countries. China has car-
significantly increases blood levels of Sputnik Light/Sinopharm, Sputnik ried out joint research and develop-
antibodies against the Delta variant Light/Sputnik Light compared to con- ment and cooperative production
and other variants of the virus. trol group Sputnik V 1 Comp./Sputnik with many developing countries, and
V 2 Comp. Sputnik Light vaccine is supported relevant companies to co-
Second COVID shot safe in folks who tested in Argentina in combination operate with foreign parties in con-
had allergic reaction to first ducting the phase III clinical trials.

If you’re a rare case of someone who

THE PHARMA WORLD 49