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Amid the recent trend of increasing patients with benign prostatic hyperplasia due to the aging population, the related treatment market is also excited.

Among them, ‘Saw Palmetto Extract (Serenoa repens)’ is attracting attention again. In the clinical field, it has already been recognized for its therapeutic effect in Europe, etc.

According to the pharmaceutical industry on the 28th, pharmaceutical companies are competitively launching over-the-counter medicines and health functional foods one after another in line with the recent increase in patients with benign prostatic hyperplasia.

In the case of over-the-counter medicines, recent Dongkuk Pharmaceutical and Hyundai Pharm’s ‘Karitopoten’ and ‘Urintamine Capsule’ are representative. Here, Karitopoten is composed of herbal medicine ingredient cucurbit seed oil extract (Western pumpkin seed oil extract), and urintamine is composed of three main ingredients: L-glutamic acid, L-alanine, and glycine.

Both products claim to improve symptoms of benign prostatic hyperplasia, and have recently been actively engaged in sales and marketing.

Their direct competitor items are dry season foods with ‘saw palmetto extract’ valued at a market of about 100 billion won.

Since last year, the Ministry of Food and Drug Safety has strengthened management, such as establishing new ingredient standards for quality control of dried foods made with saw palmetto extract. While announcing that there is no basis, it is attracting attention as an item that replaces it.

The market is rapidly being reorganized as over-the-counter drugs targeting the niche market are appearing while the withdrawal of dry food items with insufficient content is accelerating due to the stricter ingredient standards for Serenoa Repens, an extract of saw palmetto.

However, in the clinical field, it is evaluated that the need for Serenoa Refens ingredient medicine, which means saw palmetto extract, is still needed in the treatment of mild benign prostatic hyperplasia. This means that it is still used in the pharmaceutical market, apart from dry food, which has an insufficient content.

A representative item is Someto 320mg soft capsule (Serenoa Repens), a treatment for prostatic hyperplasia of Pharmbio Korea.

“In fact, in the early 2000s, the Serenoa Repens component was negative for improving prostate enlargement, but in recent years, it has been changing positively,” said Min Seung-gi, vice president of the Korean Urology Association (Goldman Urology Department, Jamsil Branch).

In fact, Serenoa Repens, the main ingredient of Someto, has already been recognized for its effectiveness in treating enlarged prostates in the European Union and elsewhere.

According to the global medical journal ‘Biological and Pharmaceutical Bulletin’, free fatty acids such as ‘oleic acid’ and ‘lauric acid’, the main ingredients of Serenoa repens, produce dihydrotestosterone, which causes enlargement of the prostate. It was found to inhibit the enzyme ‘5α-Reductase’.

If the dry season food contains 40% of such free fatty acids, Someto, which is classified as a drug, contains 80%, twice as much.

In addition, through Urology Times (Urology Times 2022), although not constant, an interview was published saying that Serenoa Repens ingredients should not be overlooked in the treatment of benign prostatic hyperplasia.

Accordingly, in the clinical field, it is evaluated that Someto, the only Serenoa Refens product that can be applied by health insurance, can be used as a treatment for benign prostatic hyperplasia. Moreover, it is believed that there is an advantage in that it has sufficient clinical data compared to other drugs that have recently been sold and marketed.

Min Seung-ki, Vice Chairman of Insurance, said, “As the Ministry of Food and Drug Safety strengthens the standards for dry foods, many of them are expected to be withdrawn from the market. Accordingly, it seems that OTC drugs are also attracting attention recently.” Medicines still have uses in the clinical field,” he explained.

He added, “It is possible to use medicines sufficiently for patients with mild benign prostatic hyperplasia,” adding, “Moreover, in the case of pharmaceuticals with the corresponding component, reimbursement is possible, but even if they are prescribed for non-reimbursement, they are cheaper than dry food on the market.”

A study has found that being infected with the coronavirus during pregnancy increases the risk of neurodevelopment, such as autism spectrum disorder, in a child born.

These effects were particularly concentrated in male children, and experts say that long follow-up measures are needed for pregnant women and children who have been infected with the corona.

On the 26th local time, JAMA Network open published the results of a large-scale study on the effect of corona infection during pregnancy on a child (10.1001/jamanetworkopen.2023.4415).

As the corona pandemic goes over to endemic, the research in the medical system is also shifting weight due to long covid and its aftereffects.

In particular, the medical community is constantly paying attention to how it affects the child if the mother is infected with corona.

In some studies, it has been reported that being infected with corona during pregnancy can cause a disability in the child’s neurodevelopment, but this is because opinions are mixed as opposite studies are also coming out.

It is because of this background that a research team led by Professor Andrea G. Edlow of Harvard Medical School started a follow-up study on this.

In fact, it is to check whether corona infection during pregnancy directly affects the child.

Accordingly, the research team followed and observed the effect of corona infection on the child for 18,355 mothers who gave birth during the corona pandemic.

As a result, 3% of babies of mothers who contracted COVID-19 during pregnancy were diagnosed with neurodevelopment within 12 months of age. A child of a mother who did not get corona is a significant percentage compared to staying at 1.8%.

Even if all other factors such as race, mother’s age, and premature birth were excluded, corona infection had a great impact on the child.

In particular, these results showed significant differences according to the sex of the child. Boys are affected more strongly than girls.

In fact, if the child born after being infected with corona during pregnancy was a male, the risk of being diagnosed with a neurodevelopmental disorder was 1.94 times, almost doubled.

However, if the child born after being infected with COVID-19 is a female child, the risk is somewhat lower. Conversely, a 10% lower risk of neurodevelopmental disorders compared to the mean (OR=0.89).

However, even in boys, if these signs did not appear by 18 months, the risk of being diagnosed with a neurodevelopmental disorder was reduced by 1.42 times.

Professor Andrea explained, “This is a result that clearly supports previous studies that corona infection during pregnancy can affect neurodevelopment, such as autism spectrum disorder.”

“Due to these risks, a longer follow-up and observation of mothers and children who are infected with COVID-19 are needed,” he said.

In 2023, the standard vaccination strategy for children and adolescents was updated. The human papillomavirus vaccine (HPV) was changed from the age of 12 to 11, and the interval between vaccinations for the Japanese encephalitis vaccine also changed.

On the 24th, the Korean Vaccine Society held the 21st Spring Conference at L Convention and shared the standard vaccination cycle for children and adolescents revised in 2023 and its rationale.

Human papillomavirus is transmitted through skin, mucous membranes, and genital infections. It is transmitted mainly through sexual contact and disappears naturally within 12 to 24 months, but 3 to 10% fall into a ‘persistent infection’ state. In this case, it develops into cancer after years or decades.

As of 2019, the first and second doses of HPV were 12 years old. On the other hand, this revised version changed to receiving the first and second vaccinations at the age of 11 to 12 years.

Lee Hyun-joo, a professor of pediatrics at Seoul National University Bundang Hospital who announced the revision of standard vaccination, said, “It has been estimated that 79% of cancers caused by human papillomavirus in the United States are accounted for.” said.

“HPV infection is transmitted through sexual contact, so vaccination before sexual experience shows the optimal effect,” he said. “he explained.

“When vaccinated at the age of 9 to 15 years, the immune response is higher than that at older ages,” he said. It is cost-effective to inoculate twice,” he explained the background of the guideline change.

The results of the 2020 Swedish registry survey also support this. As a result of the study, the risk of cervical cancer was reduced by 88% in vaccinated persons under the age of 17 compared to unvaccinated persons, whereas the risk decreased only by 53% in those vaccinated between the ages of 17 and 39.

Professor Lee said, “The WHO SAGE guideline allows 2 doses of vaccination for those vaccinated before the age of 15, and the interval between 2 doses is set at 0.6 months. This is to ensure that the vaccination is completed before the experience.”

He said, “The minimum vaccination interval standard from 2015 to 2018 was to inoculate at least 5 months after the first vaccination for Cervarix and Gardasil 9, and at least 6 months for Gardasil after vaccination,” he said. If the vaccination was received under the age of 15, the second vaccination was given at intervals of 5 months or more and ended.”

The vaccination method for Tdap (tetanus, diphtheria, adult pertussis) vaccine has also changed.

The existing inoculation method was to inoculate 0.5 mL of Td twice at 4-8 week intervals if DTaP was not vaccinated before the age of 7, and the 3rd inoculation was given 6-12 months after the 2nd inoculation.

The revised guideline recommends that if DTaP is not administered before the age of 7, Tdap or Td should be given twice at least 4 weeks apart, and the third dose should be administered 6 to 12 months after the second dose. However, at least one dose of Tdap is administered, and in this case, the first dose is recommended.

In the case of Japanese encephalitis vaccine, in the case of inactivated vaccine, the interval between the next vaccination after the first vaccination was changed from 7 to 30 days to 1 month, and the minimum interval between the next vaccination was changed from 7 days to 4 weeks. After the second vaccination, the next vaccination interval was shortened from 12 months to 11 months.

The vaccination schedule for live vaccines is to administer the first vaccination at 12 to 23 months and the second vaccination 12 months later. The minimum interval between the 1st and 2nd vaccination is 4 weeks.

Professor Lee said, “There were studies in 2016 and 2020 that evaluated the safety and immunogenicity of cross-vaccination of inactivated and live vaccines. Vaccination is possible, but cross-vaccination between inactivated and live vaccines is not recommended.”