title: Decline in the Development of New Anesthetics.
abstract: The number of new anesthetics approved by the USA FDA over the past 30 years (1985-2014) is much smaller than during the preceding 30 years (1955-1984): four versus ten. Investigational anesthetics clinically tested since 1990 have been almost exclusively intravenous anesthetics (nine compounds), with only one now approved by the FDA. All nine agents represent modifications of anesthetics introduced approximately 40-50 years ago; none demonstrates a truly novel mechanism of action. The apparent drought of novel anesthetics is difficult to explain. While there may be multiple reasons, we believe that one is especially noteworthy: the dramatic improvement in anesthesia safety owing to the context in which anesthetics are administered, effectively decreasing the pressure to develop new drugs with better safety margins.
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Kamen V
authors.initials: KV
authors.lastname: Vlassakov
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: ikissin@bwh.harvard.edu.
authors.forename: Igor
authors.initials: I
authors.lastname: Kissin
mesh_terms: D000777:Anesthetics; D017277:Drug Approval / Q000706:statistics & numerical data*; D015195:Drug Design; D004345:Drug Industry / Q000706:statistics & numerical data*; D006801:Humans; D014481:United States; D014486:United States Food and Drug Administration / Q000706:statistics & numerical data
chemical_list: D000777:Anesthetics
keywords: anesthesia; anesthesia-related mortality; investigational drugs; pharmaceutical industry; therapeutic index