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Experimental Drug Therapies

This blog is designed to cover the current controversy regarding experimental drug therapies. New drugs that are developed must go through a safety process. However, there are "compassionate use" exceptions made for seriously ill patients when no other treatments are effective. As future nurses/health-care workers, we need to be educated on this issue to be able to keep up with advancing medical science to be better advocates for our patients.

We hope that by reading this blog, we can provide you information on both sides of the issue so that you can form your own opinion on the topic. We also invite you to participate in our discussion by commenting on any of the posts!

LIfe-threatening Drug Back on Market - Is it Worth the Risk?


When I first started thinking about experimental drug therapies my initial thoughts went to patients with life-threatening diseases. A family friend of mine has been diagnosed with Multiple Sclerosis (MS). Briefly speaking, MS is a chronic neurological disease that affects the central nervous system. The CNS is made up of brain, spinal cord and optic nerves, and the disease causes symptoms that vary from person to person. My friend has had the disease for several years and is now so debilitated that he is now on disability. His main symptoms include things like severe migraines and dizziness. Some days he feels very active and others he can’t even get out of bed. He is taking a drug called Tysabri that had a very short clinical trial time and has been removed from the market once already.

Tysabri works as a monoclonal antibody and it has been made to attach to lymphocytes (white blood cells) and then prevent them from entering the brain. Typically with MS the lymphocytes cause damage to the brain and thus creates the symptoms of MS. The problem with this drug is that is has had several cases where it developes a degenerative brain infection called progressive multifocal leukoencephalopathy (PML) and it is often fatal. This is why it was taken off the market the first time.

When talking to my friend about this, he told me that having good quality of life, even for a short period of time was more important to him than having a pro-longed miserable life. That is why the risk is worth it for him. He also said that when he began the drug his chances for getting the brain infection was 1:24,000 and now after 39 infusions (one infusion every month), not only does he have the record for greatest amount of infusions, but also his chances are now 1: 1,000.

Obviously, the FDA had problems with the drug the first round, so why was it allowed to be put back on the market? The FDA’s idea is that the consumer should decide if the risks outweigh the benefits and whether or not they want to be involved with it. The problem with this thinking is that the whole purpose of the FDA is to make sure that it is safe for the general population. That is why we have experimental drug trails and why the FDA exists at all. If a drug isn’t safe it shouldn’t be let out of trials…right? For my friend, his actions say no. He wants to try anything. I guess it is up to the rest of us to decide for ourselves.

By Stacie Guinn


Additional Resources:

National MS Society

FDA - Tysabri


Sources:

Edelson, E., (2005). FDA Approves Tysabri for Multiple Sclerosis Treatment. Retrieved from http://www.medicalnewstoday.com/articles/16942.php

Medical News Today. (2004). With Tysabri decision, the FDA decalares no drug is too dangerous to be FDA approved. Retrieved from http://www.naturalnews.com/019331.html

National Multiple Sclerosis Society. (2009). What is Multiple Sclerosis?. Retrieved from

http://www.nationalmssociety.org/about-multiple-sclerosis/what-is-ms/index.aspx

Read More 2 comments | Posted by blogpharm edit post

2 comments

  1. Anonymous on October 28, 2009

    I agree with your friend. I think that there are a lot of other experimental drugs that have been pulled off the market to protect the public when it should be up to the individual whether they should be protected. Why should the government get to choose this for us? What might be right for one person may not be right for another. My mother, who was a nurse like myself would come home and tell me about patients that she had and say "there are a lot worse things than death." If there is something that improves your quality of life, I say "Go for it."
    The government should step in only if the person is incapible of making decisions for themselves...and only then if there isn't any family to speak for the patient.

     
  2. Casita Pena on October 29, 2009

    I have been on drugs that were pulled off the market. I have severe psoriasis, an autoimmune disorder that affects the skin and causes premature and immature reproduction of the skin cells. The result is a miseralbe, itchy, flakey existance. When the FDA pulled a over-the-counter drug off the market, I was devastated because it had made such a life-changing improvement for me. I am now on Humira, a twice monthly self injectable medication. If the FDA were to decide this was unsafe, my life would be miserable. A part of me says, "Let the patient decide! It's his/her life!" but then, I would have Dr. Kevorkian practicing medicine...what do I know except that sometimes the risks are worth it.

     


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UTA Pharmacology

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      Max Flores, Stacie Guinn, Ryan Wencl
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    Blog Archive

    • ▼  2009 (10)
      • ▼  October (10)
        • In Conclusion...
        • CBS News - H1N1 Experimental Drug
        • Considerations to experimental drug therapies
        • LIfe-threatening Drug Back on Market - Is it Worth...
        • Cancer Drug Not used to Fight Cancer?
        • Interview with an Experimental Drug Patient
        • “No seriously ill person should have to die merely...
        • How a Clinical Trial Works
        • Brief History of Experimental Drugs
        • Welcome!!!

    Experimental Drug Terminology


    CONTROL GROUP: The standard by which experimental observations are evaluated. In many clinical trials, one group of patients will be given an experimental drug or treatment, while the control group is given either a standard treatment for the illness or a placebo.

    DOUBLE-BLIND STUDY: A clinical trial design in which neither the participating individuals nor the study staff knows which participants are receiving the experimental drug and which are receiving a placebo (or another therapy). Double-blind trials are thought to produce objective results, since the expectations of the doctor and the participant about the experimental drug do not affect the outcome; also called double-masked study.

    DRUG-DRUG INTERACTION: A modification of the effect of a drug when administered with another drug. The effect may be an increase or a decrease in the action of either substance, or it may be an adverse effect that is not normally associated with either drug.

    EXPERIMENTAL DRUG: A drug that is not FDA licensed for use in humans, or as a treatment for a particular condition

    INFORMED CONSENT: The process of learning the key facts about a clinical trial before deciding whether or not to participate. It is also a continuing process throughout the study to provide information for participants. To help someone decide whether or not to participate, the doctors and nurses involved in the trial explain the details of the study.

    OFF-LABEL USE: A drug prescribed for conditions other than those approved by the FDA.

    PLACEBO: A placebo is an inactive pill, liquid, or powder that has no treatment value. In clinical trials, experimental treatments are often compared with placebos to assess the treatment's effectiveness

    PLACEBO EFFECT: A physical or emotional change, occurring after a substance is taken or administered, that is not the result of any special property of the substance. The change may be beneficial, reflecting the expectations of the participant and, often, the expectations of the person giving the substance.

    RANDOMIZATION:A method based on chance by which study participants are assigned to a treatment group. Randomization minimizes the differences among groups by equally distributing people with particular characteristics among all the trial arms. The researchers do not know which treatment is better. From what is known at the time, any one of the treatments chosen could be of benefit to the participan.

    SIDE EFFECTS:Any undesired actions or effects of a drug or treatment. Negative or adverse effects may include headache, nausea, hair loss, skin irritation, or other physical problems. Experimental drugs must be evaluated for both immediate and long-term side effects

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