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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!

“No seriously ill person should have to die merely because the FDA stamp of approval on a drug is years away.” - The Abigail Alliance


The Abigail Alliance’s mission is to expand the availability of experimental drug treatments for “patients that have run out of conventional treatment options.” The Abigail Alliance was founded in 2001, after the death of Abigail Burroughs who died of cancer at the age of 21. An experimental drug named Erbitux showed promising results, but unfortunately she was ineligible to participate in the clinical trial.

According to the Abigail Alliance:

- many people die while waiting for experimental drug treatments to receive approval.

- the FDA imposes many restrictive participant requirements for drug clinical trials, leaving out the most ill patients.

- many clinical studies involve the use of placebos to treat life-threatening diseases.


What the Abigail Alliances seeks to do:

- allow seriously ill patients to receive experimental drug therapies, if they have run out of all other options.

- ban the use of placebos in clinical studies.

- give patients and doctors more control over their treatment options and eliminate policies that place decisions on the FDA.

- make it more affordable for smaller biotech companies to conduct clinical studies.


The fight for earlier access to effective, new treatments is a slow but steady one. The FDA is very resistant to change, but the Abigail Alliance has had many accomplishments. Some of these include introducing the ACCESS Act (Access, Compassion, Care, and Ethics for Seriously Ill Patients) to Congress and expanding certain drugs to many seriously ill patients. Some of these drugs include Abraxane (breast & prostate cancer), Alimta (lung cancer), Avastin and many others. Despite these many accomplishments, however, their work is far from over.


By Max Flores


References:
Kovach, S. (2007). The Abigail Alliance: Motivated by the tragic circumstances, families battle an uncaring bureaucracy. Life Extension. 25-30.

Links:

http://abigail-alliance.org/ - The Abigail Alliance for Better Access to Developmental Drugs

http://www.clinicaltrials.gov/ - Registry of Federal and private clinical trials

Read More 7 comments | Posted by blogpharm edit post

7 comments

  1. Sue Guinn, RN on October 29, 2009

    It would be good if people would support this. The process for approving drugs is too long. It seems that if you are rich you can access drugs that have already been approved in other countries but are still being held up in our country. We should at least have the choice...it is our life!

     
  2. Sue Guinn, RN on October 29, 2009

    You're right, You want to believe that everyone is wanting to do the right thing, but with drug companies...I'm not so sure.

     
  3. Anonymous on October 29, 2009

    I understand that someone who is desperate for a treatment would not want to take the placebo, but isn't it important to the integrity of the study to chose whether or not they want to include a placebo? What are the benefits and disadvantages to using a placebo in a study?

     
  4. Ryan Wencl on October 29, 2009

    I can see where you are coming from. It is necessary to exhaust all treatment options before giving up, but there are guidelines for participating in clinical trials for a reason. I am sure that the FDA is aware of just how many people potentially depend on the success of this drug. Perhaps they will not be so strict on who is allowed to receive the treatment.

     
  5. Dave Hubbard on October 29, 2009

    So many issues and interesting questions and things to consider. It is not a black and white type of thing. We all know the resources that have gone into fighting cancer over the past 50 years, but what we have is a history of new drugs that may slow down the death process if you are lucky. It is so difficult to get a drug to market that once one is on the market the drug companies fight anything new someone else comes up with because they are trying to recoup their expenses in bringing their existing drug to market.
    If someone came up with a real verified cure the drug companies would fight it also for this reason. If the “cure” turned out to be a so called “natural” remedy, it couldn’t be patented and so the drug companies are never interested in testing these types of treatments and no one else has the money to go through the process the FDA requires, especially if no one can make a buck off of it.
    As far as the placebo thing goes, well folks are kind of nuts and some people will think themselves well, but so what? By the time a drug is in human trials hasn’t it been tested in a laboratory setting on animals? Even with the placebo in trials to compare the actual drug to, many drugs are approved that have a high placebo rate as well.

     
  6. Abigail Alliance for Better Access to Developmental Drugs on October 30, 2009

    From: Abigail Alliance for Better Access to Developmental Drugs
    Frank Burroughs, President

    This is great that there is such an excellent discussion going here on this blog. Let me add and clarify a few things from the extensive comments.

    As regards safety, what the Abigail Alliance and the bill in Congress, Access, Compassion, Care, and Ethics for Seriously Ill Patients Act (ACCESS Act S.3046 H.R.6270), are talking about are drugs and vaccines for cancer and other serious life-threatening illnesses that are showing significant efficacy in clinical trials. Also it is important to keep in mind that drugs and vaccines in clinical trials are very closely monitored for safety. Another important point is that the decision to take an investigational drug by a person who has run out of FDA approved options and cannot get into a clinical trial, should be the patient’s in consultation with their doctor.

    Here is what is profound (from www.abigail-alliance.org):
    "Every drug for cancer and other serious life-threatening illnesses that the Abigail Alliance has pushed for earlier access to in our eight-year history is now approved by the FDA! There is not one drug that we pushed for earlier access to that did not make it through the clinical trial process. Many lives could have been saved or extended, if there had been earlier access to these drugs!"

    As of early 2009 the count is 16 drugs! EVEN the FDA's own Science and Technology Board in their late 2007 report recommended there be a provisional approval mechanism for promising developmental drugs.

    Speaking of the FDA Science and Technology Board, they and for a long time the Critical Path Initiative (www.c-path.org) have been pushing the FDA to use more modern scientific and statistical tools in clinical trial design, drug data, drug review, and approval. The ACCESS Act covers many early access issues, including jump starting the FDA using more modern tools.

    By the FDA using more modern scientific and statistical tools, the use of placeboes would be greatly reduced. There are a significant number of patients who opt not to enroll in clinical trials, because they don’t want to take the risk of getting a placebo. Therefore the ACCESS Act would actually help speed up clinical trial enrollment.

    One last note for now is that data outside a clinical trial can add to the knowledge about a new therapy.

    Thank you all for your input.

    Frank Burroughs, Abigail Alliance

     
  7. Abigail Alliance for Better Access to Developmental Drugs on December 29, 2009

    Max,
    I have been meaning to post this for some time.
    Thank you very much for your good words and encouragement. Abigail’s inspiration, the people we have helped so far, and the people we continue to try and help brings me a good life.
    Thank you for your good work with the blog.
    Frank Burroughs
    President, Abigail Alliance for Better Access to Developmental Drugs

     


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UTA Pharmacology

  • Authors
      Max Flores, Stacie Guinn, Ryan Wencl
  • Links

    • Clinical Trials - Government
    • Society for Clinical Trials
    • Abilgail Alliance
    • Join a clinical trial
    • FDA

    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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