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posted by martyb on Thursday September 22 2016, @12:05AM   Printer-friendly
from the false-sense-of-hope dept.

Eteplirsen received approval for use as a Duchenne muscular dystrophy therapy despite the FDA review team concluding that the treatment was unlikely to show any benefit for patients.

Dr. Janet Woodcock's (Director of the Center for Drug Evaluation and Research) decision was heavily influenced by the "parading diseased children in front of the cameras" and was made before the FDA's review team completed their analysis.

Part of Dr. Woodcock's rational for approval included the stock price of Sarepta (the pharmaceutical company responsible for eteplirsen):

She opined that Sarepta in particular "needed to be capitalized." She noted that [Sarepta's] stock went down after the AC meeting and went up after FDA sent the June 3, 2016 letter. Dr. Woodcock cautioned that, if Sarepta did not receive accelerated approval for eteplirsen, it would have insufficient funding to continue to study eteplirsen and the other similar drugs in its pipeline.

FDA Commissioner Dr. Robert Califf, Acting Chief Scientist Dr. Luciana Borio, and Dr. Ellis Unger, the Director of the Office of Drug Evaluation, all opposed the approval but Dr. Califf declined to overrule Dr. Woodcock's decision.

Dr. Unger argued that the approval was unethical and counterproductive:

By allowing the marketing of an ineffective drug, essentially a scientifically elegant placebo, thousands of patients and their families would be given false hope in exchange for hardship and risk.

Dr. Borio argues:

Granting accelerated approval here on the basis of the data submitted could make matters worse for patients with no existing meaningful therapies — both by discouraging others from developing effective therapies for DMD and by encouraging other developers to seek approval for serious conditions before they have invested the time and research necessary to establish whether a product is likely to confer clinical benefit.
[...] [Sarepta] has exhibited serious irresponsibility by playing a role in publishing and promoting selective data during the development of this product. Not only was there a misleading published article with respect to the results of Study 201/202147 –which has never been retracted—but Sarepta also issued a press release relying on the misleading article and its findings.

Dr. Derek Lowe, from In The Pipeline, agrees with Dr. Unger and Dr. Borio that the drug is "unlikely to provide much benefit, and is reasonably likely to provide none at all" and that the drug "may well be [$300,000 per year] worth of placebo".

Note: Bold was added by the submitter.

http://endpts.com/senior-fda-officials-warned-that-eteplirsen-ok-would-lower-fda-standards/
http://blogs.sciencemag.org/pipeline/archives/2016/09/20/sarepta-gets-an-approval-unfortunately
https://en.wikipedia.org/wiki/Eteplirsen


Original Submission

 
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  • (Score: 4, Insightful) by bob_super on Thursday September 22 2016, @01:04AM

    by bob_super (1357) on Thursday September 22 2016, @01:04AM (#404976)

    1) look like you're working hard on something critical while you package sugar pills in fancy box.
    2) get the right person to overrule scientists who don't believe in you
    3) sell sugar pills for mind-bogglingly absurd price, per person per year - Use part of the cash to reward 2)
    4) retire to your private island out of the reach of pitchforks.

    Starting Score:    1  point
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  • (Score: 2, Informative) by butthurt on Thursday September 22 2016, @02:57AM

    by butthurt (6141) on Thursday September 22 2016, @02:57AM (#405004) Journal

    You seem to be saying that this was a scam from its inception. If that's what you mean, what leads you to that belief? It's not obvious to me that this drug was intended or expected to be ineffective. Several other drugs based on the principle of antisense therapy are being developed:

    As of 2012, some 40 antisense oligonucleotides and siRNAs were in clinical trials, including over 20 in advanced clinical trials (Phase II or III).

    --https://en.wikipedia.org/wiki/Antisense_therapy#Example_antisense_therapies [wikipedia.org]

    According to Sarepta Therapeutics,

    Eteplirsen belongs to a distinct class of novel synthetic antisense RNA therapeutics called Phosphorodiamidate Morpholino Oligomers (PMO), which are a redesign of the natural nucleic acid structure [...] PMOs incorporate modifications to the sugar ring of RNA that protect it from enzymatic degradation by nucleases in order to ensure stability in vivo.

    --http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/PeripheralandCentralNervousSystemDrugsAdvisoryCommittee/UCM481912.pdf [fda.gov]

    It's a complex molecule that contains ribose sugar groups. :-)

    • (Score: 2) by bob_super on Thursday September 22 2016, @04:49PM

      by bob_super (1357) on Thursday September 22 2016, @04:49PM (#405189)

      Not saying that this one started as a scam, just pointing out how easy it would be for a scam to work. You only need enough cash and scientific-looking people to look legit, and the right profit-seeking persons to force it through...
      Not quite unlike Theranos, I guess.

  • (Score: 0) by Anonymous Coward on Thursday September 22 2016, @07:37AM

    by Anonymous Coward on Thursday September 22 2016, @07:37AM (#405056)

    You forgot...

    5) Profit!

    • (Score: 0) by Anonymous Coward on Thursday September 22 2016, @10:31AM

      by Anonymous Coward on Thursday September 22 2016, @10:31AM (#405077)

      I'm pretty sure the "profit" part should go before the "retire" part.