Showing posts with label Food and Drug Administration. Show all posts
Showing posts with label Food and Drug Administration. Show all posts

Tuesday, July 4, 2023

FDA rejects updates to Covid-vax warning labels

In January, a group of former Food and Drug Administration (FDA) advisers asked the agency to make critical changes to Covid-19 vaccine warning labels. The FDA rejected almost every recommendation. 

Moderna Covid-19 vaccine, December 2020 photo. Public domain, Wikimedia Commons.

We tried to improve COVID vaccine labeling — the FDA said ‘no thanks’ | The Hill | Peter Doshi, Linda Wastila, & Kim Witczak: 

June 9, 2023 - "Health care providers rely on product labeling for accurate, unbiased and up-to-date information on medical products. But current Food and Drug Administration (FDA)-approved labels for the Pfizer and Moderna COVID-19 vaccines are obsolete, misleading and out of touch with regulators elsewhere....[P]eople are now getting boosted indefinitely with little reliable information about scientific developments....

"In January, a group of us — current and former FDA advisers and academics from around the country — tried to fix this problem by asking the FDA to make critical changes to official product labels. But four months later, in a 33-page response letter, the agency denied almost every single request. In doing so, the FDA failed to follow the lead of regulators elsewhere, including in Europe and Japan. 

"For instance, we cited the European regulator’s addition of heavy menstrual bleeding to product information as a potential vaccine adverse reaction. The FDA’s response was a sophisticated version of “who cares!” “Foreign regulatory agencies’ expectations and regulations regarding product labeling can differ from those of the U.S. FDA,” the agency wrote. The FDA also said the European Medicines Agency hadn’t proven causality with respect to that side effect.

"The FDA also failed to warn about the documented risk of sudden death, even though myocarditis is now a well-recognized side effect, particularly among young men. To support adding 'sudden death' to product labeling, we pointed to multiple autopsy studies on lethal vaccination-associated myocarditis.... The FDA again rejected our request, arguing that ... 'alternative causes of death…may not be apparent on autopsy.'

"Federal law requires that product labeling lists adverse reactions that recipients may potentially experience. Of course, not every adverse event type reported in the postmarketing period needs be listed on the label ... but instead 'only those adverse events for which there is some basis to believe there is a causal relationship.' With this in mind, we asked the FDA to add seven adverse event types to product labeling: multisystem inflammatory syndrome in children (MIS-C), pulmonary embolism, sudden cardiac death, neuropathic and autonomic disorders, decreased sperm concentration, heavy menstrual bleeding and detection of vaccine mRNA in breastmilk.... The FDA rejected our request, once again arguing that causality had not been definitively established. In other words, the FDA is not following its own rules.... 

"As to whether the vaccines block viral transmission, we thought it was fairly obvious that there is substantial public confusion.... We pointed to messaging from public health leadership. Anthony Fauci, until recently director of the National Institute of Allergy and Infectious Diseases, stated the vaccine turns individuals into virus 'dead ends' and Rochelle Walensky, director of the Centers for Disease Control and Prevention (CDC), declared 'vaccinated people do not carry the virus'.... 

"But the FDA instead fired back, alleging we chose 'selective statements' when quoting Fauci and Walensky.... 'Dr. Fauci has stated that the vaccines were not developed to protect against infection, and Dr. Walensky has stated that high viral loads in vaccinated individuals "suggest an increased risk of transmission."' Meanwhile, the CDC’s website still informs people the vaccines are effective at 'limiting the spread of the virus.' Despite all the mixed messages, the FDA apparently thinks the public is somehow clear-eyed about all this....

"The FDA’s double standard — failing to warn about potential harms, while simultaneously doing nothing to stop a sister agency from making unproven claims of benefit — harms patients and undermines the public’s trust in governmental institutions established to act in their interest. Product labeling should be informative and accurate, not promotional. The law requires it, and following the law shouldn’t be optional."

Read more: https://thehill.com/opinion/healthcare/4037145-we-tried-to-improve-covid-vaccine-labeling-the-fda-said-no-thanks/

Friday, January 7, 2022

Judge orders timely release of FDA's vax data

INSTEAD OF FDA’S REQUESTED 500 PAGES PER MONTH, COURT ORDERS FDA TO PRODUCE PFIZER COVID-19 DATA AT RATE OF 55,000 PAGES PER MONTH! |  Substack - Aaron Siri, Injecting Freedom: 

January 6, 2021 - "On behalf of a client, my firm requested that the FDA produce all the data submitted by Pfizer to license its Covid-19 vaccine. The FDA asked the Court for permission to only be required to produce at a rate of 500 pages per month, which would have taken over 75 years to produce all the documents. 

"I am pleased to report that a federal judge soundly rejected the FDA’s request and ordered the FDA to produce all the data at a clip of 55,000 pages per month! [lowering the time needed for full release of all documents to under 9 months - gd]

"This is a great win for transparency and removes one of the strangleholds federal 'health' authorities have had on the data needed for independent scientists to offer solutions and address serious issues with the current vaccine program – issues which include waning immunity, variants evading vaccine immunity, and, as the CDC has confirmed, that the vaccines do not prevent transmission.

"No person should ever be coerced to engage in an unwanted medical procedure.  And while it is bad enough the government violated this basic liberty right by mandating the Covid-19 vaccine, the government also wanted to hide the data by waiting to fully produce what it relied upon to license this product until almost every American alive today is dead.  That form of governance is destructive to liberty and antithetical to the openness required in a democratic society. 

"In ordering the release of the documents in a timely manner, the Judge recognized that the release of this data is of paramount public importance and should be one of the FDA’s highest priorities.  He then aptly quoted James Madison as saying a 'popular Government, without popular information, or the means of acquiring it, is but a Prologue to a Farce or a Tragedy' and John F. Kennedy as explaining that a 'nation that is afraid to let its people judge the truth and falsehood in an open market is a nation that is afraid of its people.” 

"The following is the full text of the Judge’s order ..."

Read more: https://aaronsiri.substack.com/p/instead-of-fdas-requested-500-pages

Lisa Ferdinando / DoD, Pfizer-BioNTech Covid-19 vaccine, 2020. Public domain, Wikimedia Commons 

Sunday, December 19, 2021

US struggles with at-home Covid test shortage

Where Are All the At-Home COVID Tests? | New York - Margaret Hartmann, Intelligencer:

Updated December 10, 2021 - "On February 21, the Washington Post published a story titled, 'A fast, at-home coronavirus test will be available to Americans this year.' At the time, public-health officials had been calling for fast, widely available at-home COVID-19 tests for months.... As the Post reported, the White House was finally making that a reality.... But as we approach the end of 2021, pharmacy shelves in the U.S. still aren’t teeming with COVID tests, even though President Biden announced in a televised September 9 address that he was making at-home testing a major element of his plan to manage the pandemic and using the Defense Production Act to increase test availability.... So why are these at-home COVID tests still sometimes hard to find — even if you’re willing to pay the full retail price?... 

"In many Asian and European countries, at-home COVID-19 tests are cheap and easy to find in stores. CBS News reported that home antigen tests are now used routinely in the U.K., where they are free and 'readily available at pretty much every pharmacy in the country.' The situation is drastically different here.... While some foreign governments moved quickly to encourage screening and subsidize the cost of at-home tests, the Food and Drug Administration’s approval process moved much more slowly. The FDA said it needed to ensure that the tests were accurate, but many scientists countered that the agency was letting the perfect be the enemy of the good. Rapid tests can quickly identify around 98 percent of infectious COVID cases; they’re not as sensitive as PCR tests, which can catch even noninfectious cases but need to be sent to a lab for processing.... 

"Harvard epidemiologist Michael Mina, who has been one of the most vocal proponents for mass testing throughout the pandemic, argued that U.S. officials focused too much on the accuracy of rapid antigen tests versus PCR tests, which obscured the former’s tremendous value. 'If the target is infectious people — which is really the most important public-health target — then these [rapid antigen] tests become extremely accurate,” 'Mina told Intelligencer in December 2020. “And that’s the issue — we shouldn’t be using a medical target, we should be using a public-health target. If they are being used for medical diagnostic purposes, they might not be as accurate as you would like, but as a public-health tool, they’re very accurate.'

"Due to these regulatory and messaging hurdles, the market for at-home antigen tests has been slow to develop in the U.S. For much of the last year, Americans couldn’t obtain the pricey tests, and their diagnostic value wasn’t clear to the public. Demand for the tests dropped even further in the spring of 2021, when ... the CDC said vaccinated people did not need to get tested if they were asymptomatic, even if they’d been exposed to someone who was COVID-positive.... Thus, when the Delta variant, breakthrough cases, and people returning to work and school drove up demand for at-home testing ... the U.S. was unprepared, and stores couldn’t keep the tests in stock....

"In September, the Biden administration responded with a new push toward making rapid tests more accessible and affordable, saying it would invoke the Defense Production Act and spend another $2 billion on about 280 million rapid tests.... However, the tests remained in short supply over the coming weeks, prompting the White House to announce on October 1 that it would invest an additional $1.2 billion to obtain millions more rapid tests from Abbott and Celltrion. In addition to ramping up production of tests already on the market, the government is also working to speed up the approval process. On ... October 25, the Department of Health and Human Services announced that the FDA will streamline its authorization process, and the National Institutes of Health will spend $70 million on a new program to 'establish an accelerated pathway' to aid test makers seeking approval for their products.... 

"In early December, President Biden announced plans to ramp up at-home testing by ensuring that the tests will be essentially free for Americans with health insurance, as part of a broader plan to combat emerging variants. (The Department of Health and Human Services will release formal guidance by January 15.) 'More than 150 million Americans on private health insurance will be able to submit receipts for at-home tests directly to their health insurance plans,' Jeff Zients, the White House COVID-19 coordinator, said. 'They can go to their local pharmacy, they can order online and then get reimbursed.' For those who don’t have health insurance, there will ostensibly be 'thousands of locations' such as clinics, health centers, and pharmacies where COVID-19 test kits are available for pickup.

"When White House Press Secretary Jen Psaki was asked at a press briefing on December 6 about why they administration chose such a complicated route for making free at-home tests more widely available, she gave a glib response, asking 'Should we just send one to every American?' In other, albeit much smaller, countries the government does mail out free tests. An anonymous HHS official also offered Politico an illogical answer on whether there’s much demand in America for at-home rapid tests. 'The primary channel people are getting tested isn’t at home,' the HHS spokesperson said. 'Samples are taken primarily at pharmacies and health care providers... [A]nother anonymous senior administration official offered a defensive response on why the U.S. does not have a clearer and more consistently available testing system.... 'Our pathway is multiple paths for people to get free tests. It’s less of the single, easy-to-grasp solution that people on Twitter like to hold up as a model'....

"Zients said the Biden administration’s latest $1.2 billion investment would quadruple the number of rapid tests available in the U.S. in the following weeks. That means that sometime in December, American consumers should have access to 200 million rapid at-home tests per month.... Still, in the U.S., at-home COVID testing may never be as cheap or as widespread as it is in places like the U.K. Dr. Michael Mina told NPR in October that while he’s happy to see the Biden administration devoting more resources toward rapid testing, 'it’s not enough, and it’s not fast enough. America is so far behind our peer nations.'"

Read more: https://nymag.com/intelligencer/article/at-home-covid-tests-accuracy-supply-issues.html

Photo: Decky, UK Covid home testing kit, 2020. CC BY-SA 4.0, Wikimedia Commons.

Friday, September 3, 2021

U.S. FDA officials resign over Biden booster plans

Anger, frustration at FDA over Biden’s booster plan; two top regulators resign | Ars Technica - Beth Mole:

September 1, 2021 - "Two top vaccine regulators have resigned from the Food and Drug Administration, revealing anger, frustration, and turmoil at the federal agency as it faces intensifying pressure to authorize COVID-19 vaccine booster shots and doses for children under the age of 12. The two regulators leaving are Marion Gruber, director of the FDA’s Office of Vaccines Research and Review (OVRR), and OVRR Deputy Director Phil Krause. Gruber has been with the FDA for more than 30 years, and Krause has been at the agency for more than a decade.

"Their resignations, first reported by pharmaceutical trade publication BioCentury, were apparently sparked by frustration that the Biden administration had overstepped the FDA in announcing plans to offer COVID-19 booster shots beginning on September 20. The pair also clashed with higher-up Peter Marks, who reportedly went along with the administration's plans. Marks is the director of the FDA's Center for Biologics Evaluation and Research (CBER), which includes the OVRR. Marks announced the two resignations in a letter sent to FDA staff ... published in full by biopharmaceutical outlet Endpoints News.

"As news spread of the high-profile resignations, current and former FDA regulators were quick to reveal growing tensions coming from some in the agency who see the Biden administration's booster plan as premature, unnecessary, and out of step with regulators' opinions. Politico, which spoke with 11 former and current health officials, described the situation at the FDA as a 'potential mutiny' among agency staff and outside vaccine experts."

Read more: https://arstechnica.com/science/2021/09/anger-frustration-at-fda-over-bidens-booster-plan-two-top-regulators-resign/


Biden's top-down booster plan sparks anger at FDA - Politico - Sarah Owermohle:

August 31, 2012 - "The Biden administration’s decisions over when to administer coronavirus vaccine boosters are triggering turmoil within the Food and Drug Administration, frustrating regulators and sparking fear that political pressures will once again override the agency’s expertise. FDA officials are scrambling to collect and analyze data that clearly demonstrate the boosters' benefits before the administration’s Sept. 20 deadline for rolling them out to most adults. 

"Many outside experts, and some within the agency, see uncomfortable similarities between the Biden team's top-down booster plan and former President Donald Trump's attempts to goad FDA into accelerating its initial authorization process for Covid-19 vaccines and push through unproven virus treatments.... Now the agency is facing a potential mutiny among its staff and outside vaccine advisers, several of whom feel cut out of key decisions and who view the plan to offer boosters to all adults as premature and unnecessary....

"Acting FDA Commissioner Janet Woodcock sent a memo Tuesday evening to vaccine regulators, reiterating her support as frustration over the process spreads within their ranks.... The tensions between FDA's regulators and top Biden administration officials — including Woodcock, who has publicly endorsed the booster plan — come as the agency begins to tackle its most difficult decisions yet on Covid-19 shots. Many center around making them available to children under 12, whose bodies react differently to the virus and vaccines to prevent it. FDA will have to decide whether the rising number of cases in kids warrants making shots available to them on an emergency basis, before the lengthier approval process, which is more likely to detect any rare side effects. But for now, much of the discord within the agency centers on the administration's decision to push ahead with boosters before FDA's top scientists had a chance to weigh in.

"It was 'the administration's booster plan; it wasn't the FDA's booster plan,' said Paul Offit, a University of Pennsylvania infectious disease expert who sits on FDA’s vaccine advisory committee.... Another senior health official with direct knowledge of the situation said that political appointees within the White House largely steered the mid-August booster announcement.

"Biden added to the confusion and controversy last weekend when he suggested that boosters could be administered just five months after the initial regimen, rather than the eight his administration had just proposed. Those remarks, coming after a meeting with Israeli Prime Minister Naftali Bennett, fueled worries that an administration that had pledged to 'follow the science' was letting politics dictate outcomes."

Read more: https://www.politico.com/news/2021/08/31/biden-booster-plan-fda-508149

Saturday, October 3, 2020

COVID-19 vaccines will not prevent infection

 Covid-19 Vaccine Protocols Reveal That Trials Are Designed To Succeed | Forbes - William A. Haseltine:

September 23, 2020 - "Moderna, Pfizer, AstraZeneca, and Johnson & Johnson are leading candidates for the completion of a Covid-19 vaccine likely to be released in the coming months. These companies have published their vaccine trial protocols. This unusually transparent action during a major drug trial deserves praise, [but] close inspection of the protocols raises surprising concerns. These trials seem designed to prove their vaccines work, even if the measured effects are minimal. 

"What would a normal vaccine trial look like?  Prevention of infection must be a critical endpoint.... Prevention of infection is not a criterion for success for any of these vaccines. In fact, their endpoints all require confirmed infections and all those they will include in the analysis for success,  the only difference being the severity of symptoms between the vaccinated and unvaccinated.... We all expect an effective vaccine to prevent serious illness if infected. Three of the vaccine protocols — Moderna, Pfizer, and AstraZeneca — do not require that their vaccine prevent serious disease.... The greatest fear people have is dying from this disease.... None list mortality as a critical endpoint....

"Vaccine efficacy is typically proved by large clinical trials over several years ... trials ranging from thirty thousand to sixty thousand participants. This scale of study would be sufficient for testing vaccine efficacy. The first surprise found upon a closer reading of the protocols reveals that each study intends to complete interim and primary analyses that at most include 164 participants. These companies likely intend to apply for an emergency use authorization (EUA) from the Food and Drug Administration (FDA) with just their limited preliminary results. 

"Interim analysis success requires a seventy percent efficacy.  For Moderna, the interim analysis includes giving the vaccine to only 53 people. Their success margin is for 13 or less of those 53 to develop symptoms compared to 40 or more in their control group.  For Johnson & Johnson, their interim analysis includes 77 vaccine recipients, with a success margin of 18 or less developing symptoms compared to 59 in the control group. For AstraZeneca, their interim analysis includes 50 vaccine recipients, with a success margin of 12 or less developing symptoms compared to 19 in the 25 person control group.  Pfizer is even smaller in its success requirements. Their initial group includes 32 vaccine recipients, with a success margin of 7 or less developing symptoms compared to 25 in the control group. 

"The primary analyses are a bit more expanded, but need to be less efficacious for success: about sixty percent. AstraZeneca, Moderna, Johnson & Johnson, and Pfizer have primary analyses that distribute the vaccine to only 100, 151, 154, and 164 participants respectively. These companies state that they do not 'intend' to stop trials after the primary analyses, but there is every chance that they intend to pursue an EUA  and focus on manufacturing the vaccine rather than further thorough testing.

"The second surprise from these protocols is how mild the requirements for contracted Covid-19 symptoms are. A careful reading reveals that the minimum qualification for a case of Covid-19 is a positive PCR test and one or two mild symptoms. These include headache, fever, cough, or mild nausea. This is far from adequate. These vaccine trials are testing to prevent common cold symptoms. 

"These trials certainly do not give assurance that the vaccine will protect from the serious consequences of Covid-19. Johnson & Johnson is the only trial that requires the inclusion of severe Covid-19 cases, at least 5 for the 75 participant interim analysis.... Again we find that severe illness and death are only secondary objectives in these trials. None list the prevention of death and hospitalization as a critically important barrier....

"There must be an indication that the authorized vaccines are reducing infection, hospitalization, and death, or else they will not be able to stop this pandemic.... It appears that these trials are intended to pass the lowest possible barrier of success.... It is clear from these studies that the vaccines currently under trial will not be the silver bullet needed to end the pandemic." 

Read more: https://www.forbes.com/sites/williamhaseltine/2020/09/23/covid-19-vaccine-protocols-reveal-that-trials-are-designed-to-succeed

Wednesday, September 23, 2020

Past fiascos show need for vaccine caution


September 1, 2020 - "Vaccine experts are warning the American government against rushing out a coronavirus vaccine.... Their concern that the Food and Drug Administration may be moving too quickly heightened when FDA Commissioner Dr. Steven Hahn told the Financial Times that his agency could consider an emergency use authorization (EUA) for a COVID-19 vaccine before late stage clinical trials are complete if the data show strong enough evidence it would protect people. The commissioner has the authority to allow unapproved medical products to be used in an emergency when there are no adequate or approved alternatives. An EUA is not the same as full approval and it can be withdrawn....

"For a vaccine to be FDA approved, scientists must gather enough data through clinical trials in large numbers of volunteers to prove it is safe and effective at protecting people against a disease. Once the data is collected, FDA advisers usually spend months considering it. An EUA is much quicker. Only once before has the FDA given a vaccine this lesser standard approval of an EUA, but it was in an unusual circumstance. Soldiers had sued, claiming a mandatory anthrax vaccine made them sick, and a judge put a hold on the program. The Department of Defense asked for an EUA that then overrode the court ruling in 2005, so it could continue vaccinating military personnel -- this time on a voluntary basis. Otherwise, vaccines have had to go through the entire clinical trial process and FDA approval process, which can take months or years.

"When the vaccine making process has been rushed, there have been bad outcomes.
  • On April 12, 1955, the government announced the first vaccine to protect kids against polio. Within days, labs had made thousands of lots of the vaccine. Batches made by one company, Cutter Labs, accidentally contained live polio virus and it caused an outbreak. More than 200,000 children got the polio vaccine, but within days the government had to abandon the program.... Forty thousand kids got polio. Some had low levels, a couple hundred were left with paralysis, and about 10 died," said Dr. Howard Markel, a pediatrician, distinguished professor, and director of the Center for the History of Medicine at the University of Michigan. The government suspended the vaccination program until it could determine what went wrong.
  • However, increased oversight failed to discover another problem with the polio vaccine. From 1955 to 1963, between 10% and 30% of polio vaccines were contaminated with simian virus 40 (SV40).... Scientists wrongly thought the formaldehyde they used would kill the virus.... No current vaccines contain SV40 virus, the CDC [U.S. Center for Disease Control] says, and there's no evidence the contamination harmed anyone.
  • In 1976, scientists predicted a pandemic of a new strain of influenza called swine flu. 'President Ford was basically told by his advisers, that look, we have a pandemic flu coming called swine flu that may be as bad as Spanish flu,' said Michael Kinch, a professor of radiation oncology in the school of medicine at Washington University in St. Louis.... 'Ford was being cajoled to put forward a vaccine that was hastily put together'.... Ford made the decision to make the immunization compulsory ...  and 40 million people got vaccinated against swine flu, according to the CDC. That vaccination campaign was later linked to cases of a neurological disorder called Guillain-Barre syndrome, which can develop after an infection or, rarely, after vaccination with a live vaccine....
  • The CDC said the increased risk was about one additional case of Gullain-Barre for every 100,000 people who got the swine flu vaccine. Due to this small association, the government stopped the program to investigate....
"Markel said people's mistrust of the system makes the idea that the FDA would rush this process before late stage clinical trials are complete 'colossally stupid'.... 'All it takes is one bad side effect to basically botch a vaccine program that we desperately need against this virus. It's a prescription for disaster.

"FDA Commissioner Hahn said that the vaccine decision will be based on data, not politics, but Kinch shares Markel's concern.... A too-early EUA for a vaccine could cause a 'nightmare scenario,' for a few reasons.

"One, the vaccine may not be safe. Two, if it is not safe, people will lose faith in vaccines. Three, if a vaccine doesn't offer complete protection, people will have a false sense of security and increase their risk. Four, if a substandard vaccine gets an EUA, a better vaccine may never get approval, because people would be reluctant to enroll in trials and risk getting a placebo instead of a vaccine."


Wednesday, September 9, 2020

PCR tests exaggerating COVID-19 case counts

Your Coronavirus Test Is Positive. Maybe It Shouldn’t Be | New York Times - By Apoorva Mandavilli:

Sept. 8, 2020 - "Some of the nation’s leading public health experts are raising a new concern in the endless debate over coronavirus testing in the United States: The standard tests are diagnosing huge numbers of people who may be carrying relatively insignificant amounts of the virus. Most of these people are not likely to be contagious, and identifying them may contribute to bottlenecks that prevent those who are contagious from being found in time....

"The most widely used diagnostic test for the new coronavirus, called a PCR test, provides a simple yes-no answer to the question of whether a patient is infected.... The PCR test amplifies genetic matter from the virus in cycles; the fewer cycles required, the greater the amount of virus, or viral load, in the sample. The greater the viral load, the more likely the patient is to be contagious. This number of amplification cycles needed to find the virus, called the cycle threshold, is never included in the results sent to doctors and coronavirus patients, although it could tell them how infectious the patients are.

"In three sets of testing data that include cycle thresholds, compiled by officials in Massachusetts, New York and Nevada, up to 90 percent of people testing positive carried barely any virus, a review by The Times found. On Thursday, the United States recorded 45,604 new coronavirus cases.... If the rates of contagiousness in Massachusetts and New York were to apply nationwide, then perhaps only 4,500 of those people may actually need to isolate and submit to contact tracing.

"One solution would be to adjust the cycle threshold used now to decide that a patient is infected. Most tests set the limit at 40, a few at 37. This means that you are positive for the coronavirus if the test process required up to 40 cycles, or 37, to detect the virus. Tests with thresholds so high may detect not just live virus but also genetic fragments, leftovers from infection that pose no particular risk — akin to finding a hair in a room long after a person has left, Dr. [Michael] Mina [an epidemiologist at the Harvard T.H. Chan School of Public Health] said.

"Any test with a cycle threshold above 35 is too sensitive, agreed Juliet Morrison, a virologist at the University of California, Riverside.... A more reasonable cutoff would be 30 to 35, she added. Dr. Mina said he would set the figure at 30, or even less. Those changes would mean the amount of genetic material in a patient’s sample would have to be 100-fold to 1,000-fold that of the current standard for the test to return a positive result .... The C.D.C.’s own calculations suggest that it is extremely difficult to detect any live virus in a sample above a threshold of 33 cycles.... 

"Officials at the Wadsworth Center, New York’s state lab, [have] identified 872 positive tests, based on a threshold of 40 cycles. With a cutoff of 35, about 43 percent of those tests would no longer qualify as positive. About 63 percent would no longer be judged positive if the cycles were limited to 30. In Massachusetts, from 85 to 90 percent of people who tested positive in July with a cycle threshold of 40 would have been deemed negative if the threshold were 30 cycles, Dr. Mina said. 'I would say that none of those people should be contact-traced, not one,' he said....

"The F.D.A. noted that people may have a low viral load when they are newly infected. A test with less sensitivity would miss these infections. But that problem is easily solved, Dr. Mina said: 'Test them again, six hours later or 15 hours later or whatever,' he said. A rapid test would find these patients quickly, even if it were less sensitive, because their viral loads would quickly rise....

"Highly sensitive PCR tests seemed like the best option for tracking the coronavirus at the start of the pandemic. But for the outbreaks raging now, he said, what’s needed are coronavirus tests that are fast, cheap and abundant enough to frequently test everyone who needs it — even if the tests are less sensitive. 'It might not catch every last one of the transmitting people, but it sure will catch the most transmissible people, including the superspreaders,' Dr. Mina said. 'That alone would drive epidemics practically to zero.'"

Read more: https://www.nytimes.com/2020/08/29/health/coronavirus-testing.html

Tuesday, July 7, 2020

Hydroxychloroquine cut COVID19 death rate 50% in Michigan hospital study

by George J. Dance

By now I am sure we have all heard of hydroxychloroquine (HCQ), the anti-malaria drug and arthritis treatment that may or may not be effective against COVID-19. There certainly has been plenty of debate on the drug online: A google search for "Hydroxychloroquine COVID" turns up 65 million hits. Sadly, though, for a debate supposed to be "guided by the science," little of that deals with science. As with mask wearing, HCQ has become a political "issue," and for much the same reasons. Masks are good or bad because the Orange Man doesn't wear them. HCQ is bad or good because the Orange Man uses it. (Choose an option depending on how you feel about the Orange Man.) 

Unlike with masks, though, scientific information is needed to estimate the benefits and risks of HCQ. That is the main reason the blog has refrained from mentioning the drug; in all the debate I have followed, there has been nothing worth mentioning. There was a study in The Lancet that found using HCQ not only saved no lives but led to more deaths, from cardiac arrest; but before I could find space for it on the blog, Lancet had retracted the paper.

Today I discovered a new study, "Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19,"  by Samia Arshad et al., published in the International Journal of Infectious Diseases on July 1. The paper was an observational study conducted in the Henry Ford Health System (HFHS), a six-hospital chain in southwest Michigan, by the Henry Ford COVID-19 task force. The full study is online at ijid.com, and can also be found at https://doi.org/10.1016/j.ijid.2020.06.099 

Arshad et al investigated the medical records of the more than 2,500 patients hospitalized as COVID-related admissions (defined as having a positive PCR-RT viral test in the hospital) between March 10 and May 2. Of those, some had been treated with HCQ; some with a combination of HCQ and azythromycin (AZM), an antiobiotc; some with AZM alone; and some with neither drug. The differences in mortality rates were striking:
  • Of 409 patients given neither drug, 108 died, or 26.4% [95% CI: 22.2%-31.0%]​.
  • Of 147 patients given AZM alone, 33 died, or 22.4%. [95% CI: 16.0%-30.1%]
  • Of 783 patients given HCQ and AZM, 157 died, or 20.1%. [95% CI: 17.3%-23.0%]).
  • Of 1202 patients given HCQ alone, 162 died, or 13.5%. [95% CI: 11.6%-15.5%]).

Charted, the data gives a simple and clear picture: those receiving HCQ had a mortality rate almost 50% below those who received no drugs. Of course, that apparently simple and clear picture could actually be counfounded by numerous variables. The authors point out that those can include "1) patient demographics: age, gender, race, body mass index (BMI) on admission [as well as] 2) clinical characteristics: admission date, discharge date, length of stay (LOS), comorbidities including: cardiovascular disease (CVD), chronic lung disease, chronic kidney disease (CKD), hypertension, asthma, chronic obstructive pulmonary disease (COPD), diabetes mellitus, immunodeficiency, and cancer (defined as active or past/resolved)."

The task force "used Multivariable Cox regression models and Kaplan-Meier survival curves ... to compare survival among treatment groups while controlling for demographics (e.g., age, gender), preexisting medical conditions (e.g. CVD, lung disease) and clinical disease severity (mSOFA, O2 saturation). Bivariate comparisons of the 4 medication groups were made using analysis of variance or Kruskal-Wallis tests for continuous variables, and chi-square tests or Fisher exact tests for categorical variables."

In addition, the researchers were able to exactly match two cohorts - 190 who had received HCQ, and 190 who had not - with "identical underlying patient characteristics." "The Cox regression result for the two propensity matched groups ... indicates that treatment with hydroxychloroquine resulted in a mortality hazard ratio decrease of 51% (p = 0.009)."


"The results of this study," the authors conclude, "demonstrate that in a strictly monitored protocol-driven in-hospital setting, treatment with hydroxychloroquine alone and hydroxychloroquine + azithromycin was associated with a significant reduction in mortality among patients hospitalized with COVID-19." (They also demonstrate that HCQ used alone was associated with a greater reduction. than the combination.)

The Food and Drug Administration (FDA) cautions against use of HCQ "outside of the hospital setting or a clinical trial," but does not approve the drug's use within the hospital setting, either. The FDA approved an Emergency Use Authorization (EUA) for the drug in late March, but withdrew it on June 15 after the Lancet study. The latter study has since been retracted and its data discredited; and now its conclusions have been explicitly contradicted by the Henry Ford study.

The study's findings that the drug is effective (that it reduces COVID deaths) may be overstated or confounded with other unknown variables (such as steroid use); I agree with the the Journal's call for clinical trials of the drug. Undeniably, though, the safety of the drug has been proven (it does not even correlate with any increase in deaths); that and the possibility of dramatically cutting the COVID death toll warrant the FDA restoring the medicine's EUA.  

Friday, April 24, 2020

FDA permits first at-home COVID-19 test kits

LabCorp’s at-home COVID-19 test kit is the first to be authorized by the FDA | Techcrunch - Darrell Etherington:

April 21, 2020 - "LabCorp’s at-home COVID-19 test, which is called ‘Pixel,’ has received the first Emergency Use Authorization (EUA) for such a test issued by the U.S. Food and Drug Administration (FDA). The test is an at-home collection kit, which provides sample collection materials including a nasal swab to the user, who then uses the included shipping package to return the sample to a lab for testing.

"Until now, the FDA has not authorized any at-home testing or sample collection kits for use, and in fact clarified its guidelines to specifically note that their use was not authorized under its guidelines when a number of startup companies debuted similar products for at-home collection and round-trip testing with labs already certified to run molecular RT-PCR tests to detect the presence of COVID-19.

"The FDA notes that only LabCorp’s COVID-19 RT-PCR test has received this authorization, and that it still requires any such test to have an EUA before they can being offering services, whether or not the test is administered at home with the help of guidance from an authorized medical professional via telemedicine. Some labs facilitating at home serology tests using an exception in the FDA guidelines, but these are not viewed by the agency as tests that can confirm a case of COVID-19.

"Opening up at-home testing (even via just sample collection, vs. full at-home test administration) is a big step in terms of a change in the way the agency has operated thus far. The FDA has recently updated its guidelines to note that it is working with at-home test providers to determine the best way to make those available to the public, since it 'sees the public health value in expanding the availability of COVID-19 testing through safe and accurate tests that may include home collection'....

Testing for COVID-19 in the U.S. currently relies on drive-through sites, as well as in-clinic and hospital testing. These tests have a high bar for access in terms of risk profile and symptom presentation, and their administration also exposes the healthcare professionals running them to risk of contracting the infection themselves. At-home testing could increase overall testing rates, while decreasing risk to frontline healthcare workers, providing a better picture of the true extent and depth of the COVID-19 pandemic."

Saturday, April 11, 2020

The coronavirus testing failure (video)

How the CDC and the FDA Wrecked the Economy | Reason - Jacob Sullum:

April 8, 2020 - "Public officials across the United States are flying blind against the COVID-19 epidemic. Because of a government-engineered testing fiasco, they do not know how fast the virus is spreading, how many people have been infected by it, how many will die as a result, or how many have developed immunity to it. The failure to implement early and wide testing, which was caused by a combination of short-sightedness, ineptitude, and bureaucratic intransigence, left politicians scrambling to avoid a hospital crisis by imposing broad business closure and stay-at-home orders....

"At first, the U.S. Centers for Disease Control and Prevention (CDC) monopolized COVID-19 tests. When the CDC began shipping test kits to state laboratories in early February, they turned out to be defective.

"The CDC and the Food and Drug Administration initially blocked efforts by universities and businesses to develop and conduct tests before relaxing the restrictions ... [and] the CDC set irrationally narrow criteria for testing, which meant that carriers without severe symptoms or obvious risk factors escaped detection.

"The CDC still insists that 'not everyone needs to be tested for COVID-19.' But without testing everyone — or at least representative samples — for both the virus itself and the antibodies to it, we can do little better than guess its prevalence, its lethality, and the extent of immunity among the general public.

"Even now, months after the Wuhan outbreak and the first reported case in the U.S., we have managed to test less than 1 percent of the population, and those tests have been limited mainly to people with symptoms severe enough for them to seek treatment. Since people infected by COVID-19 typically experience mild symptoms or no symptoms at all, that's a real problem....  Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, estimates that 'somewhere between 25 percent and 50 percent' of COVID-19 carriers are asymptomatic. But he cautions that 'right now we are just guessing'....

"Our ignorance about COVID-19 will have profound consequences, potentially leading to an overreaction that wrecks the economy while saving relatively few lives or (less likely, given the current political climate) an underreaction that costs many lives and allows hospitals to be overwhelmed by COVID-19 cases. You can thank the same agencies on which we are relying to guide us through this crisis."

Read more: https://reason.com/2020/04/08/how-the-cdc-and-the-fda-wrecked-the-economy/
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Also read: Coronavirus testing failure in Canada, too

Monday, March 30, 2020

Private sector tackling coronavirus emergency

The Private Sector's Heartening Response to COVID-19 | Reason - Veronique de Rugy:

March 26, 2020 - "It's easy to feel depressed and scared these days. News about the impact and death toll of the new coronavirus, COVID-19, is constant. Government responses have been chaotic, ranging from near-indifference to suddenly shutting down the economy, with politicians offering to pay for everything. Yet we shouldn't lose sight of the exceptional vitality that the private sector is demonstrating during this mess. It will make a difference....

"After what can only be described as a multilevel government failure that resulted in the United States having practically no coronavirus tests available for weeks after the onset of the pandemic, the private sector ramped up its production so much that we're now testing 65,000 people every day. This number is bound to grow..... Singapore's Veredus Laboratories, for example, said it will soon release "Lab-on-Chip" kits to test patients for three kinds of coronavirus within two hours. Four American startups had also launched at-home tests for COVID-19, until the Food and Drug Administration unwisely demanded they stop....

"[O]nly a few weeks after the beginning of this outbreak in the United States, many pharmaceutical firms worked at lightning speed to develop a vaccine. Last week, the first doses of an experimental COVID-19 vaccine were administered to a group of volunteers....

"Companies nationwide are shifting resources to produce more masks. The firm 3M, for instance, announced that it 'ramped up to maximum production levels of N95 respirators and doubled our global output to a rate of more than 1.1 billion per year'.... A group of American apparel and textile companies like Fruit of the Loom and Hanesbrands came together almost overnight to create a medical face mask supply chain....

"Researchers trying to understand where best to send supplies or how to mitigate outbreaks are now being helped by Facebook's disease prevention maps that display population density, demographics, and travel patterns. As George Mason University's Tyler Cowen also explains for Bloomberg, 'Skype and Zoom sessions will replace many a class, and the textbook companies are stepping forward with electronic portals that present classroom materials, interactive exercises and grade student answers'....

"In Canada, an anesthetist managed to turn one life-saving ventilator into nine. In Italy, a company used its 3-D printer to manufacture much-needed ventilator valves to be used in that country's overwhelmed hospitals. These entrepreneurs then ... modified 'a snorkeling mask already on the market to create a ventilation-assisted mask for hospitals in need of additional equipment, which was successful when the hospital tested it on a patient in need.' And where I live in Virginia, a couple has been 3D-printing shields to protect N95 masks. The Washingtonian reports, 'For each request received, the Filkos are covering shipping costs and sending four free masks to doctors, nurses, and other healthcare workers'....

"Burger King is giving out two free kids' meals to everyone who orders food through their app. U-Haul is providing one month of free storage for students displaced from their universities by the virus."

Read more: https://reason.com/2020/03/26/the-private-sectors-heartening-response-to-covid-19/

Friday, March 20, 2020

FDA allows commercial coronavirus testing

FDA opens the gates to commercial coronavirus testing without agency review | Fierce Biotech - Conor Hale:

Mar 17, 2020 - "In the face of urgent need, the FDA has opened its floodgates to commercial coronavirus testing. The agency is now allowing companies to proceed with their diagnostic tests without first submitting them for federal review or obtaining an official emergency clearance.

"The move comes as epidemiologists estimate that the U.S. is just days behind seeing large-scale spread of the virus similar to what is currently happening in countries such as Italy — which as of March 17 has reported nearly 28,000 confirmed cases, the most outside of China, while the U.S. now stands at over 4,600 cases, according to international health authorities.

"Tens of companies have already signed up to test under the new 'unprecedented policy,' according to Commissioner Stephen Hahn, who said the FDA aims to expand the capacity as well as the variety of COVID-19 molecular diagnostics available — and that the agency is, essentially, trusting companies and labs to make sure their tests in the field are well-validated. 'We urge state authorities and commercial developers to take all necessary steps to ensure the availability of accurate tests,' Hahn said in an agency statement....

"The policy is a broad expansion in scope from the FDA’s previous moves to accelerate testing, including allowing certain CLIA-certified, 'high complexity' labs to proceed with their own tests while submitting their data and emergency use application to the agency for review within 15 days. Commercial developers will be held to the same paperwork requirement.

"It is also a dramatic, if temporary, change in the FDA’s stance toward regulation of testing, which over the past 10 years has warned of the personal health risks that could follow erroneous test results as lab-developed tests and complex molecular diagnostics have become much more common tools in guiding clinical practice."

Read more: https://www.fiercebiotech.com/medtech/fda-opens-gates-to-commercial-coronavirus-testing-without-agency-review

Tuesday, December 10, 2019

Psilocybin called breakthrough therapy by FDA

FDA Grants Psilocybin Second Breakthrough Therapy Designation - Megan Brooks:

November 25, 2019 - "The US Food and Drug Administration (FDA) has granted the Usona Institute breakthrough therapy designation for psilocybin for the treatment of major depressive disorder (MDD).

"This marks the second time the FDA has granted breakthrough designation for psilocybin, the psychoactive ingredient in "magic mushrooms." In October 2018, Compass Pathways received the designation to test the safety and efficacy of psilocybin-assisted therapy for treatment-resistant depression....

"'The results from previous studies clearly demonstrate the remarkable potential for psilocybin as a treatment in MDD patients, which Usona is now seeking to confirm in its own clinical trials," Charles Raison, MD, Usona's director of clinical and translational research, said a news release.

"The Usona Institute is a nonprofit medical research organization that conducts and supports preclinical and clinical research to further the understanding of the therapeutic effects of psilocybin and other consciousness-expanding medicines....

"More than 17 million people in the United States suffer from MDD. Through the breakthrough therapy designation, psilocybin is recognized as possibly offering a clinically significant improvement over existing therapies.

"The new status follows the recent launch of Usona's phase 2 clinical trial (PSIL201), which will recruit roughly 80 patients at seven study sites around the United States. The study will assess the safety and efficacy of a single dose of psilocybin in comparison with placebo in patients aged 21 to 65 years who have MDD. Two of the study sites are currently recruiting patients; the others are expected to be active by the first quarter of 2020. Usona estimates that the trial will be completed by early 2021."

Read more: https://www.medscape.com/viewarticle/921789
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Thursday, May 9, 2019

Decriminalize Denver initiative wins by under 1%

Magic mushrooms decriminalization: Denver poised to become first in U.S. to loosen restrictions - Jon Murray, Denver Post:

May 8, 2019 - "Denver is poised to become the first city in the nation to effectively decriminalize psychedelic mushrooms. After closing an early vote deficit Tuesday night and early Wednesday, final unofficial results posted late in the afternoon showed a reversal of fortune — with Initiative 301 set to pass narrowly with 50.6 percent of the vote. The total stands at 89,320 votes in favor and 87,341 against, a margin of 1,979.

"The Denver Elections Division will continue accepting military and overseas ballots, but typically those numbers are small. Results will be certified May 16....

"Denver’s vote has attracted national attention. While efforts are afoot to get psilocybin-related measures on the ballot in Oregon and California in 2020, Denver hosted the first-ever U.S. popular vote on the matter, according to organizers. An earlier effort in California last year failed to qualify for the ballot.

"Though Initiative 301 attracted no organized opposition, critics of Colorado’s legalization of marijuana lamented the prospect of Denver blazing yet another trail they see as misguided and potentially harmful.... 'We’ll see what the final numbers are, but we’re a little stunned to see a 7,000-vote flip overnight on that,' said Jeff Hunt, director of the Centennial Institute at Colorado Christian University, who initially questioned on Twitter whether vote-tampering was involved....

"Supporters extolled emerging research showing potential health benefits with psychedelic mushrooms. The measure likely was put over the top by younger voters, who tend to cast their ballots closer to or on Election Day, even though all registered voters receive their ballots in the mail about three weeks earlier.

"Last fall, the U.S. Food and Drug Administration granted psilocybin 'breakthrough therapy' designation for its potential to help with treatment-resistant depression, a status that speeds up the development and review process for a medicine containing the substance....

"Some national media outlets as well as the Centennial Institute wrongly called I-301 a bust ... based on the early results. But the gap tightened throughout the night. By 1 a.m. Wednesday, when Denver Elections put out its last release before pausing counting for the night, the measure still was losing by 3.4 percentage points. It overcame that margin in the next — and final — round of results shortly after 4 p.m."

Read more: https://www.denverpost.com/2019/05/08/denver-psychedelic-magic-mushroom/
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Saturday, January 19, 2019

Lessons from the government shutdown

John Stossel: Government shutdown lessons -- We could take a chainsaw to so much of government | Fox News:

January 17, 2019 - "This government shutdown is now longer than any in history. The media keep using the word 'crisis.' But ... I see people going about their business -- families eating in restaurants, employees going to work, children playing in playgrounds, etc. I have to ask: Where’s the crisis?...

"We need some government, limited government. But most of life, the best of life, goes on without government, many of the best parts in spite of government....

"Columnist Paul Krugman calls this shutdown, 'Trump’s big libertarian experiment.' But it’s not libertarian. Government’s excessive rules are still in effect, and eventually government workers will be paid for not working. That makes this a most un-libertarian experiment. But there are lessons to be learned.

"During a shutdown when Barack Obama was president, government officials were so eager to make a point by inconveniencing people that they even stopped visitors from entering public parks. Trump’s administration isn’t doing that, so PBS found a new crisis: 'Trash cans spilling … (P)ark services can’t clean up the mess until Congress and the president reach a spending deal,' reported NewsHour. But volunteers appeared to pick up some of the trash. Given a chance, private citizens often step in to do things government says only government can do.

"The Washington Post ran a front-page headline about farmers 'reeling … because they aren’t receiving government support checks.' But why do farmers even get 'support checks'?... Most fruit and vegetable farmers get no subsidies, yet there are no shortages of peaches, plums, green beans, etc. Subsidies are a scam created by politicians who get money from wheat, cotton, corn and soybean agribusinesses. Those farmers should suck it up and live without subsidies, too.

"During shutdowns, government tells 'nonessential workers' not to come to work. But if they’re nonessential, then why do we pay 400,000 of them?...  We could take a chainsaw to so much of government.

The New York Times shrieks, 'Shutdown Curtails FDA Food Inspections!' Only if you read on do you learn that meat and poultry inspection is done by the Department of Agriculture. They’re still working.... More important, meat is usually safe not because of government -- but because of competition. Food sellers worry about their reputations ... so they take many more safety measures than government requires. One meat producer told me that they employ 2,000 more safety inspectors than the law demands....

"Even security work is done better by the private sector. At San Francisco’s airport, security lines move faster. Passengers told me, 'The screeners are nicer!' The TSA even acknowledged that those screeners are better at finding contraband. That’s because San Francisco (Kansas City, Seattle and a dozen smaller airports) privatized the screening process....

"Private contractors are better because they must compete. Perform badly, and they get fired. But government never fires itself."

'via Blog this'

Friday, July 13, 2018

Vapers urged to oppose FDA flavor crackdown

Vaping Industry Rallies To Oppose Looming Flavor Crackdown From The FDA - The Libertarian Republic - Steve Birr:

June 28, 2018 - "The vaping industry is rallying former smokers who quit using an electronic cigarette to share their stories with federal regulators, who are mulling restrictions on flavored products. The advocacy campaign, dubbed #Fight4Flavor, comes in response to a proposed rule from the Food and Drug Administration to regulate tobacco and nicotine flavoring....

"The Global Vaping Standards Association (GVSA) is leading the campaign, which encourages any users of alternative technologies and smokeless products to submit comments to the FDA on how flavors helped them make the switch from combustible cigarettes, which continue to be the number one cause of preventable death worldwide.

"The FDA is currently seeking comments on the implications of flavored products, particularly whether they are having a negative impact on youths....

"Public health experts focused on harm reduction note flavor restrictions will likely serve to marginalize former smokers relying on a vape to satiate their nicotine cravings, potentially pushing them back to deadly combustible cigarettes. They argue flavors are key to helping smokers disassociate with the taste of tobacco.

"The GVSA coalition includes companies AVAIL Vapor, Charlie’s Chalk Dust, Mama’s, SMOK, The Drip Club, Vaporesso, Midwest Distribution, My Vapor Store and Vapor Authority.

"'The industry leaders of this coalition are all committed to advocating for vapers’ rights and their right to choose flavored e-liquids while also following strict regulations to keep vape products out of the hands of minors,' Maggie Gowen, executive director of GVSA, said in a statement.... 'Today over 400,000 people have made a comment, and through our combined resources, we have the ability to reach over two million additional vapers. For adult consumers, flavoring is what helped them transition from smoking to vaping. For the manufacturers and retailers, it’s their livelihood. We have to champion an endeavor that protects all of these groups in an effort towards harm reduction'....

"Comments for the proposed FDA rule must be submitted by July 19.

"Researchers from the Yale School of Public Health and the Centre for Health Policy at the Imperial College in London published a study in September 2017 investigating the impact flavor restrictions may have on e-cigarette use. The scientists found that a ban on e-cigarette flavors in the U.S. would reduce the use of vaping devices by more than 10 percent, suggesting users would default back to more harmful cigarettes."

Read more: https://thelibertarianrepublic.com/vaping-industry-rallies-to-oppose-looming-flavor-crackdown-from-the-fda/
'via Blog this'

Sunday, September 17, 2017

Film chronicles cancer doctor's battles with FDA (video)

Synopsis - Burzynski, the Movie:

"Burzynski, the Movie is an internationally award-winning documentary originally released in 2010 (with an Extended Edition released in 2011) that tells the true story of a medical doctor and Ph.D biochemist named Dr. Stanislaw Burzynski who won the largest, and possibly the most convoluted and intriguing legal battle against the Food & Drug Administration [FDA] in American history.

"His victorious battles with the United States government were centered around Dr. Burzynski’s gene-targeted cancer medicines he discovered in the 1970’s called Antineoplastons, which have currently completed Phase II FDA-supervised clinical trials in 2009 and ... been given permission by the FDA to begin the final phase of FDA testing – randomized controlled clinical trials....This documentary takes the audience through the treacherous, yet victorious, 14-year journey both Dr. Burzynski and his patients have had to endure in order to obtain FDA-approved clinical trials of Antineoplastons....

"[T]he Food and Drug Administration engaged in four Federal Grand Juries spanning over a decade attempting to indict Dr. Burzynski, all of which ended in no finding of fault on his behalf. Finally, Dr. Burzynski was indicted in their 5th Grand Jury in 1995, resulting in two federal trials and two sets of jurors finding him not guilty of any wrongdoing."

Read more: http://www3.burzynskimovie.com/synopsis/#.Wb6aJtQrLn5
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Wednesday, August 30, 2017

Herpes vaccine trials go offshore to avoid FDA

Offshore Human Testing Of Herpes Vaccine Stokes Debate Over U.S. Safety Rules - Marisa Taylor, Kaiser Health News:

August 28, 2017 - "Defying U.S. safety protections for human trials, an American university and a group of wealthy libertarians ... are backing the offshore testing of an experimental herpes vaccine.

"The American businessmen, including Trump adviser Peter Thiel, invested $7 million in the ongoing vaccine research, according to the U.S. company behind it. Southern Illinois University also trumpeted the research and the study’s lead researcher, even though he did not rely on traditional U.S. safety oversight in the first trial, held on the Caribbean island of St. Kitts.

"Neither the Food and Drug Administration nor a safety panel known as an institutional review board, or an 'IRB,' monitored the testing of a vaccine its creators say prevents herpes outbreaks. Most of the 20 participants were Americans with herpes who were flown to the island several times to be vaccinated, according to Rational Vaccines, the company that oversaw the trial....

"'This is a test case,' said Bartley Madden, a retired Credit Suisse banker and policy adviser to the conservative Heartland Institute, who is another investor in the vaccine. 'The FDA is standing in the way, and Americans are going to hear about this and demand action'....

"Agustín Fernández III co-founded­ Rational Vaccines with tenured SIU professor William Halford. He said Halford, the lead investigator, took the necessary precautions during the trial conducted from April to August in 2016. Halford died of cancer in June....

"Fernández, a former Hollywood filmmaker, said he and his investors plan to submit the trial data to the FDA in hopes of getting the vaccine approved for treatment. If the FDA does not respond favorably, he said, the company will continue its trials in Mexico and Australia. Fernández said he hopes to set up an IRB for these next trials. No matter what, he plans to manufacture the vaccine offshore....

"Fernández said he hoped the trials would put political pressure on the FDA to give the vaccine a closer look. He said his vaccine would be initially aimed at helping patients who experience the 'worst of the worst' symptoms. He believed the vaccine eventually would be shown to be effective in preventing the spread of the disease. According to the CDC, about 1 in 6 people ages 14 to 49 have genital herpes....

"Before the trial, Halford tested the vaccine on himself and Fernández. After he failed to secure federal funding and an IRB, Halford moved ahead with the trial offshore....

"The results have not been published in a peer-reviewed journal and Halford’s previous attempt to publish was rejected.... Yet some herpes patients, who are part of a tight-knit online community, have followed the project with hope and enthusiasm. One American participant ... Richard Mancuso said ... the vaccine has stopped his severe outbreaks. 'This has saved my life,' he said."

Read more: http://khn.org/news/offshore-rush-for-herpes-vaccine-roils-debate-over-u-s-safety-rules/

Thursday, August 10, 2017

U.S. Senate unanimously passes Right to Try bill

Senate passes ‘right to try’ bill to help terminally ill patients get experimental drugs - The Washington Post - Laurie McGinley:

August 2, 2017 - "The Senate on Thursday passed by unanimous consent a measure designed to make it easier for terminally ill patients to get access to experimental treatments without oversight from the Food and Drug Administration.

"The 'right-to-try' legislation has been championed by the libertarian Goldwater Institute, which has worked to pass similar legislation in 37 states. The federal version, now headed to the House, would bar the government from blocking patients from getting access to medications that have undergone only preliminary testing in humans. Patients first would have to try all other available treatments and be unable to participate in clinical trials.

"The bill would provide drug companies some legal protection if a treatment results in harm.

"'Patients with terminal diseases ought to have a right to access treatments that have demonstrated a level of safety and could potentially save their lives,' Sen. Ron Johnson (R-Wis.), who wrote the bill, said in a statement after the vote....

"A previous version of the measure barred the FDA from considering any information on safety problems as part of its approval process for a drug used under right to try. The latest version was modified to allow the agency to consider such information if it is critical to determining whether the drug meets the agency's safety standards.

"The Senate's action on the right-to-try bill was part of a deal struck between Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander (R-Tenn.) and Johnson, who had threatened to hold up a must-pass FDA funding reauthorization bill unless a vote on his legislation took place."

Read more: https://www.washingtonpost.com/news/to-your-health/wp/2017/08/03/senate-passes-right-to-try-bill-to-help-terminally-ill-patients-get-experimental-drugs/?utm_term=.d90cbd0fab84
'via Blog this'

Sunday, February 26, 2017

MDMA in final phase of FDA-mandated tests

A campaign for FDA approval of MDMA enters final trials - Business Insider - Kevin Loria:

November 30, 2016 - After veteran Tony Macie came back from Iraq in 2007, he learned he had post-traumatic stress disorder [PTSD].... The retired sergeant then became part of a clinical trial organized by MAPS [Multidisciplinary Association for Psychedelic Studies] that was testing an unusual substance.... MDMA, ... the pure form of something commonly thought of as an illegal party drug - ecstasy.... 'One of the first things I said when it kicked in was, "This is what I've been looking for,'" Macie says....

"The trial Macie was involved in and other Phase 2 clinical studies conducted by MAPS have been so effective that the Food and Drug Administration on Tuesday agreed to allow large-scale Phase 3 clinical trials — the third and final in the three sets of human trials required before the FDA will consider a new drug for approval — to go forward, according.... If those trials continue to show that MDMA effectively treats PTSD, ecstasy could enter clinical use as soon as 2021, fitting the timeline that MAPS has been working toward for some time now....

"One of the early studies conducted by MAPS showed that 83% of the study participants no longer showed signs of PTSD two months after treatment, and long-term follow-ups conducted an average of four years later showed that most of those benefits stuck. That was a proof-of-concept study, with just 20 participants, all of whom had psychotherapy as well.... 

"Though small and preliminary, the results were encouraging enough to help lead to Phase 2 clinical trials, which MAPS announced were coming to an end last March. These trials consisted of at least eight studies that Brad Burge, the director of communications for MAPS, recently told Inverse treated 136 people using MDMA-assisted psychotherapy for PTSD.... The data released from those studies so far is very promising, with a large percentage of patients not showing any signs of PTSD more than a year after completing the therapy.

 "The final tests will involve hundreds of people and must be conducted before the FDA decides to approve a new medication. 'Phase 3 starts around 2017, and it will take four to five years to finish,' Burge has previously said. 'So that will put it at early 2021 for FDA approval'....

"MAPS is mostly raising money itself to fund what it describes as a roughly $20 million plan to complete these trials, which are largely not of interest to pharmaceutical companies since the patent on MDMA has expired. That will mean significant fundraising is required.

"Last year the organization reported $9.1 million in assets, more than $5 million of which was a bequest from a longtime board member that has been earmarked specifically for those Phase 3 trials. In fiscal-year 2015, MAPS raised a combined $2.99 million from 2,500 donors. It said in its most recent annual report that 'substantially increasing our donor base' would be necessary to move forward with Phase 3 trials."

 Read more: http://www.businessinsider.com/mdma-ecstacy-fda-approval-maps-2016-11
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