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The Potential Benefits Outweigh Concerns Over Drugs Catered to Specific Patients

Posted on: Tuesday, 12 July 2005, 21:00 CDT

The idea of moving away from treatments for the masses and focusing on individualized medical care has huge potential and is worthy of more research.

But some in the medical field, as well as patients, are worried about drugs labeled for specific groups. An example is the new drug, BiDil. The U.S. Food and Drug Administration recently approved the cardiac drug specifically for black patients.

The concern is that such drugs overestimate race's role in human biology and could steer research away from nongenetic health disparities. Drug companies, some say, are simply trying to cash in on the minority market.

Those are all valid points that should be taken into consideration. But they should not prevent researchers from studying how medicines work differently in people.

Pharmacogenomics -- which explores the inherited variations in genes that dictate drug response -- is an emerging field.

For example, some research centers and hospitals are using genetic tests to determine which children with acute lymphoblastic leukemia have genes that leave them open to adverse reactions. The research can be used in some cases to tailor drugs and eliminate side effects.

It's true that the genetic variations between races are minute. But differences, nonetheless, do exist -- and not just between races but also within races. Why shouldn't a black patient suffering from heart failure receive the best treatment for her individualized circumstances? Or Latino patients for theirs? Or Joe Smith for his?

Medicine should be about what's best for the patient. A one-size- fits-all approach may not always be the best solution.

In the case of BiDil, nitric oxide -- a naturally occurring vein- relaxer -- reduces strain on the heart. Scientists think BiDil may work more effectively in black patients because it is more common for them to have a nitric-oxide deficiency.

And nothing prevents doctors from prescribing the drug as an "off- label use" for other races.

Discriminating against patients should be avoided at all costs. And other factors shouldn't be ignored when considering why a certain group is at higher risk for a certain disease. Some of it may stem from genetics, but it also could be related to lifestyle, culture, socioeconomic reasons or access to health care.

But it is irresponsible to keep promising drugs out of the pipeline because of a few concerns that may or may not come to fruition.

Researchers should forge ahead, albeit sensibly, in this brave new world of medicine. The potential benefit is too great to pass by.

Source: Omaha World - Herald

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