Heart Pill Intended Only for Blacks Sparks Debate

[Celebration]

A tiny biotechnology company today will seek a crucial advisory panel endorsement for BiDil, a heart pill that could become the first drug approved for a single race.

The Food and Drug Administration panel will consider evidence from NitroMed Inc. that its pill — a combination of two old generic drugs — improves the life expectancy of African Americans, the only racial group included in the company's study.

.................(snip)


By approving a drug for one race, "you are giving biological reality to … a cultural prejudice, and that can be dangerous," said Gregory Dorr, an expert in the history of medicine at the University of Alabama. "The last time something was labeled for blacks, it was water coolers and restrooms."

NitroMed said the company's clinical trial was rooted in science. The firm's chief executive said its drug filled an important medical need because African Americans did not respond well to existing heart treatments.

http://www.latimes.com/business/la-fi-bidil16jun16,0,4834657.story?coll=la-home-business

[OrlandoGator]

1. If there's a scientific basis for it, why not?

Black people have specific hair and skin care products too, that's just a result of having different hair and skin from the rest of the population. There's nothing racist about any of that.

[htuttle]

2. Medically speaking, what is a 'black'?

What about 'mullattos'? 'Quatroons'? 'Octaroons'?

What genetic marker are they using to determine 'blackness'? I've never heard that there was one -- I've always thought it was more of a continuum. How many of us even know if we are 'part black'? How far back does it "count" for the purposes of this particular drug treatment?

As you might guess, I'm sort of dubious about this whole approach...

[whistle]

5. What about double dodecahedroons?

[Celebration]

6. I see your point

But the same point could be made concerning affirmative action, couldn't it?

[htuttle]

8. No

When considering affirmative action, it involves behavior that is based on 'appearance'. If somebody *appears* black, they are more likely to experience discrimination. It doesn't involve medical definitions, it involves 'cultural definitions'.

Under affirmative action, Bob Barr probably wouldn't be considered 'black' since he doesn't appear 'black', and therefore probably wouldn't have been treated in the discriminatory manner that affirmative action is meant to redress.

However, under the medical definition of 'blackness' used above, would Bob Barr be considered 'black'? You see, without a SPECIFIC genetic marker that defines the condition they are looking for, it's a meaningless categorization.


There IS a scientific basis for treatments that are based on SPECIFIC genetic characteristics. There is NO scientific rationale for basing something on the vague concept of 'race'. Race and genetics are two seperate things.

I'd argue that 'race' is a medically useless concept without having very specific genetic definitions (and then it's not 'race', but rather a subset of people who possess the specific genetic characteristics that affect the treatment).

[Celebration]

9. Appearance?

I'm not sure if that is a good guideline-- someone actually has to "judge" that. Do you go by skin color (I am darker than some African Americans) or facial characteristics?

The problem with genetic testing to determine whether a drug will work is that it is quite expensive and also takes a bit of time to get the results. Otherwise, I agree with you on this one.

[htuttle]

11. I think the Affirmative Action laws just punt on that

As far as I know, AA laws are based on a person's own conception of their 'race'. So if a person considers themselves 'black', they get reported on the EEOC forms as 'black', whatever they look like. My point was that Affirmative Action is based on behavior, which is based on apparent appearance. Approval of medical treatments should be based on much more concrete factors than that.

I'd argue that if it matters what genetic characteristics a person has for medical purposes, then the testing should be done first. I just don't see any indication that they even know what genes affect it.

Here's a quote from the article:

But some scientists say it's doubtful that only African Americans will respond to BiDil.

"It is not like one group has all the bad genes," said Neil Risch, a UC San Francisco geneticist. "They are pretty well distributed."

So what if their initial test group only consisted of people with red hair? Would that imply that the treatment only worked on people with red hair? Or would it imply they should have tested a more diverse group of people?

Since they didn't even test the drug on people whom the testers considered 'non-black', I don't even see how they can determine whether genetics has ANY affect on drug's effectiveness -- there doesn't seem to be any control group.

[Celebration]

12. Testing only on blacks

I read the article again, and just have a sense that it may be known that a lot of medications don't work that well in blacks, but that this combination does. Therefore, they thought that they could get the most positive results in this population, compared to a control group of African Americans. Thus it would be easier to prove efficacy in a subset of people for whom other options don't seem to work well. This would make sense in terms of saving money-- being able to run smaller studies and still reach statistical significance.

It seems that genetic testing may be done in the future. Based on the quotes, some feel that this can also be effective in non blacks for whom other medications don't work.

[Warpy]

7. Did they test it on anyone who wasn't Afro?

It looks like this bunch didn't, and that's the racist part.

However, if this story is hogwash and they found significant differences in the way it worked (unlikely), then marketing it to the target group who got the most benefit is good sense.

I just think this story smells to high heaven. Men and women metabolize drugs very differently according to different body chemistry. The same can't be said for people of the same sex with different skin colors.

[Celebration]

10. more info from article

"Loberg, NitroMed's CEO, says his company does not plan to test BiDil in nonblacks. But it will look for underlying genetic traits in patients already studied, in an effort to identify patients of any race who may benefit................... snip......

Cohn, who will receive a royalty on sales of BiDil, says he believes it probably will be effective in patients who aren't black. In fact, he says, he prescribes the generic drugs that make up BiDil for the 25% of his white patients who don't do well on other drugs.

"I actually think everybody should be using it," Cohn said."

[iamjoy]

3. This Is A Good Thing

IMO
It seems most medical research done is based on white males. Drugs or study findings are often approved/released for the general public, but then, the results aren't the same in blacks (or women, for that matter).

So now we have a medication that we know works in African Americans and some would deny them access to a life saving drug because they're worried about racism?

I do see the concern, and think the drug manufacturer is more concerned about profit than health (aren't they all?) - but I think we need to ask ourselves is this more good than bad and are there ways to approve it which will lessen any affects of racism concerns.

[sam sarrha]

4. This debate is Racial Predjudice..this is stupid.ignornant Right wing BS!!

[applegrove]

13. There are issues like sickle cell anemia. I doubt very much if this

drug will not be available to someone 'white' who it works for. Don't know the background but we are all dependent disease-wise on our genes..whatever they may be. And we don't know what a mixture many of us are. That concerns me. How they will define black? But otherwise..there are many illnesses the world over that need to be looked into and studied and treatment resulted...that have been ignored because they were 'woman' in nature (remember it was two women who opened up their rich purses and said to scientists "come up with a birth control pill why don't you!! Reproductive health is the leading cause of death among women!!!"). Any new pill that really, really works is a good thing. Now to fix your crummy health care system.

[Heddi]

14. I know that with regards to hypertension,

blacks generally do not respond as well to hypertensive medications as whites do. Why? I don't think they know. But it's one of the reasons why hypertension is so much more serious and fatal in the African American population than it is in the white population (of course, the main reason for that is also due to the fact that a larger number of African Americans are without adequate (or any) health insurance, making them unable to get preventative treatment for hypertension)

There are many diseases that tend to affect certain races more than others. Ashekanazi Jews (I know I completely misspelled that) have higher rates of certain cancers than people who do not belong to that particular race.

Sickle Cell, also, tends to affect blacks more than it does whites in very higher degrees.

According to my textbooks in Nursing School, the hypertension thing most likely has to do with the lack of an enzyme in the blood that is passed genetically, that inhibits with the absorption of hypertensive medications in blacks. So technically, someone could be racially white, but have black ancestors and still have this genetic predisposition with regards to lack of an enzyme in the body.

If the medicine works for them, I don't see any reason to withold it. It's not like it's a sub-par medicine made in a 3rd world country that we're passing off to blacks because 'they're not good enough' to take "White" medicine. This is a medication that, for whatever reason pharmacologically and physiologically, reacts differently in those that are black than it does in those that are white.