CNN.com - FDA panel OKs drug aimed at blacks - Jun 17, 2005

Short update today, debate training is really draining...*ack*. I suppose there is a reason why UBC (University of British Columbia) classifies it as a sport.

Background: In a 9-0 vote, the FDA voted to approve a new drug called BiDil which in clinical trials seems to work exceedingly well in the control of heart failure amongst Black Americans. In medical parlace (for any medics who actually read this blog), yes, we're talking about Congestive Heart/Chest Failure (CCF/CHF). Basically, because of the heart's (or more accurately it's ventricles) inability to pump out blood fully, you get a buildup of blood and fluids backwards from where the failure begins. So from the right ventricle to the right atrium to the left ventricle to the left atrium back into the pulmonary artery to the lungs resulting in persistent shortness of breath and an overall bloating.

At any rate, the drug was not entirely successful during initial clinical trials which attempted to work across the entire cross-section of society. But held the promise of working particularly well for Blacks. So it's not just simply that it actually does so but also that it was eminently so successful that the trials were cut short. What is nice also is that there is now a form of drugs that works in a populace that is twice as likely to get heart failures than Whites and for whom the current batch of medication i.e ACE inhibitors don't work as well for them.

Anyway, we're looking at the future of medicine. Because of the peculiarities of our individual genetic makeup, very often medication only works in about half the patient populace. And efficacy of a particular drug can vary immensely from one country (racial populace) to another. For example, clinical trials for a particular biological marker ended up demonstrate a massive varience from between 25% to 90% efficacy between various nationals. So now we know that genetics do play a huge role in the manner in which we metabolise and respond to drug treatments.

Ultimately of course, the aim is to be able to create custom medication for the individual which would work at full efficacy instead of the current diagnose and guess what medications would actually work. As a result, doctors do normally hedge their bets and either prescribe a number of medications or ask to come back and see them if it doesn't work. Either way adding to the overall cost of medical services in a nation.

Peace.