Friday 14 March 2008

If It Wasn't for Fear of Libel, I Would Have Called Him an Asshole

Recently, one of the many forgettable junior ministers in our government here made an insensitive remark about a sickle-cell baby in relation to a badly run over-funded and incompetently managed textile factory. He likened the fresh infusion of funds and entry of a strategic investor into the establishment to a lease of life for a sickle-cell baby who had gotten a blood transfusion.

This factory was one of those grandiose projects that are initiated by the government as part of the drive to get the nation out of the economic doldrums to the take-off stage and a better life for its people. It was one of the initiatives crafted to benefit from the Africa Growth Opportunities Act (AGOA) passed by the US Congress [is there anything initiated by African leaders for African people?]

The gist of his presentation to the Parliament was that the venture was a sickle-cell baby that had been saved from a certain death because of a timely transfusion.

Coming from a leader in a nation where a significant part of population are either carriers or sufferers of the sickle-cell anaemia condition, it was definitely out of line. If I remember right, the statistics put the figure at 5 million carriers and sufferers.

In many of our communities, there is a particular stigma attached to the condition, ranging from it being a result of witchcraft to it being a generational curse. But science shows that it is a question of genetics, if two carriers have children, there is a one-in-four chance that the baby will be a "sickler". If a sufferer and a carrier have children, the likelihood is similar but in these two scenarios, the possibility of carriers also rises. So the minister's remarks definitely hurt a lot of people

The Sickle-Cell Association had something to say about it and host of other people especially parents of "sicklers" who made their feelings known in letters of the newspapers. A few days later, he issued a terse apology which I think was inadequate. Inadequate because therein he said he made the remark in jest [let him try his joke in relation to HIV/AIDS....so you know what I mean?]

To redeem himself and to help highlight the plight of sickle-cell sufferers, he should visit the only facility for treating and managing sickle-cell anaemia at the National Referral Hospital. It is neglected and badly in need of support and the services should be extended to other areas of the country. In this way, we could turn a bad remark into a beneficial act.

1 comment:

Asclepius said...

NICOSAN, FDA Orphan Drug for the Treatment of Sickle Cell Disease Developed in NIGERIA




I would like to make you aware that there is a
non-toxic viable treatment for sickle cell in the
world and awaiting application for approval in the
U.S. and E.U.

Through awareness there may come availability for
those who so desperately need it. All it is going to
take is the effort of a few individuals, patients and
doctors to make this drug a reality in the U.S. sooner
than later. Although this drug was developed in
Nigeria, the man behind it, Dr. Ramesh Pandey is a
distinguished biochemist who has worked for the
National Cancer Institute's (NCI) Frederick Cancer
Research Center as a Senior Scientist, Head of the
Chemistry Section, Abbott Pharmaceuticals and
produced the first commercially viable generic version
of Vancomycin for Lyphomed Inc., a Visiting Professor
at the Waksman Institute of Microbiology at Rutgers,
the State University of New Jersey, holds patents for
biotechnology analysis and rare drug production
processes. He also holds several US and international
patents for paclitaxel and its new analogs. He is a
member of the Editorial Board of the International
Journal of Antibiotics and of several professional
societies. He has been awarded several grants from
NASA, NCI and NIH. The drug NICOSAN has been granted
Orphan Drug Status by both the FDA and E.U..



There is a relatively new treatment for sickle cell being
produced in Nigeria by an American company called NICOSAN®,
it's proprietary name is NIPRISAN® . It was developed on
the premise of traditional Nigerian plant based medicinal
practices for the treatment of sickle cell disease.

It has been tested through phase IIb clinical trials and
found to be highly efficacious. Phase III trials have yet
to be completed however it was approved for sale in Nigeria
based on phase IIb trials and toxicity studies which showed
it to be safe and non-toxic.

Double-blind, placebo-controlled, randomised cross-over
clinical trial of NIPRISAN® in patients with Sickle Cell
Disorder

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7GVW-4DS346T-1S&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=211981d545303693affebb8c012d2cac



Efficacy of Niprisan in the prophylactic management of
patients with sickle cell disease

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VS8-43DFJCH-G&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=10528ecbab3ec7e977301fb9f2688ef6



NIPRISAN -- Nix-0699 Toxicity Studies

http://www.biospace.com/news_story.aspx?StoryID=15890720&full=1


Niprisan (Nix-0699) improves the survival rates of
transgenic sickle cell mice under acute severe hypoxic
conditions

http://www.blackwell-synergy.com/doi/abs/10.1046/j.1365-2141.2003.04536.x?journalCode=bjh


THE DEVELOPMENT OF NICOSANTM/HEMOXINTM
A DRUG FOR THE MANAGEMENT OF SICKLE CELL DISEASE.
HISTORICAL BACKGROUND

http://shestco.net/5_tech_park/nicosan.pdf


NIPRISAN Case, Nigeria
A Report for GenBenefit (2007)

http://www.theparliament.com/NR/rdonlyres/F46A1A12-0A1A-41DA-9F5D-A11486CA9BFA/0/Nigerian_Case.pdf




This drug is a major advancement in the treatment of sickle
cell disease unfortunately it is not available in the U.S..
Although the compound has been granted orphan drug status
by the FDA and the regulatory body of the European Union,
to date investigational drug applications for the approval
process have yet to be submitted. Getting a drug approved
in either area is extremely expensive. Until there is
funding available to proceed with the FDA and EU
applications it will be difficult for non-Nigerians to
obtain the drug.

I do say difficult but it is not impossible. If you have a
hematologist or hemoncologist who is willing to put fourth
the effort there are special dispensations available
through the FDA for the importation of unapproved drugs on
a compassionate use basis.



"Expanded access program (EAP). EAPs are typically designed
to provide widespread access to a drug that has proven
efficacy in clinical trials but is still awaiting FDA
approval. They’re similar to standard clinical trials with
a specific treatment plan and certain FDA requirements, but
they have looser patient eligibility criteria. More than
23,000 U.S. cancer patients enrolled in an EAP for Iressa
before it was FDA-approved, for example."

"Single patient use. This program offers an experimental
drug to an individual patient, rather than a group. The FDA
approves these uses on a case-by-case basis. Decisions are
based on other treatments already available and information
about the drug’s efficacy and potential toxicities."

http://www.curetoday.com/backissues/v3n3/departments/specialreport/index.html



To date I have no knowledge that anyone has sought any
single use or expanded access from the FDA for Nicosan.
Unfortunately regardless of the dissemination of this
information thus far no one has put forth the effort to
obtain the drug for use.

If just one person would start the ball rolling with a
caring and concerned medical practitioner it could open up
the drug for wide spread use by tens of thousands of
patients across the U.S. Unfortunately thus far the general
response I receive is that people don't believe that their
physician would be interested in going to this sort of
effort nor do they themselves seem to be inclined to seek
the use of a treatment that could potentially end their
crises.

There has to be at least one physician out there who has
enough care and concern for his patients to be willing to
put forth the effort necessary to obtain this medication
legally. I urge anyone who is effected by sickle cell to
approach their physicians with this information and attempt
to obtain this treatment not only for themselves but for
all patients who could potentially benefit from it's use.

We already know the benefits of the treatments available in
the U.S. and the E.U.. In many cases they are only
marginally effective or in the case of hydroxyurea cause
side effects so serious that many choose not to use it as
treatment. Here we have an opportunity to use a treatment
that has been shown to be highly effective, eradicating
crises in the majority of patients and reducing crises by
50% in the most refractory cases.

Although the clinical trial group was what the casual
reader might interpret as quite small it is common for
drugs which fall into the orphan drug category to use small
sample groups. Many orphan drugs have been approved based
on very small phase II and phase IIb clinical trials in the
U.S. In the case of FDA fast track status, a drug may be
approved during phase II trials if the drug shows
significant advantage over current approved therapies for
life threatening illness.

Fast Track Designation is a program that, if granted, is
designed to facilitate the development and expedite the
review of new drugs, thereby allowing the FDA to approve
drugs used to treat a serious condition or a
life-threatening disease with less safety data following
the conclusion of phase II studies, rather than phase III,
the normal practice.

The main criterion for a Fast Track Designated drug is the
potential to treat a life-threatening illness or fill a
major unmet medical need. Fast Track may be submitted with
the IND or at any time during the clinical development of
the drug. The Fast Track designation may allow a company's
application to follow Priority Review, Standard Review, or
a Rolling Review of the application.

http://www.fda.gov/CbER/gdlns/fsttrk.pdf



Nicosan by Western standards is an extremely inexpensive
drug. It is available in Nigeria without prescription at
$23/month for adults and child doses at $18/month.

Here is a link to the company and product website.

http://xechemnigeria.com/products.htm


I sincerely hope that you find this information helpful. I
would encourage you to forward and post this information
to any person, blog or website where persons effected by
sickle cell anemia can have access to this information.

Feel free to write me with any questions you may have.

Krisitna Bruce RN
NicosanForSickleCell@yahoo.com