Showing posts with label Pharmaceuticals. Show all posts
Showing posts with label Pharmaceuticals. Show all posts

02 September 2008

HEALTH CARE : Cure Worse Than the Disease?

SLEEVES UP. The elderly, who account for most influenza deaths, have been urged for decades to receive annual vaccinations. Photo by Mario Tama / Getty Images / NYT.

'To be approved as a drug, harm must be proven'
By Janet Gilles / The Rag Blog / September 2, 2008

The New York Times has two articles undermining the present widespread belief in the American medical care system. It is not so much backed up by science as we would expect and hope, but rather backed up by the bottom line and corporate profits.

Our public health officials say that we can never achieve our health goals while we subsidize junk food, and now Lancet publishes research showing that a heart medicine taken by millions every day does not improve health but does contribute to cancer.

To be approved as a drug, harm must be proven. That is why you need a prescription. If it is harmless, no prescription needed, but on the other hand, without the pharmaceutical sales crew, there is not much chance your doctor will have heard about harmless remedies.

Cholesterol lowering:

For Widely Used Drug, Question of Usefulness Is Still Lingering / New York Times / September 1, 2008

And the futility of the flu vaccine:

Doubts Grow Over Flu Vaccine in Elderly / New York Times / September 1, 2008

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04 August 2008

Foster Kids In Texas Get Lots of Meds

Copyright © Illustration by Olaf Hajek.

They get 'three times the amount of psychotropic meds as their non-fostered Medicaid counterparts'
By Craig Malisow / August 4, 2008

As if they weren’t getting shafted enough, foster kids on Medicaid in Texas are receiving at least three times the amount of psychotropic meds as their non-fostered Medicaid counterparts – without any proven benefits.

This is according to a study led by Julie Zito, a professor of pharmacy and psychiatry at the University of Maryland-Baltimore, and published in the January issue of the journal Pediatrics.

The findings were based on the review of 32,135 Texas foster care kids enrolled in Medicaid between September 2003 and August 2004. More than 75 percent of the medications were used “off-label,” meaning not for their prescribed purposes.

“When two-thirds of foster care adolescents receive treatment for emotional and behavioral problems, far in excess of the proportion in non-foster care population, we should have assurances that the youth are benefiting from such treatment,” Zito testified in May, before a subcommittee of the U.S. House Ways and Means Committee.

She also testified that “Poverty, social deprivation, and unsafe living environments do not necessarily justify complex, poorly evidenced psychopharmacologic drug regimens.”

Read Zito’s complete testimony here.

Source / Houston Press

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24 July 2008

HEALTH CARE : Bone Density Drugs Can Do More Harm Than Good


Big Pharma Pushes Drugs That Cause Conditions They Are Supposed to Prevent
By Martha Rosenberg / July 24, 2008.

Yet again, women are the industry's main targets.
Like gastroesophageal reflux and bipolar disease, osteopenia began to inflict millions when a drug to treat it was patented.

"Osteopenia, or the risk of developing osteoporosis, was concocted as a disease at a World Health Organization osteoporosis conference in Rome in 1992 that was sponsored by two drug companies and a drug company foundation," writes Susan Kelleher in the Seattle Times.

Using the bone density measurements or "T scores" of a 30-year-old woman as a standard, the new condition, osteopenia, had "boundaries so broad they include more than half of all women over 50," writes Kelleher. And it didn't hurt that 10,000 bone density measuring machines appeared in doctors' offices to detect the new disease -- only 750 existed in 1995 -- many owned and financed by Merck, whose anti-bone-thinning drug Fosamax came online in 1995.

No wonder doctor visits for thinning bones increased by 5 million from 1994 to 2003, according to the Associated Press.

Of course, selling "prevention" to at-risk patients is a pharma gold mine.

It keeps patients on meds for decades through fear, alarmist marketing and after-this-because-of-this reasoning -- since a patient doesn't know if she would have gotten the disease anyway.

So even when reports of Fosamax-related jaw problems called osteonecrosis surfaced -- 1,000 cases have been documented -- and even when a study in the Archives of Internal Medicine this year found that Fosamax doubled women's risk of irregular heartbeat, which can cause clots and strokes, few doubted its primary action of protecting women's bones.

But now, like hormone replacement therapy, which also exploited women's fear of aging and social marginalization, Fosamax appears to cause the conditions it's supposed to prevent.

Since 2006, articles in the New England Journal of Medicine, Journal of Orthopedic Trauma, Journal of Bone and Joint Surgery, Journal of Clinical Endocrinology & Metabolism and Aging Clinical and Experimental Research have suggested the anti-bone turnover action of bisphosphonate drugs like Fosamax can in some cases cause fractures.

Oops.

While preventing bone loss that is caused by the process of bone turnover or remodeling, bisphosphonate drugs can fossilize and petrify a bone so it breaks spontaneously and with minimal trauma -- like chalk. It will not heal properly.

Thighbones of patients on bisphosphonates have "simply snapped while they were walking or standing," following "weeks or months of unexplained aching," reports the New York Times.

Like other fast-tracked-to-Wall-Street drugs that are effectively "tested" on the first users, adverse reports about bisphosphonates came from patients and practitioners long before they came from the FDA or manufacturers.

Bisphosphonate patients have documented excruciating pain from Fosamax since 2001 and GlaxoSmithKline's Boniva since 2006 on askapatient.com, many calling the drugs "poison" and saying they were forced into wheelchairs.

But only in March did the FDA alert health care professionals to the "severe, sometimes incapacitating, musculoskeletal pain" that bisphosphonate drugs could cause in their patients and caution them to consider whether musculoskeletal pain "might be caused by the drug" rather than the bone condition.

Not only is the pain that bisphosphonate patients report "not in their heads" -- imagine 1,257 men on askapatient.com saying their doc dismissed their constant pain and symptomology -- it is emblematic of what is really going on.

"There is actually bone death occurring," Dr. Phuli Cohan told Mallika Marshall, M.D., a medical reporter for Boston's WBZ-TV News in May. "People don't want to believe that this is happening, but it is a side effect of the medicine," she said.

Dr. David Hunter of New England Baptist Hospital concurs that bisphosphonates can cause "dead bone syndrome" and that patients should have a "drug holiday to allow bone cells to rejuvenate," reports Marshall.

Even drug reps on the industry chat room cafepharma are skeptical about bisphosphonates.

"They over-suppress the bone and 'may' cause subtrochanter fractures. ... It's the next hot button," wrote one anonymous poster on a thread titled "Is Boniva dead?" sparked by a rumor that Boniva pitchwoman Sally Fields had fallen and broken a bone.

Nor do bisphosphonates exit the body quickly when patients quit taking them, according to a 2006 study in the Journal of the American Medical Association -- rather, they remain for years.

(Patients "need not take costly bone-building drugs such as Fosamax for life to reap the medicine's protective benefits," was the News & Observer's upbeat interpretation of the drug's tenacity.)

Will bisphosphonates be the next hormone replacement therapy? Another example of women getting the diseases they were supposed to avoid, thanks to misogynistic marketing?

Is there a market for 10,000 used bone density measuring machines?

Source / AlterNet

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22 July 2008

Jim Hightower : 'Gooberhead Award'


VA treating vets as lab rats
By Jim Hightower / July 22, 2008

Time for another Gooberhead Award, presented periodically to those in the news who’ve got their mouths going 100 miles an hour – but forgot to put their brains in gear.

There are so many gooberheads in today’s story that it’s hard to tell who is the gooberest of all. It’s certainly not James Elliot, an Army veteran who came back from Iraq with PTSD. During his treatment by the Veterans Administration, he was recruited by VA doctors to be part of a behavioral study of Chantix, an experimental drug developed by Pfizer to help people stop smoking.

But no one told Elliott about one small detail: a side effect of Chantix is that it can make you suicidal. Not good for a PTSD victim. Sure enough, weeks into the drug test, he suffered a mental breakdown, got a gun, and ended up being tasered and arrested by the police.

Three weeks later, the VA finally notified the 940 other vets in the study that... uh... there could be a... uh... side effect. Unabashed, the lead doctor declared that Elliott’s breakdown was no reason to deprive veterans of “an effective method of treatment to help them stop smoking.” Well, yes, suicide is very effective at stopping smoking.

Then came the goobers in the White House to defend their VA appointees for running a dangerous human experiment on vets without telling them. Bush PR flack Tony Fratto hailed the “wonderful leadership” of VA secretary James Peake. Yet, when told that Elliott said he’d been treated like a “lab rat” by the VA, Mr. Wonderful responded that such a comment “hurts me.” Yeah Peake, it’s all about you! Then he said he saw “no evidence to suggest the study should be stopped.” Well, not unless you count Elliott’s breakdown as “evidence.”

So Secretary Peake’s attitude wins today's Gooberhead Award – because he’s definitely the gooberest of all.

Source / Jim Hightower

Also see 'Disposable Heroes' / ABC News

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14 July 2008

HEALTH CARE : Do Cholesterol Drugs Do Any Good?

Graphic courtesy of Pharma Marketing.

Statins: Looking at the stats
By Duncan Echelson
/ The Rag Blog / July 14, 2008

Statin pharmaceuticals are marketed ferociously on TV ads and by many MD's. The statins are major money makers for the pharmaceutical companies. For relatively small groups of specific types of patients the real research shows some benefit but for most of the patients taking statins it is based on conjecture, not research.

Not only is there no proven benefit for many of the people taking
statins, there are some rather significant side effects such as severe
muscle pain, memory loss and sexual dysfunction.

There are more than 18 million Americans taking statins and worldwide sales totaled more than 33 billion dollars in 2007.

The history of statins and cholesterol theory make a very interesting
case study of the pharmaceutical and medical industries and is well
worth studying, in order to learn how we can avoid being manipulated
for power and profit.

Just as interesting is learning how medical science can be led into
taking positions that are based on political maneuvering and sloppy
data analysis rather than science.

You might be one of the 18 million people taking statins and if not, I
am sure that you know people who are (friends, siblings, parents). If
so, then please read the series of pieces so you can ask questions,
find answers and make decisions as to whether taking statins is really
a benefit or if it is a danger waste of your health dollars and
efforts.

For step one, in our investigation, I offer you a very well written and referenced article from the Jan. 17, 2008 issue of Business Week magazine. Please note this is only step one of a series of articles and documents to help us understand. The source of this article is surprising but I guarantee you will find it very interesting.
Duncan Echelson is a licensed Acupuncturist/Herbalist who can be found at Oak Hill Oriental Medicine in Austin. His focus is helping people become healthier. He particularly enjoys teaching people simple ways to maintain and improve their health.

He has great respect for those physicians who truly live by the Hippocratic oath and for those researchers who are dedicated to understanding their study subjects without fear or favor.

In addition, he knows of many cases where the judicious use of pharmaceuticals and medical procedures have been very important for treating disease and trauma.

It is the misuse of pharmaceuticals, medical techniques, and research studies that he finds deeply offensive and drives him to keep up with news and analysis of these fields.

He welcomes comments, favorable or critical. Leads to stories in medicine and pharmaceutical are also welcome.

You can reach him at duncanechelson@gmail.com.
Do Cholesterol Drugs Do Any Good?

Research suggests that, except among high-risk heart patients, the benefits of statins such as Lipitor are overstated
By John Carey

Martin Winn's cholesterol level was inching up. Cycling up hills, he felt chest pain that might have been angina. So he and his doctor decided he should be on a cholesterol-lowering medication called a statin. He was in good company. Such drugs are the best-selling medicines in history, used by more than 13 million Americans and an additional 12 million patients around the world, producing $27.8 billion in sales in 2006. Half of that went to Pfizer (PFE) for its leading statin, Lipitor. Statins certainly performed as they should for Winn, dropping his cholesterol level by 20%. "I assumed I'd get a longer life," says the retired machinist in Vancouver, B.C., now 71. But here the story takes a twist. Winn's doctor, James M. Wright, is no ordinary family physician. A professor at the University of British Columbia, he is also director of the government-funded Therapeutics Initiative, whose purpose is to pore over the data on particular drugs and figure out how well they work. Just as Winn started on his treatment, Wright's team was analyzing evidence from years of trials with statins and not liking what it found.

Yes, Wright saw, the drugs can be life-saving in patients who already have suffered heart attacks, somewhat reducing the chances of a recurrence that could lead to an early death. But Wright had a surprise when he looked at the data for the majority of patients, like Winn, who don't have heart disease. He found no benefit in people over the age of 65, no matter how much their cholesterol declines, and no benefit in women of any age. He did see a small reduction in the number of heart attacks for middle-aged men taking statins in clinical trials. But even for these men, there was no overall reduction in total deaths or illnesses requiring hospitalization—despite big reductions in "bad" cholesterol. "Most people are taking something with no chance of benefit and a risk of harm," says Wright. Based on the evidence, and the fact that Winn didn't actually have angina, Wright changed his mind about treating him with statins—and Winn, too, was persuaded. "Because there's no apparent benefit," he says, "I don't take them anymore."

Wait a minute. Americans are bombarded with the message from doctors, companies, and the media that high levels of bad cholesterol are the ticket to an early grave and must be brought down. Statins, the message continues, are the most potent weapons in that struggle. The drugs are thought to be so essential that, according to the official government guidelines from the National Cholesterol Education Program (NCEP), 40 million Americans should be taking them. Some researchers have even suggested—half-jokingly—that the medications should be put in the water supply, like fluoride for teeth. Statins are sold by Merck (MRK) (Mevacor and Zocor), AstraZeneca (AZN) (Crestor), and Bristol-Myers Squibb (BMY) (Pravachol) in addition to Pfizer. And it's almost impossible to avoid reminders from the industry that the drugs are vital. A current TV and newspaper campaign by Pfizer, for instance, stars artificial heart inventor and Lipitor user Dr. Robert Jarvik. The printed ad proclaims that "Lipitor reduces the risk of heart attack by 36%...in patients with multiple risk factors for heart disease."

So how can anyone question the benefits of such a drug?

For one thing, many researchers harbor doubts about the need to drive down cholesterol levels in the first place. Those doubts were strengthened on Jan. 14, when Merck and Schering-Plough (SGP) revealed results of a trial in which one popular cholesterol-lowering drug, a statin, was fortified by another, Zetia, which operates by a different mechanism. The combination did succeed in forcing down patients' cholesterol further than with just the statin alone. But even with two years of treatment, the further reductions brought no health benefit.

Doing the Math

The second crucial point is hiding in plain sight in Pfizer's own Lipitor newspaper ad. The dramatic 36% figure has an asterisk. Read the smaller type. It says: "That means in a large clinical study, 3% of patients taking a sugar pill or placebo had a heart attack compared to 2% of patients taking Lipitor."

Now do some simple math. The numbers in that sentence mean that for every 100 people in the trial, which lasted 3 1/3 years, three people on placebos and two people on Lipitor had heart attacks. The difference credited to the drug? One fewer heart attack per 100 people. So to spare one person a heart attack, 100 people had to take Lipitor for more than three years. The other 99 got no measurable benefit. Or to put it in terms of a little-known but useful statistic, the number needed to treat (or NNT) for one person to benefit is 100.

Compare that with, say, today's standard antibiotic therapy to eradicate ulcer-causing H. pylori stomach bacteria. The NNT is 1.1. Give the drugs to 11 people, and 10 will be cured.

A low NNT is the sort of effective response many patients expect from the drugs they take. When Wright and others explain to patients without prior heart disease that only 1 in 100 is likely to benefit from taking statins for years, most are astonished. Many, like Winn, choose to opt out.

Plus, there are reasons to believe the overall benefit for many patients is even less than what the NNT score of 100 suggests. That NNT was determined in an industry-sponsored trial using carefully selected patients with multiple risk factors, which include high blood pressure or smoking. In contrast, the only large clinical trial funded by the government, rather than companies, found no statistically significant benefit at all. And because clinical trials themselves suffer from potential biases, results claiming small benefits are always uncertain, says Dr. Nortin M. Hadler, professor of medicine at the University of North Carolina at Chapel Hill and a longtime drug industry critic. "Anything over an NNT of 50 is worse than a lottery ticket; there may be no winners," he argues. Several recent scientific papers peg the NNT for statins at 250 and up for lower-risk patients, even if they take it for five years or more. "What if you put 250 people in a room and told them they would each pay $1,000 a year for a drug they would have to take every day, that many would get diarrhea and muscle pain, and that 249 would have no benefit? And that they could do just as well by exercising? How many would take that?" asks drug industry critic Dr. Jerome R. Hoffman, professor of clinical medicine at the University of California at Los Angeles.

Drug companies and other statin proponents readily concede that the number needed to treat is high. "As you calculated, the NNT does come out to about 100 for this study," said Pfizer representatives in a written response to questions. But statin promoters have several counterarguments. First, they insist that a high NNT doesn't always mean a drug shouldn't be widely used. After all, if millions of people are taking statins, even the small benefit represented by an NNT over 100 would mean thousands of heart attacks are prevented.

That's a legitimate point, and it raises a tough question about health policy. How much should we spend on preventative steps, such as the use of statins or screening for prostate cancer, that end up benefiting only a small percentage of people? "It's all about whether we think the population is what matters, in which case we should all be on statins, or the individual, in which case we should not be," says Dr. Peter Trewby, consultant physician at Darlington Memorial Hospital in Britain. "What is of great value to the population can be of little benefit to the individual." Think about buying a raffle ticket for a community charity. It's for a good cause, but you are unlikely to win the prize.

Statin proponents also argue that when NNTs are calculated after the drugs have been taken for just three or five years, they're misleadingly high. Pfizer says that even though only one heart attack was prevented per 100 people in its trial, "it may be a possibility that several or even all [100] benefit" by reducing their risk of a future heart attack. And the benefit grows when the drugs are taken for more years, backers believe. "It does not make sense to take a statin for five years," says Dr. Scott M. Grundy, chair of the NCEP committee that called for more aggressive statin treatment and director of the Center for Human Nutrition at the University of Texas Southwestern Medical Center at Dallas. "When you take a cholesterol-lowering drug, it is a huge commitment," he says. "You take it for life." Grundy figures the chances of having a heart attack over the course of a lifetime are about 30% to 50% (higher for men than women). Statins, he argues, reduce that risk by about 30%. As a result, taking the drugs for 30 years or more would bring 9 to 15 fewer heart attacks for every 100 people. So only 7 to 11 people would have to take the drugs for life for one to benefit.

Critics reply that this rosier picture requires several leaps of faith. A 30% reduction in heart attacks "is the best-case scenario and not found in many of the studies," says Wright. What's more, statins have been in use now for 20 years, and there's little evidence yet that the NNT decreases the longer people take the drug. Most important, the statin trials of people without existing heart disease showed no reduction in deaths or serious health events, despite the small drop in heart attacks. "We should tell patients that the reduced cardiovascular risk will be replaced by other serious illnesses," says Dr. John Abramson, clinical instructor at Harvard Medical School and author of Overdosed America.

Read the rest of this article here. / Business Week

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12 June 2008

Old McDonald Had a Pharm...


...And genetically modified his goats and chickens to produce drugs for humans.

But hold on. Should we be doing this to animals?
By Elizabeth Svoboda / June 11, 2008

Encompassed by pastoral green fields, the headquarters of GTC Biotherapeutics looks like any other New England farmstead. But its serenity is deceiving. Behind barn doors, the farm's most valuable employees -- a herd of pygmy goats from New Zealand -- are working round the clock, their milk glands churning out hundreds of gallons of high-grade pharmaceutical compounds.

The white gold extracted from the goats' udders will someday command big bucks in the American healthcare marketplace -- or so GTC hopes. The company's genetically modified animals possess a human gene that allows them to produce milk rich with a protein called antithrombin, which helps prevent blood clots from forming and staves off related conditions like heart attacks and strokes

Tom Newberry, GTC's vice president of corporate communications, leads me into a corrugated-metal hutch. Goats enclosed in pens train inquisitive rectangular pupils on us and poke their heads through the bars. "They're looking for a handout," Newberry says, chuckling. But we can't give these goats kibble or even a pat on the head; that would be a breach of strict sanitary regulations.

ATryn, GTC's goat-derived antithrombin, cleared its first regulatory hurdle in 2006 when the European Commission approved it for sale in all 25 European Union countries. This past fall, GTC successfully lobbied the U.S. Food and Drug Administration to designate ATryn as a "fast-track product," making it eligible for accelerated review on this side of the Atlantic.

But GTC is out to prove it's no one-trick ruminant. Staff scientists have created transgenic goats that can churn out a smorgasbord of human proteins, including compounds that halt tumor blood-vessel development and blood-clotting factors for hemophiliacs. Protein-based human antibodies that protect against all kinds of diseases -- from SARS to incurable cancers -- could be next in the dairy pipeline.

A bevy of biotech companies is crowding the drug market with takes on the transgenic-remix concept. Origen, located in Burlingame, Calif., is developing a transgenic production line that employs chickens instead of goats as drug incubators. The company has bred birds that produce a range of human anticancer proteins and other antibodies in their eggs. In Athens, Ga., AviGenics is using a transgenic-chicken system to make a protein compound that stimulates the bone marrow to make more white blood cells -- essential in helping cancer patients bounce back after chemotherapy.

"Transgenic drug technology has been in the incubation stage for a long time," says Robert Kay, president and CEO of Origen. "But within the next five to 10 years, we should be seeing many new products in the clinic and pushing their way toward approval." Future drug-producing menageries, he predicts, will include pigs, cows and rabbits.

While these transgenic pioneers might seem to be cruising toward FDA approval, the road is hardly without obstacles. To the frustration of executives like Kay and Newberry, most of the snags are not financial or logistical but arise from people's reflexive reactions -- as in, Omigod, they're putting human genes into animals! It's "The Island of Dr. Moreau" made real.

But the revulsion to transgenic animals is more than reflexive; some animal biologists say biotech companies are overselling the safety of the resulting drugs. Meanwhile, ethicists question whether we should be restyling animals as drug producers at all.

GTC transforms goats into drug factories thanks to a recently perfected biological sleight of hand. Once a goat embryo is artificially fertilized in the lab, technicians zero in on the portion of the goat's genome that codes for a sugar found in goat milk and insert a human gene that codes for a naturally occurring protein. When the animal reaches maturity and begins producing milk, every cup of the white stuff contains large quantities of the therapeutic protein, which can be chemically extracted in pure form. "The mammary gland is nature's way of making proteins that are nutritious for offspring," Newberry says. "All we're doing is placing extra DNA coding in this natural pathway."

Before transgenic breeding, pharmaceutical companies normally extracted such protein compounds from donated blood plasma. But to get the same kilogram of antithrombin that a single transgenic goat produces each year, you'd have to get 50,000 people to donate blood -- a time-consuming process with its own inherent risks. "It's so bloody expensive, excuse the pun," Newberry says, "and the Red Cross just got hit with another set of fines for insufficient screening. Now, would you rather have a drug derived from human blood donors, or from our goats, given that we know where they slept last night?"

That question ignores a key fact. "Using goats for drug production has unpredictable effects, and the genetic inheritance of the modified genes is not a given -- 90 to 99 percent of the animals bred are killed immediately because they don't incorporate the desired gene," says Jessica Sandler, director of the regulatory testing division at People for the Ethical Treatment of Animals.

Creating transgenic animals does indeed have a high failure rate. With the technique known as pronuclear injection, only about one to 10 of every 100 attempts results in transgenic offspring, producing a high number of animals typically earmarked for euthanasia. The more sophisticated nuclear-transfer method that GTC uses ensures that virtually 100 percent of viable offspring are transgenic. Still, the transgene does not always land in the targeted section of the genome, and some offspring end up with severe birth defects for reasons that are still not well understood.

Tom Regan, a philosophy professor emeritus at North Carolina State University and author of "Empty Cages," sees the death and suffering of defective animals as a grave ethical misstep. "The animals used for these purposes are in fundamental ways like us -- their behavior tells us they're like us, evolutionary theory tells us they're like us," he says. "What we have with transgenic research is another incentive for reducing animals to something whose purpose for being in the world is to serve human interests. And that's fundamentally flawed."

Others contend that raising animals to produce drugs is no crueler than raising them for agricultural purposes. "I've been involved in this for a long time, and the animals we have are positively spoiled," says dairy scientist Robert Bremel, founder of transgenics company ioGenetics. "If the drug product is innocuous to the animals themselves, they do fine."

Debates over animals' welfare and self-determination aside, there's the question of whether transgenic animals will produce drugs that create unexpected side effects in humans. "We have to be careful about the activation of retroviral or pathogenic agents," says Doug Gurian-Sherman, a senior scientist with the Union of Concerned Scientists' food and environment program, adding that human drug products derived from animals could potentially pass on such pathogens to recipients.

Spurred by similar worries, the National Academy of Sciences' research council formed a committee to assess the safety of animal biotechnology products. "The mere fact that something is produced by a genetically altered animal does not make it harmful," says John Vandenbergh, a biologist who chaired the committee. "But there was concern that some of these new proteins could induce allergic reactions in people." The report the committee issued in 2002 recommended controls to keep transgenic animal products out of the food supply. (GTC adheres strictly to such standards, Newberry says: "We don't sell our milk, and we give our dead goats to a licensed contractor that incinerates them.")

To be sure, squeamishness about human-animal hybrids has a storied pedigree: Geryon of Dante's "Inferno," who dwells in the lowest circles of hell, is a fearsome crossbreed with a human face and a scaly tail. But is equating chimerism with fallen virtue still justified? What rules should govern foisting part of the genetic code that makes us human -- no matter how small -- onto chickens, goats and rabbits?

"With chimeras, we are challenging our concepts of what it means to be 'human,'" bioethicist Linda MacDonald Glenn, a former ethics fellow at the American Medical Association, said in a 2003 speech. "We need to be prepared to ask, 'How can we preserve our human rights and dignity despite the fact that our "humanness" may no longer be the exclusive possession of Homo sapiens?'"

Today, Glenn still struggles with questions about what "humanness" signifies. "If you say, 'Humans are the ones who can reason,' what happens when you have a child who's born with mental deficiencies?" she says. "It's insulting to say that child's not a person. On the other hand, there are also animals that have high cognitive abilities." The lack of a clear-cut distinction between humans and animals, Glenn says, makes it difficult to justify the process of drastically modifying animal genomes, though she feels some genetic alterations may be appropriate if they stand to improve human health and well-being significantly. "We are all interconnected. It's important that we treat the goats with respect, because they're really not that far away from us."

In Newberry's view, this kind of deep-waters philosophy is unwarranted. He scoffs at the implication that GTC's operations are even in the Dr. Moreau ballpark. "People say, 'Are they breeding centaurs out there, some kind of man-goat beast?' No, of course not. We put a control sequence in the transgene to make sure it's only turned on during lactation. And there's a big difference between manipulating a single gene, like we're doing, and manipulating a whole chromosome. Treating them the same is like saying, 'I moved my brother-in-law into his new apartment with a pickup truck. Now I'm going to move all of New York City with that same truck.'"

Despite the deeply ingrained public perception that, darn it, there's something just not right about this kettle of fish, companies like GTC may succeed if they can make a lights-out case for the medical necessity of their products. After all, even conservative grande dame Nancy Reagan became a stem-cell research crusader once she realized the treatment was the best hope to reverse her late husband's Alzheimer's.

"The bottom line is that people do these trade-off calculations," says Edna Einsiedel, a communications professor at the University of Calgary. The World Organization for Animal Health commissioned her to write a 2005 survey report assessing the tenor of public opinion regarding transgenic animals. "There seems to be a hierarchy in terms of preferences -- people view medical-related applications more positively than food-related ones. But there's still some discomfort with the idea that you're taking genes from one species and putting them into another. People ask things like, 'What kind of animal will you end up with?'" At the same, Einsiedel continues, "Sometimes when you explain things to people in greater depth, their initial reluctance can change."

Naturally, Newberry is at the ready with examples illustrating how transgenic drugs can transform patients' lives. If hemophiliacs had an unrestricted supply of factor-7 protein -- a drug that currently costs more than $1,000 a milligram -- courtesy of his goats' mammary glands, the drug "could be used as a prophylactic, not just a rescue therapy," he says. This development, he adds, could markedly improve sufferers' prospects, as they'd no longer have to endure the pinpoint bleeds that cause debilitating joint damage over time.

In reality, though, transgenic drug development simply isn't far enough along for the public to perceive it as a medical grand slam. Being able to treat clotting disorders more cheaply and effectively is great, but whether transgenic medicines will ever vanquish intractable tumors or keep drug-resistant tuberculosis in check is still an open question.

Still, extrapolation -- warranted or not -- is one of the things visionary firms do best, and GTC is no exception. The company's current full-tilt focus is on shepherding ATryn through the FDA approval process. When Newberry looks ahead, he likes to picture the day when GTC's goat herd will become the pharmaceutical equivalent of a soft-drink machine, dispensing a vast array of life-giving substances on command.

"You can make hundreds of different proteins this way, and the system is linearly scalable: If you need more, you breed more," he says. "This is like 'Back to the Future.' It's Buck Rogers combined with farming, the oldest trade known to man."

Source. / salon.com

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