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Whosetosay

11/15/13 10:23 AM

#38830 RE: Whosetosay #38823

Of course, I left the "t" off of "this"in my post 1st sentnece. Senator Warren is a woman. Apologies.

grandma_of_jbraika

11/18/13 5:12 AM

#38994 RE: Whosetosay #38823

To Sen. Warren: Doctors treat the patients physically. They know about the safety/toxicity of Iclusig more than anybody else.

Sillily believing Doctors know more about Iclusig than the FDAI wrote to Senator Elizabeth Warren the following (my thanks to 2damoon1 for his help):
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Please inquire into an evolving situation regarding Ariad Pharmaceuticals, a Biotech company based in Cambridge, MA, and the FDA.

Recently, the FDA reviewed its accelerated approval of Ariad's life-saving drug named Iclusig and forced Ariad to ‘voluntarily’ withdraw it from the market.

Doctors and patients across the country obviously disagree with the FDA as 23 leukemia specialists and 3 patient advocacy groups sent the FDA a letter saying they were concerned right after the FDA withdrew the life-saving drug Iclusig according to an article titled "Doctors Fear Losing Leukemia Drug Deemed Risky" published on The New York Time, November 1, 2013. The link to the article is provided at the end of this message.

Virtually every leading physician in the CML field has written the FDA in support of Ariad, and countless patients have also. There is an enormous gulf between these doctors' view of SAE's vs. the FDA's views, in one case 4% SAE's for the doctors, 24% for the FDA. Other disparities are even greater. How can the disparities be so great?

Don't the doctors who conduct the clinical trials of Iclusig and treat the patients physically know about the safety/toxicity more than anybody else? They believe Ponatinib (Iclusig ) is well tolerated and Adverse Events are manageable as evidenced by their presentations at the coming 55th ASH, Dec. 7 - 10, 2013. (A link is also provided at the end of this message).

The leukemia specialists believe "Ponatinib is a good drug. We don’t want it to be killed and not given to patients." Don't the doctors know more and better about Iclusig than the FDA?

“Without this medication, they won’t have long to live. My patients are panicked. I have patients right now who are benefiting from this medication with very few side effects.” said Dr. Brian Druker, the director of the Knight Cancer Institute at Oregon Health and Science University.

“What we don’t want to have happen is for a good drug, ponatinib, to be killed and not given to patients,” said Dr. Javid Moslehi, a co-director of the cardio-oncology program at the Dana-Farber Cancer Institute and Brigham and Women’s Hospital in Boston.

The doctors will tell more truth about the Efficacy and Safety of Iclusig at the 55th ASH, December 7-10, 2013. They believe Ponatinib is well tolerated and Adverse Events are manageable.

Dr. Javid Moslehi said in an interview that if, for instance, the problems were known to occur because of excessive blood clotting from a cancer drug, then patients could also be given another medication to prevent clots. Or, if the cancer drug were causing plaque to build up in the arteries, patients might be given a statin to try to prevent it.

“What we don’t want to have happen is for a good drug, ponatinib, to be killed and not given to patients,” Dr. Moslehi said.
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The problem with the FDA’s position is two-fold. Statistically, over time, the number of SAE’s actually drops, meaning that the longer the patient population stays on the drug, the rate of SAE’s actually drops somewhat. Secondly, the FDA changed the definition of SAE’s to include virtually any side effect, serious or not, and attributes them to the treatment. This definition change has literally doubled (and more) the FDA’s SAE count from when the drug has been approved.

Keep in mind, this drug's registration trial was on the sickest of the sick patients with CML, patients who had failed all other drugs and treatments. Most were older, with many other afflictions, and physically damaged having gone through years of other similar medications to which they had become refractory.

To boost their claim, the FDA listed in a press release the events of some rather unfortunate side effects to illustrate their point, ignoring that the very ill patients had other conditions besides CML, notably diabetes, that could very well have been the leading cause of those SAEs. In some cases, the FDA points out at least two patients in their 20's who experienced FDA-defined SAE's, ignoring to state in their press release these patients were in the end state, or blast phase of the disease, with no alternative treatment than Iclusig. The drug saved one, the other sadly did not respond to treatment. Few of these very ill patients actually die from a SAE while the hundreds and hundreds of patients are alive today because of Iclusig.

Immediately after asking (forcing) Ariad to stop selling the drug, the FDA told existing patients that they could apply through the FDA so that Ariad would provide the drug for free. And that is on-going. Nothing has changed, except that this upstart biotech, Ariad, is slowing going out of business by keeping these desperate patients, who were paying for the drug, alive with free drug.
Nonetheless, doctors and Ariad have designed dose limiting strategies for this powerful drug, Iclusig, techniques that are fairly common with cancer drugs to address the FDA’s concerns, and is reworking its label to limit SAE prone patients access to the drug. Still, time is running out for new patients now blocked from the drug.

Compounding this, much damage has already been done to Ariad. Ariad is in deep financial danger. Last week, to survive, the company laid off 40% of its Cambridge, MA staff, that is 200 scientists and other workers. Promising trials of the drug in other very nasty cancers, notably GIST, remain closed to new patients. Those shut out will suffer or die on some inferior treatment.

Please look into this. I ask that you speak to Ariad management, get their side of the matter. Then, likewise, to the FDA team. Something just isn’t right. Consider if the FDA is overreacting here. Permit Ariad to immediately resume selling the drug to those for whom life would end without it.

I am saddened to see the tortuous and unnecessary destruction of this company, and the end to its groundbreaking treatments. The FDA’s actions are antipodal to their mandate, and to government itself. Instead of helping and protecting patients, it is hurting, in some cases certainly, killing off desperate patients who are not permitted to start on the drug now. Patients dying, jobs lost, FDA dragging its heels. It’s not the way government was meant to be. I know you care about good government oversight. Please help.

Ariad’s phone (617) 494-0400. The CEO's email address is harvey.berger@ariad.com.
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P.S:

Link to the New York Time article "Doctors Fear Losing Leukemia Drug Deemed Risky":
http://www.nytimes.com/2013/11/02/health/doctors-fear-losing-leukemia-drug-deemed-risky.html?pagewanted=1&_r=3&partner=rssnyt&emc=rss&adxnnlx=1384675370-qFR2pICcxyo2PSRUr7j9Pw

55 ASH presentations are related to Iclusig's Efficacy and Safety:
https://ash.confex.com/ash/2013/webprogram/start.html#srch=words%7CPonatinib%7Cmethod%7Cand%7Cpge%7C6%7CbyDayany%7Cany%7CbySymposiumany%7Cany