The FDA just okayed a new drug that they called a "tailored" drug. It's supposed to be designed to work on black patients, who have historically suffered the most from heart disease. Their studies show that blacks will benefit from this drug whereas whites show no real effect. Some doctors are in total disagreement saying that there shouldn't be any difference whether this drug may or may be effect anyone from any race.
Here is this story.
Since I know so little about the medical world, I would like your input on this and thanks.

Honestly, I am suspicious of a drug that seems to target such a specific group of people for good reasons.

Almost all drugs have side effects. The reason for side effects is because drugs are like "skeleton" keys, able to open more than one lock. If you look at the cells in the body as each having a different key combination, it is EXTREMELY difficult to make a key/medicine that ONLY opens that ONE lcok/cell.

That is what side effects are all about. Men do not yet have the technology to create meds that finely tuned. Only mother nature has been able to do that in terms of the various hormones, etc that operate how the cells and tissues in our body works.

Except for the pigmentation in skin and some basic musculature differences (more related to environmental origin than race), there is no difference (at least that I know of) in HOW human bodies function and work at the cellular level.

I am not a doctor, I am a nurse but there was absolutely nothing in my training to direct me to think that there WOULD be such differences in bodily function.

I don't know what all the hoopla is. First, the drug (BiDil) is merely a new combination of two old and established cardiovascular drugs -- hydralazine and isosorbide. Second, it was not developed specifically for blacks. But in clinical testing on a mixed population of patients with heart failure, only the black patients responded well to the combination. Hence its marketing as the first "racial" drug.

I agree with Sherasi that racial phenotypes are generally only skin-deep, and are in no way fundamental to the workings of the body. However it is also well known that some diseases are selective for particular races or ethnic groups. For example, sickle-cell anemia (Blacks), Tay-Sachs disease (Jews), etc. Whatever the genetic determinants of disease may be (and we have barely scratched the surface here), it's not surprising that some of those genes might be linked (by proximity on DNA) to the handful of genes that happen to determine racial phenotype. Open a medical textbook on any disease and you will usually find a predilection for a particular sex, race, or ethnicity.

African-Americans have a higher risk of hypertension and certain other cardiovascular diseases. Again, nobody knows exactly why. Treatments are still largely empirical, and you have to go where the scientific findings lead you.

I don't see any moral or ethical dilemma with developing drugs targeted to benefit one particular race -- at least medically. However it might open a Pandora's box of ugly marketing and pricing practices. We'll see how this all plays out.

Thanks, Sherasi & Professor for your responses.
Yes, I see, Professor, what you mean by possibility of opening Pandora's box here.
I think that basically, of course, whatever helps anyone, bring it on. (not meaning to quote Bush here-- please )
I thought that I had read that some white European have developed sickle-cell anemia now. I do know that every race/gender/body structure/age/etc. is predisposed to their own unique diseases or conditions; I guess part of that Pandora's box is watching how involved the insurance companies may become.

Professor already said it, but I wanted to emphasize that this drug was not designed for blacks. It was designed for the general population, but testing didn't find a significant benefit across the whole tested population. Given that all drugs have side effects, the FDA wouldn't approve the drug. Deeper analysis of the data sugtgested there might be a benefit to Blacks, so there was another study whihc only tested blacks and tested a larger number of them. This study showed a significant benefit.

Although the drug is technically approved specifically for the treatment of blacks, the way the law works is that doctors can now prescribe it to anyone to treat anything they have reason to believe it will help with.

It is doubtful that whatever makes the drug more effective in blacks is present in every black and absent in every white - and that's a big part of the controversy. It is much more likely (since there is no such thing as a 'black' gene') that there is some trait and/or gene that is more common in blacks which affects the effectiveness (as professor points out, there are known traits like this - such as the diseases he cites). That means that it is more likely for the drug to work for you if you are black than not, but that it is likely helpful to some whites, hispanics, etc. Until we can find what deeper trait/gene correlates both with the drugs effectiveness and with 'blackness,' whether or not a person is black is the best we can do.

The bigger question this raises is our approval of other drugs for the general population. Recently there has been building questioning of drugs that were first tested only in men and not in women and of drugs that have been tested in adults but not children (think of the anti-depressants that make suicide more likely in teens). Now this suggests that drugs approved based on predominantly white test populations might not be as effective in all minorities. Ideally, we would know a gene to look for and base the drugs used on that, but we're not there yet.

Thanks, Methos -- I always value your opinion.

Frankly, I find it rather odd, and wouldn't want any part of it. Blacks should stay away from any tailored meds that geered toward them.

I agree that it seems odd that a drug would work better on a black patient...but aren't there some differences in us? There must be some because black people get sickle cell where whites don't, so maybe this drug somehow targets certain cells??? I don't know anything medical either though, just a thought.

Kitty, I'm still hassling with the idea that the 'Aid Virus' was deliberately put here to target the Blacks. However, something went amok, and it's targeting other races. Maybe this is the second attempt to wipe them out. Who knows?

I thought a small percentage of Whites were afflicted with sickle cell.

Honi, funny that you brought up the aids/HIV issue.
I just watched a documentary which discussed the possible origins of aids. According to this flick, the polio vaccine was being distributed worldwide in order, of course, to defeat this terrible disease. The vaccines themselves were developed from cultures from live tissues taken from pigs at the time. And this epidemic was getting under control except for one of the last places to receive the vaccine -- the continent of Africa. In an effort to decrease the cost of the vaccine, apparently monkey tissue was used instead of pig and thusly the aids disease was able to make the leap from monkey to man.
Don't think that this has ever been proven but it unfortunately it does sound like a logical explanation.

Honi, while I hate to think anyone would do that it is certainly a possibility. I think sickle cell was mostly a black disease, maybe some medeterrainian too (???) but with people now marrying into other races any disease that once maily targeted a certain race will become just another all around disease. I'm not really sure what would be different about our cells anyway that would make black people more prone to get sickle cell anyway.

quote:

Originally posted by kittypal:
I'm not really sure what would be different about our cells anyway that would make black people more prone to get sickle cell anyway.

You have to think about why there are differences, not just that there are differences. For example, perhaps the mutation provides a survival advantage. There's a discovery that, while being harmful normally, the sickle cell mutation also provides an immunity from malaria. Malaria is prevalant around places with tropical areas like Africa. So sickle cell inherited lineages survive malaria thanks to their sickle cell, yet when living in places where people aren't prone to malaria, the sickle cell isn't an advantage anymore, there's only the normal sickle cell problem that people would normally die from if it weren't an advantage.

Thanks jusork, I never thought of that, but I guess oyu have to think of way back...just like you said survival.