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- HEALTH, Page 83Rushing DDI to Market
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- For four years, the list of approved drugs for AIDS patients
- began and ended with AZT. The drug, also called zidovudine, can
- extend a patient's life-span, but not everyone can tolerate its
- side effects, which may include nausea and severe anemia. Now,
- after billions of dollars of research and constant pressure from
- AIDS activists, the Food and Drug Administration has bypassed
- some of its usual requirements to approve another medication,
- didanosine, known as DDI.
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- Developed by Bristol-Myers Squibb, DDI resembles AZT in
- that it interferes with replication of the AIDS virus. Whether
- it will extend the life of patients remains unknown, but it has
- been shown to boost levels of disease-fighting T cells. Last
- week's approval, granted with unusual speed, will enable
- doctors to prescribe the drug to those who cannot tolerate AZT
- -- about half of AIDS patients.
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- Though AIDS activists were delighted with the decision,
- there are several concerns. About 23,000 people have been
- receiving the pills for free, as a humane gesture. Now they are
- expected to pay $2,000 a year for the treatment. Bristol-Myers
- says, however, that it will continue to offer free pills to
- those who cannot afford the drug or obtain insurance coverage.
- Another worry is side effects, including inflammation of the
- pancreas, numbness in the hands and feet, and diarrhea. Most
- important, DDI has yet to pass the rigorous testing usually
- required by the FDA. "We are giving DDI a status it has not
- earned, and we are lowering the scientific standards for drug
- approval," complains Dr. Deborah Cotton of Harvard, who reviewed
- the DDI approval application. FDA chief David Kessler justifies
- the decision by saying that "people are dying." Whether DDI can
- forestall their deaths will be clearer within six months, when
- the results of clinical trials are in.
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