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US storm over 'ethnic drugs'
JACQUI GODDARD
IN MIAMI
SCIENTISTS have developed the world's first race-specific medicine, reawakening the controversy over whether black people are genetically different from whites.
BiDil, a drug combination for treating heart failure, has proved three times more effective in black patients than it has for their white counterparts, its manufacturer claims.
Due to go before the United States Food and Drug Administration for approval next week, BiDil is further proof that skin colour is a factor in human genetic make-up, says the pharmaceutical company NitroMed.
The firm wants to market its product for use only in black people. If approved by the FDA, it would be the first drug ever to be licensed for use by a single ethnic group.
"There has been a lot of controversy, but we know we have to take ethnic origin into account," Manuel Worcel, the firm's chief medical officer, told New Scientist magazine. "Heart failure is a catastrophe. This is huge progress."
But others say NitroMed's argument could be based more on commercial considerations than hard science and that the reasons given for its efficacy in black patients might be misleading.
"You can't just say, 'We're saving people by using race' and imply races are genetically different when they're really not," Professor Jonathan Kahn, a bio-ethicist at Hamline University, Minnesota, said. "Some people talk about heart failure as a different disease in blacks in what I can only describe as an irresponsible manner."
The results of clinical trials are testament to BiDil's value. In trials, it improved survival rates among black people who had suffered heart failure by 47 per cent. In white patients, the figure was only 15 per cent.
While no-one contests these findings, there has been a long-standing debate over the reasons, based on conflicting opinions as to the root causes of heart disease in black people.
BiDil works by boosting the level of nitrous oxide in the walls of the body's arteries and capillaries, allowing them to expand and thereby reducing the body's blood pressure. In turn, this reduces overall strain on the heart.
It proved more effective in African-American patients, its manufacturer suggests, because they have naturally lower levels of nitrous oxide in their blood vessels than Caucasians, and when they suffer heart failure it is generally a result of long-term high blood pressure.
By contrast, the leading causes of heart failure among white people are clogged arteries and damage to the cardiac muscle caused by previous heart attacks.
However, experts such as Prof Kahn point out there are also socio-economic factors at play that have not been properly addressed - issues such as the increased levels of poverty among African-Americans, which can be responsible for a poorer diet and make access to healthcare more difficult.
The issue of whether biological differences can be determined by one's ethnic origins is a long-standing one, and it raises a number of legal and ethical questions.
Prof Kahn, while welcoming any drug that can increase patient survival, feels that the focus on race is "unfortunate and dangerous". He told New Scientist: "When you start talking about races being genetically different, it can distract us from seeing these very real health inequalities."
Yet, there is also a powerful lobby which is in favour of racial profiling when it comes to drug development, backed by evidence that suggests a degree of truth in the ethnicity theory.
For example, a study led by Dr Juan Celedón at Brigham and Women's Hospital in Boston, Massachusetts, last year concluded that Puerto Rican children with asthma are up to three times more likely to have reactions to certain allergens than white children with the same condition.
The reasons for this difference are unclear although it is thought that genes play a major role.
Other research has shown that type-2 diabetes is more common among people from the Indian subcontinent.
This is thought to be due to a combination of genetic factors and environmental ones, such as people from that part of the world having a diet that is high in animal fats.
And at the University of Texas Southwestern Medical Centre in Dallas, a new study has shown that cases of increased heart weight - an abnormality that can cause heart attacks, heart failure and stroke - is up to three times more prevalent among African-Americans than whites.
Dr Ronald Victor, the senior author of the Dallas study, said: "These exciting results suggest the extent to which even the early stages of heart disease could be prevented in the African-American community by prevention and treatment of hypertension."
US storm over 'ethnic drugs'
JACQUI GODDARD
IN MIAMI
SCIENTISTS have developed the world's first race-specific medicine, reawakening the controversy over whether black people are genetically different from whites.
BiDil, a drug combination for treating heart failure, has proved three times more effective in black patients than it has for their white counterparts, its manufacturer claims.
Due to go before the United States Food and Drug Administration for approval next week, BiDil is further proof that skin colour is a factor in human genetic make-up, says the pharmaceutical company NitroMed.
The firm wants to market its product for use only in black people. If approved by the FDA, it would be the first drug ever to be licensed for use by a single ethnic group.
"There has been a lot of controversy, but we know we have to take ethnic origin into account," Manuel Worcel, the firm's chief medical officer, told New Scientist magazine. "Heart failure is a catastrophe. This is huge progress."
But others say NitroMed's argument could be based more on commercial considerations than hard science and that the reasons given for its efficacy in black patients might be misleading.
"You can't just say, 'We're saving people by using race' and imply races are genetically different when they're really not," Professor Jonathan Kahn, a bio-ethicist at Hamline University, Minnesota, said. "Some people talk about heart failure as a different disease in blacks in what I can only describe as an irresponsible manner."
The results of clinical trials are testament to BiDil's value. In trials, it improved survival rates among black people who had suffered heart failure by 47 per cent. In white patients, the figure was only 15 per cent.
While no-one contests these findings, there has been a long-standing debate over the reasons, based on conflicting opinions as to the root causes of heart disease in black people.
BiDil works by boosting the level of nitrous oxide in the walls of the body's arteries and capillaries, allowing them to expand and thereby reducing the body's blood pressure. In turn, this reduces overall strain on the heart.
It proved more effective in African-American patients, its manufacturer suggests, because they have naturally lower levels of nitrous oxide in their blood vessels than Caucasians, and when they suffer heart failure it is generally a result of long-term high blood pressure.
By contrast, the leading causes of heart failure among white people are clogged arteries and damage to the cardiac muscle caused by previous heart attacks.
However, experts such as Prof Kahn point out there are also socio-economic factors at play that have not been properly addressed - issues such as the increased levels of poverty among African-Americans, which can be responsible for a poorer diet and make access to healthcare more difficult.
The issue of whether biological differences can be determined by one's ethnic origins is a long-standing one, and it raises a number of legal and ethical questions.
Prof Kahn, while welcoming any drug that can increase patient survival, feels that the focus on race is "unfortunate and dangerous". He told New Scientist: "When you start talking about races being genetically different, it can distract us from seeing these very real health inequalities."
Yet, there is also a powerful lobby which is in favour of racial profiling when it comes to drug development, backed by evidence that suggests a degree of truth in the ethnicity theory.
For example, a study led by Dr Juan Celedón at Brigham and Women's Hospital in Boston, Massachusetts, last year concluded that Puerto Rican children with asthma are up to three times more likely to have reactions to certain allergens than white children with the same condition.
The reasons for this difference are unclear although it is thought that genes play a major role.
Other research has shown that type-2 diabetes is more common among people from the Indian subcontinent.
This is thought to be due to a combination of genetic factors and environmental ones, such as people from that part of the world having a diet that is high in animal fats.
And at the University of Texas Southwestern Medical Centre in Dallas, a new study has shown that cases of increased heart weight - an abnormality that can cause heart attacks, heart failure and stroke - is up to three times more prevalent among African-Americans than whites.
Dr Ronald Victor, the senior author of the Dallas study, said: "These exciting results suggest the extent to which even the early stages of heart disease could be prevented in the African-American community by prevention and treatment of hypertension."
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