-Caveat Lector-

Government not told of deaths in gene studies
http://www.austin360.com/statesman/editions/today/news_23.html

By Deborah Nelson and Rick Weiss
The Washington Post
Wednesday, November 3, 1999


WASHINGTON -- Scientists and drug companies have failed to notify the
National Institutes of Health about six deaths that occurred in gene therapy
experiments in the past 19 months, keeping details of the deaths from
becoming public, according to interviews with researchers and federal
officials.

The deaths are the first gene therapy deaths known to have been purposely
withheld from the NIH, one of two federal agencies charged with overseeing
the safety of this controversial field of medical research. Gene therapy
seeks to cure diseases by giving patients new genes.

The lack of disclosure reflects escalating efforts by gene therapy companies
to weaken federal reporting regulations.

Confirmation of the six deaths follows revelations last week of a death and
two serious illnesses in gene therapy patients that were reported to the NIH
with the unprecedented insistence that they be kept confidential, in
defiance of a long-standing agency policy of public disclosure.

The six deaths occurred in heart studies headed by two leading gene
researchers -- Ronald Crystal of the New York Hospital-Cornell Medical
Center in Manhattan and Jeffrey Isner of Tufts University in Boston. The two
are racing to be the first to grow new blood vessels as an alternative to
bypass surgery.

Crystal and Isner said that, unlike the widely reported death of a teen-age
patient at the University of Pennsylvania in September, they believe that
the fatalities in their studies were not directly caused by the gene therapy
but by complications stemming from the patients' underlying illnesses.

Because they decided the deaths weren't caused by gene therapy, they argued,
federal regulations don't require them to notify the NIH -- a new
interpretation of those regulations that stands in sharp contrast to the one
held by NIH officials and a decade of practice.

The researchers said they reported the deaths to the Food and Drug
Administration, which keeps such information secret.

But NIH officials are adamant that even deaths not initially believed to
have been caused by the therapy must be reported to the NIH and made public,
because often it is not clear until later whether the therapy actually
caused the deaths.

"It may take five, six, seven patients ill, or 20 patients, before you find
out, `Hey, this is also happening in other people's trials,' " said Amy
Patterson, who heads the NIH Office of Recombinant DNA Activities, which
oversees gene therapy studies. "And if you don't know what's going on in
other people's trials, then you can't put two and two together."

The FDA can suspend a study if it determines it is dangerous, but the agency
only makes such information public if the therapy eventually is approved or
with the permission of the study's sponsor.

Most of the new deaths are coming to light only because federal officials
put out a plea for gene researchers to report any undisclosed deaths or
illnesses, after the death of the teen-ager at the University of
Pennsylvania. His death is thought to be the first directly caused by gene
therapy.

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