Roche Backs Out on Seaside Therapeutics Drug Trial for Fragile X. Parents Dismayed.
By Melissa Welin
Most pharmaceuticals represent years of research, millions of dollars of investment, and the tacit promise made by the government that what is in the bottle is safe and effective.
Most pharmaceuticals also represent the personal stories of patients and their families; stories that are often filled with suffering, struggle, but most importantly hope.
Of course, we understand the responsibility of the FDA to protect the public.
Of course, we understand that pharmaceutical companies are responsible to shareholders and have a complex formula to determine how they allocate resources.
But sometimes, amidst shareholder meetings, bottom lines and risk aversion, our personal stories are lost. Sometimes, we have to remind those who control access to promising treatments that there are lives at stake… that balanced against their ledger is our precious, fragile hope.
Recently, Roche Pharmaceuticals was involved with a Cambridge, Massachusetts-based company called Seaside Therapeutics, Inc., which has been developing a drug called STX209 (arbaclofen). This compound has been in Phase III trials for children with fragile X syndrome (the most common known single gene cause of autism) and Phase II trials for children with ASD (which has had positive results).
When Roche pulled back on R&D investment, it ended its involvement and financial support for STX209. Without Roche’s backing, Seaside Therapeutics was forced to issue the following statement on May 15, 2013 to the clinics involved in the administration of arbaclofen:
We regret to inform you that Study 209FX303 [An Open-Label Extension Study to Evaluate the Safety, Tolerability, and Pharmacokinetics of STX209 (Arbaclofen) in Subjects with Fragile X Syndrome] is being terminated immediately. The closure of the study is due to resource limitations at Seaside Therapeutics, Inc., and is not related to any known safety issues in patients dosed with STX209.
As of June 7, 2013, Phase III trial participants will no longer have access to STX209. The abrupt end of the study will leave our children in danger of significant regression.
For many of us in the study, arbaclofen has been that miracle for which we had hardly dared hope. A child, who had never wanted to be touched, opened his arms for a hug. For the first time, a five-year-old said, “Mommy”; a ten-year-old said, “I love you.” Children were making friends, learning to read and write. We started to believe in the possibility of a “normal” normal.
But, as each morning brings us one dose closer to the end, we have to find a way to cope with the very real possibility that our children will retreat back to that frightening, isolating world of their own.
In addition to funding issues, Seaside Therapeutics, Inc. Vice President Dr. Paul Wang identified another systemic problem:
The FDA requires companies to pick one, and only one, assessment as the “primary endpoint” of the study. In their eyes, the result on that one pre-selected endpoint makes or breaks the study. In our recent autism study, STX209 did not show an advantage over placebo (see above) on the primary endpoint of social withdrawal, so the FDA and some news reporters regard it as a negative study. In fact, STX209 did show advantages over placebo on a number of other assessments. Some of these secondary endpoints are just as meaningful as the social withdrawal assessment, or even more so, but in the FDA’s eyes, they don’t make the study a positive study, because they were not pre-selected as the “primary endpoint.”
While the FDA must safeguard the public, it is time to reconsider regulations that stifle research and, as with arbaclofen, bring an untimely end to a life-changing medication.
For all we give to make drug trials possible, our voices must be heard. We have decided to take action.
A few parents of children affected by the end of the arbaclofen trial are writing to Dr. Severin Schwan, chief executive officer of Roche Pharmaceuticals to ask that they reconsider their support of Seaside and arbaclofen.
Separately, discussions have been taking place within the fragile X community regarding how the FDA measures trial success; it’s current method adds even more difficulty to drug research aimed at treating complex, spectrum disorders like fragile X and autism.
We know this will not be an easy battle, but we all have plenty of experience persisting in the face of a difficult fight. That said, there is strength in numbers, which is why we wanted to reach out to you and communicate our situation and plan.
Innovation and risk-management in the pharmaceutical industry are both essential and we want to continue to support research any way we can. But, there’s only so much heartache a family can stand. There has to be a better way. What’s happened to our families, and to Seaside, clearly illustrates why there has to be change.
We would be deeply grateful for your support. To receive more information, please contact Melissa Welin: firstname.lastname@example.org.
Melissa Welin is the mother of a son with fragile X syndrome, she lives in Cambridge, MA with her husband. In addition to blogging about their lives at www.basicallyfx.com they are active advocates in the fragile X community.
The treatment category is sponsored by Lee Silsby, the leader in quality compounded medications for autism.
Drug development should be science/experimental evidence-driven but not emotion-driven.
Posted by: Good scientist | August 01, 2013 at 10:21 AM
There just bowing to the FDA who is keeping us ALL Sick. AIds cancer all cured.. there keeping us sick!!! Wish we could revolt some how and show the guilty party!!!
Posted by: Mr | July 15, 2013 at 11:25 PM
Xenoport also is developing arbaclofen.
Posted by: GEM | June 10, 2013 at 10:25 PM
How does this drug differ from Namenda?
Posted by: Maurine Meleck | June 07, 2013 at 12:03 PM
--Namenda does not target the GABA receptor, it is an antagonist of the NMDA receptor, which is a glutamate receptor.
Posted by: Michael Gertner, MS | June 10, 2013 at 05:33 PM
While benzodiazepines, like Lorezepam, and baclofen both work on GABA receptors, their mechanism of action is quite different. Benzos target the GABA "A" receptor, which is a chloride channel, while baclofen targets the GABA "B" receptor, which is a G-protein coupled receptor and regulates a different set of molecules from GABA "A". So it's possible that arbaclofen has a safer tolerability profile in children than benzos because of this reason.
-Michael Gertner, MS
PhD Candidate in Neuroscience
Albert Einstein College of Medicine
Posted by: Michael Gertner, MS | June 10, 2013 at 04:45 PM
My son got "PANS" from being seated next to a student who's parent shoved both the seasonal flu mist and H1n1 in her child's brain thru his nose, and sent him in to shed on unsuspecting classmates in 2010. This caused him to regress for the THIRD time, and he lost years.My formerly 90% recovered son suddenly went berzerk with hyperactivity, OCD, weird tics (like flipping girls hair and spitting). He's never been the same these past 3 years, but I have managed to get rid of the very worst facial and body tics, unusual fear, paranoia, aggression, hyperactivity, math skill losses, handwriting went to hell, etc- after 16 straight months of antibiotics . What hasn't gone away is this complete and total "brain fog". He was left with zero reading comprehension, zero inability to hold fluent conversations, and other symptoms like depression. BACLOFEN has been helping those remaining symptoms, which are caused by inflammatory cytokines.
Posted by: Dan's mom | June 07, 2013 at 06:02 PM
Arbaclofen is derived from baclofen which is generally considered safe, it has been in use for many years. Given the improvements that I and many others saw, I have no doubt that for us the benefits outweigh the risks. My son has been able to participate in the world in ways he could not before.
The children are not at risk for withdrawal symptoms. A safe protocol for removing the medication was required for the study to take place. Drug trials with children are very strictly monitored and controlled, there are many layers of safety testing that must take place before it can even begin.
Posted by: Melissa Welin | June 07, 2013 at 12:09 PM
How does this drug differ from Namenda?
Posted by: Maurine Meleck | June 07, 2013 at 12:03 PM
I have two questions/comments. First, from the brief reading I did about this drug, it appears that it acts on the GABA receptors, in some ways similar to benzo drugs. If that is the case: 1) Are these children going to suffer withdrawal, similar to benzo withdrawal, when their supply runs out, and if so, what is going to be done to prevent this? Some people require years of tapering down to be removed from benzo drugs without very severe withdrawal symptoms.
2) If this drug does have the potential for benzo-like withdrawal, should any children have been taking it in the first place, regardless of whatever benefits it may offer?
I ask these questions because a stupid doctor once put me on a very powerful benzo drug (Lorezepam) and got me addicted at what was considered a "small" dose. When I realized what at happened, I stopped the drug and had very serious withdrawal for YEARS afterward. This, it turns out, is not that uncommon.
If this experimental drug can cause a similar type of benzo withdrawal in children, I seriously have to question whether any children should be taking it, under any circumstances.
Posted by: lisa | June 07, 2013 at 10:19 AM
recommended reading :
end of my addiction by olivier ameisen
Posted by: White Rose | June 07, 2013 at 06:52 AM