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November 18, 2004
Heart drug found effective
for blacks
Jeremy Schwab
Last week, researchers announced the results of
a study that found that a new drug, BiDil, helps African Americans
with heart failure to live longer.
Lexington-based NitroMed, which conducted research in Lower Roxbury
in the mid-1990s, plans to market BiDil if the Federal Drug Administration
approves the drug.
An estimated one million African Americans are currently diagnosed
with heart failure — accounting for roughly 20 percent of
total diagnoses in the United States.
Blacks suffer heart failure at an earlier age than do whites,
for reasons that remain unclear. But some speculate that one cause
is the higher rate of nitric oxide deficiency in blacks.
Nitric oxide reduces blood pressure by helping the heart pump
blood more efficiently and relaxing blood vessels. BiDil works
to boost nitric oxide levels by combining two drugs — isosorbide
dinitrate, which adds nitric oxide to blood, and hydralazine,
an anti-oxidant that protects nitric oxide from destruction.
BiDil may be the first drug ever developed specifically to treat
a racial minority in the United States, according to its creator,
Dr. Jay Cohn of the University of Minnesota Medical School.
“There is lots of discussion and concern about the fact
that we studied a single racial group,” said Cohn. “Some
people suggest we’re stigmatizing the African Americans,
whereas we found a remarkably good treatment for them.”
Many drugs for a wide array of diseases and conditions
are not well-tested on blacks or other people of color, according
to Cohn.
“Most existing drugs have not been studied very well in
black patients,” he said. “That has been a big problem,
so we feel it is very important to carry out studies in patients
of all backgrounds. Hispanics have not been well-covered in clinical
trials. We know very little about Asians. Most studies are predominantly
white men, and certainly cardiology studies have been predominantly
in white men. And the recommendations that come out of those studies
apply to white men for sure, but we can’t be certain they
apply to other people.”
In the clinical study of 1,050 black patients with severe heart
failure, those treated with BiDil had a 43 percent lower chance
of dying than those treated with a placebo. Patients receiving
BiDil were 33 percent less likely to spend time in a hospital.
Research has found that most people under the age of 65 diagnosed
with heart failure — the failure of the heart to pump blood
efficiently — will die within eight years, many of them
of heart attacks.
NitroMed conducted research in nitric oxides, the same type of
drug as BiDil, in Lower Roxbury in the mid-1990s. The company
moved out of the space it was renting from Boston University at
801 Albany Street in 1997. A few years later, Cohn approached
NitroMed with his idea for the study on the drug now known as
BiDil.
NitroMed representatives could not be reached for comment. The
study on BiDil was recently released in the New England Journal
of Medicine.
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