Related to GW Pharmaceuticals Epidiolex - the story features the family whose epileptic son was the first human test subject of the new CBD pill. Long, interesting article about the difficulties they had to go through to be allowed to try the treatment even when all other options had failed spectacularly.https://www.wired.com/2015/07/medical-m ... -epilepsy/One Man’s Desperate Quest to Cure His Son’s Epilepsy—With Weed
"This is Sam. He’s my son. His epilepsy caused him to have up to 100 seizures a day. After seven years we were out of options. Our last hope: an untested, unproven treatment. The only problem? It was illegal."
"THE HOSPITAL PHARMACIST slid three bottles of pills across the counter, gave my wife a form to sign, and reminded her that this was not the corner drugstore. The pharmacy knew how many pills had been dispensed, he said; it would know how many had been consumed; and it would expect her to return the unused pills before she left the country. The pharmacist made it clear that he was not only in touch with our doctor but with the company supplying the medication. They would know if she broke the rules.
Evelyn said she understood and slipped the brown glass bottles into her purse. She and our 11-year-old son, Sam, were jet-lagged. They’d flown from San Francisco to London the previous day, December 19, 2012. Now, 30 hours later, it was just after 7 pm. They’d been at the Great Ormond Street Hospital for Children since midmorning. Sam had been through a brain-wave scan, a blood test, and a doctor examination. Some gel left in his hair from the brain scan was making him grumpy.
Evelyn was terrified. They’d come 5,350 miles to get these pills, medicine we hoped might finally quiet Sam’s unremitting seizures. He was to take a 50-milligram pill once a day for two days, increasing the dose to maybe three pills twice a day. Evelyn was to keep a log of his symptoms during their two-week stay. They would need to revisit the hospital two more times before they returned to San Francisco on January 3, 2013. That meant two more rounds of brain scans, blood tests, and doctors’ appointments.
Sam Vogelstein has had epilepsy since he was 4 and a half. He turned 14 in May.
We were confident the medicine wouldn’t kill Sam or hurt him irreversibly, but the prospect still made us nervous. The pills contained a pharmaceutical derivative of cannabis. People have been smoking cannabis medicinally for thousands of years. Deaths are rare. But Sam would get a specific compound made in a lab. The compound, cannabidiol, known as CBD, is not an intoxicant. (Tetrahydrocannabinol, or THC, is the stuff in pot that makes you high.) Nevertheless, US drug laws made it nearly impossible to get CBD at this purity and concentration in the States.
It had taken four months of phone calls, emails, and meetings with doctors and pharmaceutical company executives on two continents to get permission to try this drug. Sam wasn’t joining an ongoing clinical trial. The company made the pills just for him. It believed CBD was safe based on animal studies. It also said it knew of about 100 adults who had tried pure CBD like this over the past 35 years. As a percentage of body weight, Sam’s dose would approach twice what anyone else on record had tried for epilepsy. Would it make him vomit or become dizzy, or give him a rash or cause some other unpleasant event? We didn’t know. We’d volunteered our son to be a lab rat.
Then there was a bigger question: Would the medicine work? No one knew. The reason Evelyn, Sam, and others in my family—including Sam’s twin sister, Beatrice, and Evelyn’s sister, Devorah—traveled to London during Sam’s winter vacation was that two dozen other treatments we’d tried had all failed. (I stayed behind in San Francisco, scrambling to meet an end-of-year book deadline.)
The one thing we were certain about: This was not going to be a bargain. We’d already spent tens of thousands of dollars on consultants to help Sam’s doctors set up the visit, and we were still at the starting line. The best-case scenario was that the medicine would work and eventually we’d be allowed to import it into the US. We secretly hoped that this would encourage the company to make the drug easily and cheaply available to others. We also knew this was quixotic. Our previous experience with medications suggested the whole venture would end in failure. This much we knew: Importing an experimental cannabis-based drug into the US would involve more than giving the company my address and FedEx account number."
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"The total bill for getting GW’s CBD into the US was roughly $120,000, not including travel. Two consulting firms—one an expert in the workings of the FDA, the other an expert in the DEA—generated most of those expenses. It’s an enormous amount of money to pay for outside help, more than double what we’d thought it would cost.
The total bill for getting Sam’s cannabidiol into the US was roughly $120,000—double what we thought it would cost.
But it’s hard to imagine how we could have done it without them. Cilio had dozens of other patients to attend to besides Sam. And because she was new to the US, she had no idea how complicated and emotionally charged anything associated with cannabis can be here. The consultants showed her how to fill out the mountain of paperwork involved in applying to the FDA and the DEA. And they worked their contacts inside the agencies to make sure our application kept moving. The DEA agents, despite being antagonistic with Cilio and demanding that we get a safe to store Sam’s drugs, also moved our application along quickly when we speedily met their demands. The day we had the safe delivered to Cilio’s office, an agent visited to ensure it met DEA requirements. And he immediately advanced our application to the next step.
We wouldn’t have even known that consultants did work like this had Steve Willard, a Washington, DC, drug company entrepreneur, not introduced us to them. Sam now says he’s his best adult friend, even though he was my dad’s friend first.Usually, getting access to experimental drugs that are potentially lifesaving doesn’t work this way. With terminal cancer patients, for example, oncologists know what new drugs are in development and have a mechanism already established to work with a company and quickly get FDA approvals. Yet GW was supplying drugs that were illegal in the US. No US hospital would take on a project like this.
But it appears our enormous bill for helping Sam has also jump-started the development of what doctors tell us could be one of the most exciting new drugs to treat epilepsy in a generation. Within a month of our return from London in early 2013, Guy and GW started talking to epileptologists at four other US hospitals about doing studies with their sickest kids. And on January 26 in New York City, 15 doctors, researchers inside and outside the US government, and GW officials sat in a conference room at NYU and began mapping out a strategy.
Those initial investigations—five hospitals, 25 kids apiece—proved so encouraging that GW last year expanded them to what it expects will be 1,400 patients at more than 50 hospitals in the US and the UK by year’s end. The drug now has a name—Epidiolex—though for a day or two Guy talked about naming it after Sam. It has a fast-track designation from the FDA, meaning that it could be available at Walgreens inside of three years.Epidiolex is not a miracle cure. The most recent data, out in April, shows that of 137 kids who tried it for 12 weeks, it helped about half, reducing their seizures by at least 50 percent, with 9 percent becoming seizure-free. This is a better response rate than it sounds. All of the patients in the trials are those like Sam who had already run out of conventional options. But it is also a reminder that CBD, Epidiolex, or any seizure drug doesn’t help everyone.