The headline on this story from STAT promises to highlight a “new era” in allergy treatment built around the idea of preventing histamine and other immunologic explosions in our bodies’ mast cells and basophils before they start.
What it delivers is something less–updates on efforts at immunologic therapies that are way short of popping up at the pharmacy anytime soon–and more: an eye-opening look at how Big Pharma and Big Science are investing Big Money in a potentially huge worldwide market for treatments that probably won’t do much better than antihistamines, epinephrine and allergen-avoidance.
Parents curious about these forthcoming treatments–including very pricey immunotherapies–are likely already wondering if they’ll be affordable, yet the story skirts any discussion of pricing. But readers who stick with the piece to the end will learn something about the intentions and operations of the medical/pharmaceutical industrial complex, and that’s a good thing.
Stories that describe new allergy treatments are likely to have mass audiences, including parents who are hopeful they can ease their child’s severe food allergies. But will any of these treatments pan out, and one day be widely available and/or affordable to the masses? It’s too early to say, and the story may raise some false hopes for not reining in some of the excitement with more about the realities of drug development.
Although the story cites the hundreds of millions of dollars of investment made by drug companies and research institutions, it doesn’t address the potential costs of some newly developed commercial products, including one in stage 3 clinical trials that (literally) encapsulates bits of peanut protein designed to offer desensitization to peanut allergy. The approach has long depended on what the article calls the “home brews” of food allergy “concoctions” and injections that have been compounded and prescribed by allergists for decades. Nor does it mention the cost of a biologic made by Genentech that already is on the market for a form of asthma and is likely much more expensive than antihistamines and even the notorious Epi-Pens that would compete for an expanded market. The story also mentions Xolair, but does not mention the cost of this drug, which is quite prohibitive.
Although the article finally does get to the point that biologics, immunologics, and quicker ways to achieve desensitization may not — for many patients — work better than golden oldies like antihistamines, the story could have, but didn’t, make any attempt to pin down what kinds of patients and how many of them might need or want the newer drugs, which are at best mostly years from being available.
Particularly for the new-style food-desensitization therapies under development, the article explains potential (and even deadly) risks associated with them and it alludes to some of the downsides of immunotherapies (“allergy shots,” for instance) that can take months or years to work. But it says essentially nothing about the potential or actual adverse effects of a DNA vaccine under development, noting only that it “hypothetically decreases the risk for adverse events.”
The article does a fairly good job of describing some of the hypotheses involved in the development of new or updated treatments, but it doesn’t offer enough information about the research underway. For example, we’re given no information about the status of the research on using the immunotherapy drug Xolair for food allergies combined with allergy desensitization therapy.
No mongering: the prevalence of allergies is high and, according to some sources, rising rapidly in the developing world as well as in the U.S.
The article casts a pretty wide net of sources, including interviews with allergy researchers at Stanford and at Mass General Hospital in Boston, as well as investigators with drug companies.
There is acknowledgment of the possibility that the new treatments may not work any better than older ones for many patients. The story would have been stronger if it had done more head-to-head comparisons of effectiveness.
The article, admirably, makes clear that movement through the new drug pipeline is likely to be slow for most of the newly envisioned therapies.
The article makes clear that the some of the proposed “new era” treatment are actually old wine in new bottles–commercial versions of things allergists have been hand-tailoring to their patients for years. And it does examine some novel twists in describing the development of a DNA vaccine, and the expanded use of a relatively new “biologic” drug that exploits the immune system’s weaknesses and strengths. However, it could have been stronger at pointing out that nothing here is really brand new.
The article was certainly not based on a single news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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