Good News for AIDS Patients
For the first time, a drug exists that has been shown to help AIDS patients in controlled studies. The final test results are not in, and there are no definitive conclusions about possible long-term effects, but the government has wisely decided to allow the drug--azidothymidine, or AZT--to be made available to the thousands more people who are suffering from the deadly disease. In doing so, the National Institutes of Health is striking the proper balance between protecting the public and providing effective medication to people who need it.
The six months of tests so far involved 282 patients with Pneumocystis carinii pneumonia, an opportunistic infection that commonly attacks people whose immune systems have been crippled by AIDS. Only one of the 145 people who received AZT died, while 16 of the 137 people who were given a sugar pill--a placebo--died. The odds against these results occurring by chance are just five in 10,000, according to researchers. In addition, the patients who received AZT had fewer serious medical problems than the others.
This is most encouraging news, so encouraging that the National Institutes of Health and the drug’s manufacturer, Burroughs Wellcome Co., have decided to cut short the first round of tests and to give AZT immediately to those patients who had been receiving the placebo. In addition, Burroughs Wellcome will make the drug available free of charge on a “compassionate-plea basis” to others with AIDS-related pneumonia. As many as 6,000 people in the country may be eligible to get this drug. So far, AIDS has struck about 25,000 Americans, of whom 14,000 have died.
When to approve the use of a promising but unproven drug is a continuing dilemma for health authorities. AZT is not a cure for AIDS, and no one knows how long its beneficial effects will last or whether it will present a dangerous side effect, as yet unknown, that would be as bad as the disease--or worse. The U.S. government has traditionally been extremely cautious in approving the use of new drugs, judging that the doctor’s oath to “do no harm” means that drugs that have not been proved safe and effective should not be dispensed.
But that attitude has been changing. Increasingly, “do no harm” is interpreted to mean that drugs that show promise, such as AZT, should not be withheld. Although it involves greater risk, this seems to be a better policy, especially when the disease being treated is fatal. Still, health authorities must continue to insist that drugs show some degree of effectiveness before being made widely available.
If all goes well, AZT will be tried on AIDS patients with other infections, including Kaposi’s sarcoma, and the Food and Drug Administration may approve it for general commercial use by January. In the long fight against this terrible disease, this is the first real ray of hope.
