3 ms·

I'm confused about why Bexarotene can be sold as Targretin to treat "skin problems"[1], but cannot be used as a potentially life-saving treatment for MS. Is it

I'm confused about why Bexarotene can be sold as Targretin to treat "skin problems"[1], but cannot be used as a potentially life-saving treatment for MS. Is it that the dosages must be higher to treat MS? [1] https://www.webmd.com/drugs/2/drug-17979/targretin-oral/details https://www.webmd.com/drugs/2/drug-17979/targretin-oral/deta...

neltnerb 6y ago
Could also be that the MS treatment effects are a different delivery mechanism.
Ovah 6y ago
Drugs may only be prescribed for an approved set of diseases. Using a drug for a new disease indication without a study to back it up falls"experimental treatment". In other words, using a drug for an unapproved indication is doing scientific experiments on humans without approval which of course is unethical (and illegal). That said it's easier to get permission to use a new drug for a new disease indication if the drug has had previous clinical history of treating other diseases. At least in my country such permission is handed out on a case by case basis after the responsible physician has applied to the proper regulatory authorities.
- caymanjim 6y ago
  Not so in the US. Doctors commonly prescribe drugs for off-label use. They are legally allowed to and don't need the government's permission. Insurance companies might not cover it, the doctor's employer might not allow it, and if something goes wrong, they might be sued, and their malpractice insurance coverage might be canceled, but the practice is widespread, legal, and ethical. There are just limits and risks to consider.
PragmaticPulp 6y ago
It’s not just pedestrian skin problems. Your quote stopped short of the full context: “Bexarotene is used to treat skin problems from a certain type of cancer (cutaneous T-cell lymphoma-CTCL).” Bexarotene is an already-approved cancer drug. Cancer drugs often have worse side effects than normal drugs because they’re taken toward end of life, or taken to delay or prevent death. The difference is that MS patients would presumably need to take this medication over the course of their lifetime, as it doesn’t address the core disease. If Bexarotene accelerates heart disease and causes thyroid problems, a lifetime of taking this medication might actually worsen quality of life and even shorten lifespan. Unfortunately, many patients desperate to improve the symptoms they know might rush to replace them with side effects they don’t yet know.

neltnerb 6y ago

Could also be that the MS treatment effects are a different delivery mechanism.

Ovah 6y ago

Drugs may only be prescribed for an approved set of diseases. Using a drug for a new disease indication without a study to back it up falls"experimental treatment". In other words, using a drug for an unapproved indication is doing scientific experiments on humans without approval which of course is unethical (and illegal). That said it's easier to get permission to use a new drug for a new disease indication if the drug has had previous clinical history of treating other diseases. At least in my country such permission is handed out on a case by case basis after the responsible physician has applied to the proper regulatory authorities.

caymanjim 6y ago
Not so in the US. Doctors commonly prescribe drugs for off-label use. They are legally allowed to and don't need the government's permission. Insurance companies might not cover it, the doctor's employer might not allow it, and if something goes wrong, they might be sued, and their malpractice insurance coverage might be canceled, but the practice is widespread, legal, and ethical. There are just limits and risks to consider.

PragmaticPulp 6y ago

It’s not just pedestrian skin problems. Your quote stopped short of the full context: “Bexarotene is used to treat skin problems from a certain type of cancer (cutaneous T-cell lymphoma-CTCL).” Bexarotene is an already-approved cancer drug. Cancer drugs often have worse side effects than normal drugs because they’re taken toward end of life, or taken to delay or prevent death. The difference is that MS patients would presumably need to take this medication over the course of their lifetime, as it doesn’t address the core disease. If Bexarotene accelerates heart disease and causes thyroid problems, a lifetime of taking this medication might actually worsen quality of life and even shorten lifespan. Unfortunately, many patients desperate to improve the symptoms they know might rush to replace them with side effects they don’t yet know.