Tuesday, November 27, 2012

My Thoughts Kalydeco

Ran onto this old post I wrote about my thoughts on Kalydeco. Updated it with some current information. Hope you enjoy.

I am sure you are aware of this.  What does the CF population in general think about this?  Does it help you?
The CF community is in one of two camps concerning this: uber excited or feeling that its bitter-sweet.

This particular drug will only work for those in the community that have the G551D mutation. It's estimated that in America, that number stands at somewhere between 2000 - 3000. So, obviously those patients and their families are over the moon right now. There are also many (me included) that are super excited for them and know that this is a potential step forward for the CF community at large.

Then there is a portion of the community that feel happy for "them" but sad for themselves or their kids. Most of this camp has the most common mutation, DF508 (I have two copies). So far, a drug for our specific mutation hasn't yielded great results. We're all hopeful, but I'm not holding my breath for anything ground-breaking for at least 5-10 years.

(Update: The results weren't a slam dunk, but they weren't terrible either. I may have to go with 3-7 years instead :) )

So in short, it was an amazing day for many of my friends and a huge step forward for all in the CF community. I'm pumped over here!!


I guess my view is that they figured out a delivery system for genetic modification, right?  That seems HUGE to me.  This drug, when taken, will correct the genetic mutation in certain cells, yes?
Are there any other drugs that actually correct gene mutations on the market, CF or otherwise?  Just seems like a huge thing to me.

It's big, but we're still a ways away.

The real issue with CF, and ultimately the effectiveness of these drugs, is that there are over 1600 mutations affecting the cell and CFTR in different ways (thankfully not over 1600 different ways, however). This new drug works for those with G551D, because it actually gets the "door" (CFTR) on their cell wall to open up and exchange sodium, potassium, water, etc to a level within "normal range". The key here is that their CFTR is actually on the cell surface to begin with.

The challenge for those of us with the DF508 mutation, is that our CFTR is "stuck" on the nucleus of our cell. They are currently trying to get the CFTR away from the nucleus and to it's proper place on the cell wall. If they can do that, they will in theory be able give this new drug to us as sort of a one-two punch.

I'm not sure whether or not there are other drugs on the market that are similar. This drug doesn't correct the mutation, it's correcting the result of the mutation.

Looks like there are between 2000-3000 WORLDWIDE that can benefit from this drug, not just America.

They have said lately that it will eventually be able to benefit others outside of the G551D mutation, but even then, the majority of people with CF will not see the benefit.

So in short, we're closer than we were yesterday, but not as far as we'd like to be tomorrow.

Comments (8)

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Ronnie my man! I would agree that we are closer today than ever before. But I think we are still a good 5 + years away from a big game changer for almost every CFer. It is great that Kalydeco has come to the market for G551D survivors. I could not be more excited for the people who are receiving this drug and benefiting.
My comment is to long so I will be posting another comment. Sorry!
My biggest concern is not that Vertex doesn't have the answer it is more of the concern that what will happen to future progress on Vertex's drug pipeline when Obamacare is fullly implemented. Not just Vertex but any drug company. Look what is happening in Europe. There are people in the UK, Ireland, Scotland and even in Canada that could be benefiting from Kalydeco but the government is dragging their feet due to the cost of Kalydeco. This really is hard to believe that the government can dictate the decisions of whether people are allowed to receive drugs that will benefit them. I can see this coming to the USA when many people will be on the "government" health care plans, as most employeer sponsored health care will no longer be offered. It all boils down to $$$ in the govenments eye.

I am curious to hear your thoughts on this topic Ronnie. Maybe you could write a blog?????
1 reply · active 644 weeks ago
I don't think any of us know how it will truly affect our healthcare and access to drugs here in the States. I'm definitely taking a "wait and see" kind of approach. For now, I cross my fingers and hope for the best :)
Wow thank you for posting this Ronnie! Yesterday I was wondering just what the difference between the mutations is, and why Kalydeco only suits one mutation. You not only answered all of my questions I had, but have also pegged the way I feel on the issue. I may not be benefiting me directly, but to see the hope it gives to all with the G551d mutation makes it worth while! Plus it's a huge step towards a cure for all of us! =) The important thing now is maintaining your health, getting and keeping those lungs in good condition with as little scar tissue as possible. It sounds like no matter who the drug helps it can do one function, stop CF dead in it's tracks, from creating further damage... but it can not recover what has been done to our lungs already. In other words, these great strides should be a call to action, for all of us to take the best care of our lungs. =)
1 reply · active 644 weeks ago
Ronnie, maybe VX-809 for the G508 is a small good step, but it´s still on clinical trails at the moment (Germany). Don´t know what experience you made in US ...
1 reply · active 644 weeks ago
It's underway in trials here as well!
Agree this post..

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