Tot's treatment for rare illness not covered by Alberta's government

‘The provincial government has the opportunity to do the right thing…’: family friend

BY  ,EDMONTON SUN

FIRST POSTED: | UPDATED: 

Aleena Sadownyk
St. Albert Toddler Diagnosed With Ultra-Rare Condition; Treatment Already Being Funded In Numerous Provinces Alberta Health is currently considering an application for exceptional funding of an expensive life-sustaining treatment required by an Alberta toddler. Three year-old Aleena Sadownyk was recently diagnosed with MPS VI, and requires the life-sustaining treatment immediately in order to halt further progression of her devastating disease. Alberta Health has already denied funding for the treatment through the Alberta Rare Diseases Funding Program. They are now reviewing a second application through the Short Term Exceptional Drug Therapy (STEDT) program. While Aleena needs to begin treatment immediately, there has been no timeline set for a decision from Alberta Health. Family Hand Out Photo

Three-year-old Aleena Sadownyk was recently diagnosed with a rare and fatal enzyme deficiency called Maroteaux-Lamy Syndrome or MPS VI.

The toddler is already experiencing serious symptoms — Aleena’s hands and shoulder joints have begun to seize up — and without treatment officials say the disease is likely a death sentence.

“Left untreated, children have a severely shortened life-span,” said family-friend Andrew McFayden.

“There are varying degrees of progression in children and right now it’s suspected that Aleena has a rapidly progressive form.”

McFayden is a new friend of Aleena’s parents — Laura and Dane Sadownyk.

The Sadownyk’s reached out to McFadyen after they learned about his son Isaac — who lives with the same disease their daughter was diagnosed with — and McFadyen’s fight to have the Ontario government foot his treatment bill.

Individuals with MPS VI require an enzyme replacement therapy that can cost up to $1 million per year, and the treatment must be continued once a week for the rest of their lives.

It’s already covered by provincial health care in Ontario — where McFadyen battled to have the treatment brought to Canada using the Federal Government’s Special Access Program (SAP) and paid for by the province, as well as in British Columbia, Saskatchewan and Quebec.

Now, McFadyen is hell-bent on helping Aleena get the treatment that has allowed his son — who was crippled with spinal pressure and enlarged internal organs — to burst through their back door today at a full run.

“As I’m talking to you right now he’s racing outside to play with his brothers,” said McFadyen, of Isaac, 9, who has been receiving the treatments for seven years now.

“The damage that was done to his spine, bones and joints can’t be reversed but there has been no further build up of disease.”

Though he’s grateful it wasn’t worse, he doesn’t want to see Aleena left with the same life-long damage.

“Aleena is waiting to begin treatment – her hands are beginning to claw up, she can’t lift her shoulders above her head, that’s the latest,” he said. “She needs to start treatment in order to halt any further deterioration.”

According to McFadyen — who runs a charity called the Isaac Foundation — Alberta Health has already denied funding for the treatment through the Alberta Rare Diseases Funding Program.

But officials are currently revising a second application through the Short Term Exceptional Drug Therapy (STEDT) program — with no timeline set for a decision.

It’s time Aleena doesn’t have, and McFadyen says his hope is for Premier Alison Redford to step up and expedite the process.

“The provincial government has the opportunity to do the right thing and ensure that Aleena receives the treatment she so desperately needs,” he said.

“Parents should not have to put their children’s faces on the front of newspapers in order to get the treatment they deserve.”

angelique.rodrigues@sunmedia.ca

St. Albert family hopes province will pay for child’s expensive medical treatment

Toddler already slowed by rare disorder that worsens without therapy

BY JODIE SINNEMA, EDMONTON JOURNAL AUGUST 2, 2013
St. Albert family hopes province will pay for child’s expensive medical treatment

Aleena Sadownyk has a rare enzyme deficiency called MPS VI that causes buildup of cellular waste in their body. They need a synthetic form of the enzyme to be injected each week. Supplied by family

Photograph by: Greg Southam

St. Albert – Inside Aleena Sadownyk’s three-year-old body, cellular waste is building up in her finger joints, around a heart valve and enlarging her liver and spleen.

Without a crucial enzyme in her body called glycosaminoglycan to break down that waste, it will continue to build up, restricting her movements, clouding her eyesight and damaging her organs. Without treatment, her life expectancy will dwindle.

Aleena is already exhausted, passed out on the couch of her St. Albert home as her parents tell her story in the hopes the provincial government will listen and fund her $300,000 – to $1-million annual treatment.

Her cause is being championed by Wildrose MLA and health critic Heather Forsyth who has written the government asking it to help.

“It’s devastating,” said her father Dane Sadownyk, speaking both of his daughter’s diagnosis of the rare Maroteaux-Lamy Syndrome and of waiting for the provincial health department to review the case and decide if it will cover the cost.

“You’re on pins and needles,” Dane said. “You know there’s a treatment there and it’s just a matter of her being able to receive it.”

While there is no cure, a synthetic enzyme called Naglazyme is approved in the United States. Through weekly hours-long infusions, Naglazyme can break down the cellular waste building in up a patient’s body. Patients need to be on the enzyme-replacement therapy for life, but symptoms won’t worsen.

Even though it isn’t yet approved for use in Canada, seven other children with MPS VI are receiving the treatment after their families successfully lobbied their governments in B.C., Saskatchewan, Ontario and Quebec to cover the cost. The provinces only gave coverage after public awareness campaigns, said Andrew McFadyen, whose son Isaac was diagnosed when he was 18 months old.

It took six months to get funding for Isaac’s treatment which stopped the progression of the disorder, made his skin and hair soft again, and shrunk down his swollen organs. But the treatment won’t reverse the damage already done to Isaac’s eyes, give his shoulders full range of motion or allow his hands to make a fist, since his fingers clawed up.

“It was tough,” McFadyen said from Ontario. The Sadownyk family contacted him for help when their request for funding through the Alberta Rare Disease Funding Program was turned down. “The only thing that works is public advocacy campaigns. Once the public understands that the public health system has the ability to look after a very sick child and they’re not, then action gets demanded.”

Isaac is now nine and heading into Grade 4. This type of enzyme deficiency doesn’t cause compounds to build up in the brain. McFadyen wants Aleena to have a chance to grow up too.

“I have all the hope in the world that this will shift things and prompt a decision,” he said.

The province currently has a funding application from the family through the Short-term Exceptional Drug Therapy Program, which provides six months of treatment.

“My heart goes out to the Sadownyk family. I know they want to do everything they can to help their daughter,” Health Minister Fred Horne said in a statement. “As a politician, I don’t get directly involved in assessing which drugs would be funded through that process — and appropriately leave that assessment to medical experts. Department officials will continue to support the application process, a clinical review is underway now and I understand we expect a response soon.”

It can’t come soon enough for the Sadownyks. Aleena was in gymnastics this past spring and couldn’t grip the bars or kneel on all fours because of stiffness in her hands and knees. Nor can she properly grasp a crayon.

“It’s traumatizing for her,” said her mother Laura Sadownyk. Aleena doesn’t fully understand her condition, but she certainly doesn’t enjoy all the doctor appointments.

“We don’t know how fast it will progress in her,” Laura said. “We need the minister to accept the funding request.”

jsinnema@edmontonjournal.com

twitter.com/jodiesinnema

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More Family Team Raises Funds For The Isaac Foundation

The Wellington Advertiser – June 14, 2013

Screen Shot 2013-07-23 at 10.38.01 AMJourney for Jasper – The More family team travelled to Ottawa to participate in a 5km race to raise funds for The Isaac Foundation. From left: front, MPS VI patients Isaac McFadyen and Jasper More; centre,  Brad Craven, Ellen Buck-McFadyen, Gabe McFadyen, Spencer Dyce, Clayton More, Troy Dyce, Quinn Dyce, Andrew Craven, Daphnie More, Pam More; back,  Erica Dyce, Russel Dyce, Jordy Dyce, Wayne Dyce, Dennis Craven, Darren More.  submitted photoPALMERSTON

The More family, including four-year old Jasper, and a team of dedicated family and friends travelled to Ottawa to participate in the annual race weekend on May 25.

A hard working team of 24 individuals collected sponsorships and took part in the 5km event, one of the many race events held that weekend in the city. They were raising money for The Isaac Foundation, a charity dedicated to funding medical research into MPS VI, an extremely rare and devastating disease that Jasper was diagnosed with in 2011.

Since the diagnosis, the family has joined forces with The Isaac Foundation to co-ordinate events and raise money in hopes of finding better treatments and ultimately a cure for the condition. The foundation is currently funding two research projects that are leading to some promising data.

Together the team was able to raise over $14,000 in preparation for their walk. The More family team, known as “Journey for Jasper” was amazed at the support the community had to offer and thanked all their team members for their dedication to participate. They also thanked those who so willingly donated to the cause. Every dollar collected goes directly to research.

The next event the family is planning is a huge yard and bake sale and barbecue on June 29 from 8am to 2pm at the Lawrence Park pavilion in Palmerston.

The family is accepting donations of items to be sold from now until the date of the event and hopes the community will come out to support The Isaac Foundation and their quest for a cure. If you wish to get involved please contact Pam or Darren at 519-343-5923 or pam@theisaacfoundation.com

 

Foundation Calls For Commitment of Timely and Accessible Outcome for Families

Mt. Sinai Takes Steps To Develop Potential Treatment for MPS I Patients

Foundation Calls For Commitment of Timely and Accessible Outcome for Families 

Isaac Foundation Logo - Red and Blue - Hi-Res copy

On this International MPS Awareness Day, The Icahn School of Medicine at Mt. Sinai announced a partnership agreement with bene pharmaChem to conduct clinical studies on the use of pentosan polysulfate (PPS) in patients suffering from MPS I disease.  With this announcement, The Isaac Foundation is calling on Mt. Sinai and bene pharmaChem to immediately commit to ensuring that such studies take place in a timely fashion and that any marketed treatment is made readily available, accessible, and affordable for children and adult MPS sufferers alike.

Sufferers of MPS lack an enzyme in their blood that breaks down cellular waste in the body called glycosaminoglycan (GAG).  These GAGs build up in the bones, tissues, organs, and muscles of affected individuals and lead to many devastating symptoms including heart and airway disease, corneal clouding, stiffening of the joints, shortened stature, and premature death.

PPS has been shown to reduce the chronic inflammation associated with the majority of MPS cases; inflammation that leads to many devastating physical symptoms for sufferers.  The major research on PPS was completed by Dr. Cologera Simonaro at Mt. Sinai University and supported in part by grants from The Isaac Foundation for MPS Treatment and Research.

The Isaac Foundation has taken an active role in ensuring an in-depth and proper study be conducted on the potential use of PPS as an adjunct therapy for patients suffering from all MPS diseases and has led the advocacy efforts to bring pharmaceutical giant Johnson & Johnson on board to help with such study.  As a direct result of these advocacy efforts, Johnson & Johnson created an advisory panel consisting of the top MPS clinicians and researchers in North America.  This panel is set to meet on May 20th with an aim to look at the data compiled by Dr. Simonaro and thoroughly discuss the potential impact of PPS on the patient community worldwide.

With today’s announcement by Mt. Sinai, Andrew McFadyen, the Executive Director of The Isaac Foundation, wants to ensure that the best interests of MPS sufferers remain at the forefront of any discussion and advancement of PPS as a treatment option.  McFadyen states, “We’re being very cautious about today’s news for a number of reasons.  All along, we have felt the best path forward was through a collaborative and very scientific approach to the current data, especially given the fact that there is already an FDA approved medication, albeit for a different indication, and it is among the least invasive administrations, oral administration.  We received assurances from Johnson & Johnson that their commitment to the study of PPS would always be patient focused, and all decisions made moving forward would be based on a patient-centered model.  Essentially, they committed to moving forward based on best science for our kids and without a marketing and profit-taking strategy.  With this announcement from Mt. Sinai today, we’re calling on them to publicly commit to the same goals.”

In the United States, under the Orphan Drug Act, new treatments for rare diseases receive years of market exclusivity, which leads to the marketing of some of the most expensive drugs on the planet.  McFadyen wants to ensure this doesn’t become the case for any marketed PPS treatment: “While it’s fantastic to see movement on the clinical trial front for these treatments, it won’t do patients any good if the development is lengthy, the administration is burdensome, and the medication is approved and marketed at an unaffordable price point. Reformulation of approved drugs via changes in administration or dosing accompanied by exponential price increases has been seen before. Those are the circumstances we were trying to avoid in seeking to work with Johnson & Johnson and their already approved drug Elmiron®. On just the price point issue alone, for an adjunct therapy (MPS I, II, and VI already have approved high dollar therapies), in Canada, it could come down to fighting Provincial governments to approve yet another expensive treatment, while in the United States it will be up to families to fight with their insurance providers.”

McFadyen sums up his request simply.  “The lives of our kids should never hinge on dollars and cents.  This is why we are calling on Mt. Sinai to commit, in the same manner that Johnson & Johnson did, to ensuring any marketed treatment for our patients is accessible and affordable.  If moving forward is truly and solely patient focused, I’m sure Mt. Sinai would be happy to make such a commitment for our kids.”

#  #  #

For more information about this topic, or to talk with The Isaac Foundation, please call Andrew at 613-328-9136 or email Andrew at andrew@theisaacfoundation.com.

Drug Company’s Decision Gives Trent Hills Father Hope

Experts will review research data on rare disease

Northumberland NewsTRENT HILLS – Months of lobbying capped by an intense advocacy campaign conducted online have paid off for Andrew McFadyen: Johnson and Johnson has agreed to form a medical advisory panel to determine whether one of its medications could help his son, Isaac, and others who suffer from a rare disorder.

“That’s incredible news for our families and our kids,” Mr. McFadyen said. “We’re pretty pleased.”

The elementary school teacher has been relentless in trying to persuade the pharmaceutical company to undertake a clinical trial of an anti-inflammatory drug it makes to treat a bladder condition.

Research involving rats funded by Mr. McFadyen’s Isaac Foundation indicates the medication could also benefit people with MPS, a group of disorders caused by an enzyme deficiency. Its symptoms vary but in the case of his eight-year-old son, MPS IV has stunted his growth, restricted his mobility and affected his breathing.

Mr. McFadyen received word of Johnson and Johnson’s decision from the company’s chief medical officer for its pharmaceuticals division, Dr. Amrit Ray, last Saturday. They talked several times over the phone and are to meet in person in a couple of weeks.

Isaac “was pretty excited to hear the news,” he said.

Mr. McFadyen said “almost every MPS specialist in the world … the who’s who” of the profession, will sit on the panel. They will review the research data and recommend if a clinical trial is warranted.

He’s “very confident” they will but should they decide against it, “that’s also in the best interests of our kids. I would never want to move forward with something that’s unsafe or not going to help.”

Mr. McFadyen said a public advocacy campaign he mounted recently resulted in “hundreds and hundreds of people sending e-mails” to Johnson and Johnson in support of his efforts.

Drug Company's Decision Gives Trent Hills Father Hope

Experts will review research data on rare disease

Northumberland NewsTRENT HILLS – Months of lobbying capped by an intense advocacy campaign conducted online have paid off for Andrew McFadyen: Johnson and Johnson has agreed to form a medical advisory panel to determine whether one of its medications could help his son, Isaac, and others who suffer from a rare disorder.

“That’s incredible news for our families and our kids,” Mr. McFadyen said. “We’re pretty pleased.”

The elementary school teacher has been relentless in trying to persuade the pharmaceutical company to undertake a clinical trial of an anti-inflammatory drug it makes to treat a bladder condition.

Research involving rats funded by Mr. McFadyen’s Isaac Foundation indicates the medication could also benefit people with MPS, a group of disorders caused by an enzyme deficiency. Its symptoms vary but in the case of his eight-year-old son, MPS IV has stunted his growth, restricted his mobility and affected his breathing.

Mr. McFadyen received word of Johnson and Johnson’s decision from the company’s chief medical officer for its pharmaceuticals division, Dr. Amrit Ray, last Saturday. They talked several times over the phone and are to meet in person in a couple of weeks.

Isaac “was pretty excited to hear the news,” he said.

Mr. McFadyen said “almost every MPS specialist in the world … the who’s who” of the profession, will sit on the panel. They will review the research data and recommend if a clinical trial is warranted.

He’s “very confident” they will but should they decide against it, “that’s also in the best interests of our kids. I would never want to move forward with something that’s unsafe or not going to help.”

Mr. McFadyen said a public advocacy campaign he mounted recently resulted in “hundreds and hundreds of people sending e-mails” to Johnson and Johnson in support of his efforts.

Virtual Zeal Rare Disease Caregivers Carry A Powerful Voice In Social Media

Globe and Mail Photo

 

isaac10lf4-2Figure 2: Isaac McFadyen (front) who suffers from MPS VI, flanked by his family including his father and advocate Andrew McFadyen (right). Image courtesy of The ISAAC Foundation.

According to Mr. McFadyen, his efforts were rebuffed several times until finally in February 2012, he began a social media campaign, including a website not so subtly titled “ShameonJNJ.com”, Twitter and e-mail barrage, and Facebook community to encourage Janssen / Johnson &, Johnson to reconsider its decision. The campaign culminated around February 28, Rare Disease Day, with several Janssen executives receiving hundreds of e-mails from impassioned parents and supporters of MPS families.

 

This article highlights how rare disease patients and caregivers can harness the power of social media to support or challenge pharmaceutical companies. The equivalent of a modern day megaphone, telephone, and printing press combined, social media showcases its power in no more passionate…

Melissa Hogan – SavingCase

This article explores the voice of rare disease patients and caregivers in social media and the power they wield to support or challenge the pharmaceutical companies that serve them.

The equivalent of a modern day megaphone, telephone, and printing press combined, social media showcases its power in no more passionate an arena than in rare disease.

While some think of Facebook as a fun pastime, in private rooms or sometimes publicly, rare disease sufferers and their caregivers are offering diagnoses and treatment advice, discussing side effects, and advising on every other aspect of life with a chronic or rare condition. While some follow celebrities on Twitter, those affected by rare disease might use Twitter to make sure their views are heard by pharma and their governments alike.

On the heels of Rare Disease Day, you’d be remiss not to know that rare disease advocates are often proud of their status as ‘zebras’. “If you hear hoofbeats, think horses, not zebras” is the oft-quoted tenet of medical diagnosis, the assumption being that often the simplest explanation, rather than a rare or exotic disease, is usually the best.

Zeal is not just a pack of zebras

It is that perspective that has made rare disease groups stand up and proudly claim the title of zebras, often displaying stuffed zebras at their events. But when zebras become a pack, as they often do on social media, they become a zeal, a title that is not only categorically appropriate, but descriptively appropriate as well.

In addition to describing a pack of zebras, zeal is defined as “great energy or enthusiasm in pursuit of a cause or an objective.” More than almost any other online group, those affected by rare disease approach their cause of support, education, medical care, and advocacy with great energy and enthusiasm. In describing them and others like them as the “alpha geeks” of health care, internet geologist Susannah Fox notes: “They are in the crucible. They ‘roll their own’ by creating communities of health information exchange where none had existed.”

“On the heels of Rare Disease Day, you’d be remiss not to know that rare disease advocates are often proud of their status as ‘zebras’.”

Feeling the zeal

Not only can rare disease patients utilize social media in their diagnosis, support, and treatment efforts within their population, one should be cognizant of both the benefits patients can confer in raising awareness and getting expensive treatments reimbursed, but also the damage they can inflict via the democratizing medium of social media. An example of both can be found in the efforts of Canadian-based The ISAAC Foundation and its founder, Andrew McFadyen, a parent of a child with the rare disease Mucopolysaccharidosis (MPS) VI.

To date, Mr. McFadyen’s social media efforts have succeeded in obtaining reimbursement of high priced enzyme replacement therapies for several patients, including his own son Isaac, by their Canadian provinces after the provinces first declined or delayed reimbursement. While pharma companies are surely lobbying for reimbursement of their treatments, sometimes only the efforts of the patients they serve are viewed with collective sympathy.

In 2012, for example, the family of a young girl with MPS VI, Violet Revet, had been awaiting for approximately six months for word on reimbursement for the drug Naglazyme® by the Saskatchewan, Canada health ministry. Without an answer, and watching the disease progress in their daughter, the parents went to Mr. McFadyen for help. A Twitter campaign caught the attention of Premier Brad Wall who responded and the treatment was approved within days. The effect was as clear as the Premier’s statement: Twitter “democratizes things.”

“While pharma companies are surely lobbying for reimbursement of their treatments, sometimes only the efforts of the patients they serve are viewed with collective sympathy.”

Amplifying the voice of reason

While pharma can benefit from the efforts of patient advocates, they can be the target of such efforts as well, such as Mr. McFadyen’s latest endeavor, which I was able to view from the inside out.

Over the last several years, scientists began studying the use of a Janssen FDA-approved drug for interstitial cystitis called Elmiron® for the bone and joint problems that plague children with MPS. The ISAAC Foundation was one financial supporter of those studies. Data from small animal studies were completed in 2012 and presented at several conferences. This precipitated Mr. McFadyen’s conversations with Janssen itself to explore the research further and possibly support human trials.

“…it is clear that their behaviors and efforts cannot be ignored.”

On March 1, Johnson &, Johnson changed its Twitter handles that had been receiving some of the barrage, from @JNJComm and @JNJStories to the new @JNJCares, @JNJParents, and @JNJNews. Janssen also quickly began organizing a medical advisory board to both bring Janssen up to speed on a disease with which it was unfamiliar (Mucopolysaccharidosis) and to consider the scientific evidence and what next steps to take.

Some might disagree with the public pressure of social media tactics like those employed by Mr. McFadyen and his supporters, calling it public bullying. When asked what he thinks of those who might say that using such tactics make him a bully, Mr. McFadyen replied:

This is not being a bully. I’m just one man with a firm belief in the rights of those with rare disease to have treatments just like those with cancer or heart disease. One might instead call a large pharmaceutical company or a government a bully when they make decisions without considering who they affect. With social media, we simply help amplify the voice of reason.

Whether studying, interacting, advertising to, benefitting from, or even suffering from the behaviors of rare disease sufferers on social media, it is clear that their behaviors and efforts cannot be ignored.

Related articles

Angry Parents Force J&,J To Do Damage Control – pharmalot

When Rare Just Isn’t Enough: The Case of Elmiron – SavingCase.com

References

1. http://susannahfox.com/2011/07/06/alpha-geeks-in-health-care/.

2. http://www.newstalk980.com/story/saskatchewan-girl-waiting-help-rare-disease/67994

3. http://www2.canada.com/saskatoonstarphoenix/news/story.html?id=6e79808f-1adf-45de-92ba-589a8517e2d1

About the author:

Melissa Hogan is a lawyer and strategic consultant by profession, but since her youngest son Case’s diagnosis with MPS II in 2009, she has also applied her experience to become an advocate, author, and speaker on behalf of rare disease families. She writes about advocacy, medical research, pharma, clinical trials, therapies, social media and special education on SavingCase.com, a blog that is now read in over 100 countries. She also uses other social media strategies such as Twitter, Facebook, Pinterest, YouTube, and LinkedIn and serves on the Advisory Board for the Mayo Clinic Center for Social Media.

She is also the author of the e-book Calmer: Medical Events with Cognitively Impaired Children (2012) which seeks to share strategies for preventing medical trauma in children with chronic medical conditions.

For more information, visit www.savingcase.com. Melissa can be reached via Twitter @savingcase or by e-mail at melissa@savingcase.com.

 

 

Angry Parents Force J&J To Do Damage Control

http://www.pharmalive.com/angry-parents-force-jj-do-damage-control
There is nothing like a bit of pressure from an angry mom or dad to generate heat. And thanks to the modern wonders of the Internet, an Ontario schoolteacher has succeeded in forcing Johnson & Johnson to scramble to contain a mushrooming controversy. At issue: a months-long refusal by the health care giant to support further research involving one of its own drugs for a debilitating disease.

The uproar emerged two weeks ago. Andrew McFadyen, whose eight-year-old son suffers from MPS, a group of rare genetic disorders caused by the absence or malfunctioning of lysosomal enzymes, grew frustrated with J&J and turned to the Internet to publicize his quest. For more than a year, he had hoped J&J would agree to work with researchers at the Mt. Sinai School of Medicine who found that a J&J drug called Elmiron may offer some hope.

His primary contact at Mt. Sinai is Calogera Simonaro, an associate professor in the Department of Genetics and Genomic Sciences, who recently co-authored a paper showing various improvements in rats given Elmiron, a J&J drug that is approved for treating interstitial cystitis, which is also known as painful bladder syndrome. The two met a few years ago when Simonaro applied for a grant from the foundation that McFadyen created to further MPS research and help his son, Isaac (see photo above).

“She met with (J&J representatives) last spring to present her data to show how the drug worked and she reported back to me that they weren’t interested,” says McFadyen, who hoped J&J would back additional studies, such as testing in larger animals. “Essentially, we were put off. The discussions were not going anywhere. Our researchers and their medical team finally held a teleconference last November, but then, there was no follow up.”

“We spent nearly a year trying to convince J&J that they should (support the MPS research at Mt. Sinai and clinical research using Elmiron). It could save the healthcare industry lots and lots of money. Right now, it can cost $500,000 to $1 million a year for enzyme replacement therapy, which is an imperfect situation,” he says. “But most important, it might increase the quality of life for the children and save a lot of lives.”

Simonaro declined to comment, other than to offer a statement in which she said “we are in discussions with potential partners who have an interest in testing (Elmiron) for MPS in a formal clinical trial setting so that the therapy can be approved and available for use by all patients.” Mt. Sinai, by the way, is obtaining intellectual property rights to use the drug for MPS treatment, according to sources.

There are actually several forms of MPS, which can cause a variety of symptoms, including mental retardation, cloudy corneas, short stature, stiff joints, incontinence, speech and hearing impairment, chronic runny nose, hernia, heart disease, hyperactivity, depression, pain and a shortened life span. The disease occurs in about one in every 25,000 births, according to theInternational MPS Network.

In other words, this is a rare disease and Fadyen has openly expressed concerns that J&J was not interested in making an investment that called for pursuing years worth of costly research for a treatment for a small patient population, even though orphan drugs are increasingly commanding price tags of $250,000 or more per year for each patient (read this and this).

So last month, McFadyen reached out once again to J&J and received a reply from Steve Silber of the R&D team at Janssen, the J&J unit that sells Elmiron. Silber offered to make the drug available to McFadyen’s son on a compassionate use basis and to work with physicians on a so-called investigator-initiated study (read his letter here). McFadyen responded two ways – he wrote a harsh response that accused J&J of stalling tactics and he created a web site calledshameonjnj.com.

The web site quickly attracted attention not only among those with MPS and their family members, but people who were upset that J&J appeared unwilling to extend its largesse to others. As McFadyen viewed it, J&J was offering only his son compassionate access, which he declined to accept because he believed the health care giant should make Elmiron available to anyone who might benefit. And since J&J released its letter publicly, he placed that and his own reply on the new web site.

“From the very beginning, we have approached Johnson & Johnson about working toward such a study and, time and time again, we were ignored, rebuffed and put off,” he responded to Silber. “Families dealing with this disease are incredibly vulnerable and being caught in the middle of weighing the risks vs. rewards of putting our children on this treatment off label without adequate safety and efficacy data.”

By last week, this very public exchange, which prompted angry parents to Tweet links to the web site and post on a Facebook page as well, was on the verge of giving J&J (JNJ) yet another image headache. The health care giant, you may recall, has suffered a series of embarrassing gaffes over the past three years – manufacturing problems that led to the recall of countless over-the-counter items such as Tylenol and Motrin; courtroom setbacks over Risperdal marketing (seethis and this) and a scandal over the safety of hip implant replacements.

And so, J&J late last week began a counterattack. In response to the sudden burst of negative publicity, Jannsen had its chief medical officer, Amrit Ray, respond to McFadyen in yet another letter. And this time, he made a point of writing that compassionate access would be available to any child and reiterated the offer to support an investigator-initiated study with any physician would be interested in doing so. Ray also maintained that J&J was convening a group of experts to explore the possiblities for supporting MPS research with Elmiron.

“We’re trying to get in the right place to where we can get the right data. It’s not one of the areas where we have a lot of experience,” Ray told us. “There has never been any data to indicate it would help patients.. but we’re eager to understand the data… and we’re certainly open to hearing a proposal. In this case, we would like to get some additional expertise to assess any proposal” from a physician willing to administer the drug. However, he disputed some of the chronology that McFadyen offered about miscues last year for substantive discussions.

Initially, McFadyen responded with skepticism and continued to express concern that experimental usage of the drug poses risks and that J&J should be willing to commit to supporting a regular clincical trial. By the start of this week, though, he had held several telephone conversations with Ray and now tells us he is willing to give J&J a chance to work with families. In fact, he is considering pulling down the shameonjnj web site. “I think the web site achieved its goal,” he says.

“Does this mean that a clinical trial is imminent? The answer is no, we aren’t there yet. But this does mean that a true review of Elmiron by Janssen will be thoroughly conducted by the some of the best minds in the field of MPS, from all over the world,” McFadyen wrote on the Isaac Foundation web site (read here). “We look forward to monitoring the progress of those discussions as we seek to find the best treatment options possible for all of our kids suffering from MPS.”

Whether J&J follows through, of course, remains to be seen. The drugmaker is not under any obligation to fund additional research, although the resources needed to explore the possibilities – with the help of scientific experts who can ballpark the odds of success – are relatively modest. For now, though, J&J has scored a win. In a hurly burly world where just about everything can – and often does – go viral quickly, the health care giant has managed to diffuse a potential crisis. And unless J&J commits yet another blunder and angers MPS families again, this is a rare accomplishment when considering the recent spate of scandals, gaffes and setbacks on so many fronts.