Hacker News new | ask | show | jobs
by iechoz6H 836 days ago
One wonders how they got as far as Phase III trials without actually working.
2 comments

Final 'graph of the article:

[T]he patient advocacy groups took victory laps after Relyvrio was approved, and they were a big part of the pressure that made the FDA reverse its initial correct decision.

Motivated reasoning, whether by commercial interests, patient advocates, or any other group, is inimical with truth-finding.

Though on the grounds of potential benefit vs. known harm (which is assessed in Phase I/II trials) and partial knowledge, a provisional approval in the case of a treatment for a chronic, progressive, and fatal condition is reasonably defensible. The FDA's conditional approval was based on Phase III trials showing efficacy. The dice were rolled, though the gamble in this case proved fruitless.

ALSA ALS association funded AMX0035 (previous name of Relyvrio) and by contract would get up to 3.3 $M if the drug was successful:

https://secure2.convio.net/alsa/site/SPageNavigator/blog_090...

Phase III is when you test efficacy so it’s exactly how it’s meant to be
In this case, the FDA had approved the drug, though conditionally.

Second 'graph of TFA:

A second advisory committee meeting was convened, and if that phrase sounds odd to you, it should. That's a very unusual thing to do. This one voted for approval, and the FDA did approve the drug in September of 2022. There was a condition, though: Amylyx was already working on a Phase III trial, and they committed to withdrawing the drug if this trial showed no efficacy.

considering costs this doesn't sound very utilitarian
Why would you test something for efficacy before you're sure it's safe? You'll end up testing a bunch of harmful substances that don't actually do anything.
Maybe because the real standard is "the benefits out weigh the risks" you might want a drug that has a 10% chance of harm if it has a 90% chance of benefit, for a condition that is terminal if untreated.
Fair point, although it also seems nonsensical to test safety for human consumption before having a robust hypothesis for desired effects.

It's not true that safety is fast and easy to check.

Is there utility in knowing the lethal dose of a drug before you administer an efficacy study. Libertarians wonder…