Hitting New Targets
Researcher's third AIDS drug adds to synergy.
RUTH LITTMANN STAFF WRITER
r. Jerome P. Horwitz, in- vary in their constitution, but your eyes. The virus is a verita-
ventor of the benchmark they share a trait: They are ble Houdini," Dr. Horwitz said.
Therefore, as soon as one drug
AIDS drug, AZT, was set chemical impostors, playing a
lethal trick on HIV viruses by im- succeeds in detonating a strain
to retire in 1990.
First on his agenda: a trip to personating the building blocks of the virus, another develops.
On a brighter note, the re-
of DNA, the body's genetic code.
Israel.
HIV viruses (more specifical- searcher foresees a day when
Dr. Horwitz and his wife,
Sharon, were stepping out the ly called retro-viruses) incorpo- AIDS will be tamed from a fatal
door when the phone rang. It was rate these "suicide substrates" disease into a chronic condition.
Dr. Laurence Baker, chief of the into their genetic templates only Many new drugs are in the mak-
division of hematology/oncology to realize afterward that they've ing.
Not that there aren't risks in-
at Wayne State University got the wrong stuff.
'The viruses take them up and volved.
School of Medicine, who was call-
Dr. Horwitz acknowledges the
ing to inquire about the 70-year- bang! They're dead," Dr. Horwitz
pitfalls of his drugs. They often
old researcher's long-range plans. explained.
(In the 1960s, he had hoped have painful side-effects. AZT,
Perhaps, he queried, Dr. Hor-
witz would consider postponing the same phenomenon would for instance, sometimes causes
retirement to work as a full-time stymie tumor growth, but dis- blood and bone-marrow toxicity.
covered that cancerous mam- Stavudine causes tingling in a
professor?
"I thanked him for the offer malian cells do not have an person's extremities. Users must
and told him I'd let him know affinity for these drugs the way be monitored closely.
"Some people benefit. Some
when I got home," Dr. Horwitz retro-viruses do.)
Stavudine is administered in people have immediate side ef-
said.
Evidently not one for long va- much the same way as AZT. fects. AIDS tends to be a very in-
dividualized disease,"
cations, much less re-
said Perry Ryan, edu-
tirement, Dr. Horwitz
cation prevention ad-
later accepted. Since
ministrator for
that time, the Federal
Wellness Networks, a
Drug Administration
nonprofit AIDS orga-
has approved two more
nization in Michigan.
of his AIDS drugs —
Because of the
the ones Dr. Horwitz
risks, Dr. Horwitz be-
created for a wholly dif-
lieves the years spent
ferent purpose during
testing these drugs be-
the 1960s.
fore putting them out
The most recent
on the market is time
FDA approval came on
well-spent.
June 26 for a drug
Today, Dr. Horwitz
called Stavudine.
is a professor in the
It has been nearly 30
department of internal
years since Dr. Horwitz
medicine at Wayne
led a medical team
State University. He
seeking a cure for can-
also serves as a mem-
cer. At the time, he was
ber of the Drug Dis-
working as chief of the
covery Group in the
department of chem-
division of hematol-
istry at the Detroit In- Dr. Jerome Horwitz's AIDS drugs come from his 1960s attempt
ogy/oncology.
stitute of Cancer at a cancer cure.
The researcher lives
Research (now called
the Michigan Cancer Founda- Users generally take between in Farmington Hills and belongs
five and 12 pills a day. The price to Congregation B'nai Moshe.
tion).
He says he has accepted the
Though the drugs he invent- is comparable to AZT, which re-
ed in the 1960s proved ineffec- tails at about $150 for 100 pills. fact that an English company,
Dr. Horwitz believes AIDS pa- Burroughs-Wellcome, secured
tive in battling solid tumors, they
were later shown to prolong the tients will benefit from a mix of the patent to AZT when it was
rediscovered as an AIDS drug
lives of those with AIDS — Ac- the drugs.
"Hopefully, we'll be able to in the 1980s. Hoffmann-La
quired Immune Deficiency Syn-
drome — which has killed combine the drugs for a syner- Roche and Bristol Myers Squibb
gistic effect," he said. 'The drugs possess the rights to the other
220,871 Americans since 1981.
There are four FDA-approved in combination are a better way two.
Though Dr. Horwitz will nev-
AIDS drugs: AZT, ddC, Stavu- of treating AIDS patients than a
dine (all three created by Dr. single drug. If you have three dif- er see royalties emerge from
Horwitz) and a fourth, ddl. ferent drugs that attack three dif- these discoveries, his accom-
Stavudine, the latest, provides ferent targets, the effect goes up plishments hold value beyond
monetary worth. Pointing to
an alternative for AIDS patients exponentially."
Dr. Horwitz predicts no cure plaques on his office wall at De-
who become resistant to AZT. It
is also an option for people who or vaccine for AIDS. The prob- troit's Harper Hospital, he says,
suffer serious side effects from lem is, the HIV virus mutates too "Those mean a lot to me. It's
quickly. Its genetic RNA coding recognition by my peers, and
AZT.
All AIDS drugs on the market enables it to change "right before that's meaningful." O
Dr. Leider
disagrees with a
report in JAMA.
Say What???
Myths aside, ear tubes drain the pain away,
a local doctor says.
RUTH LITTMANN STAFF WRITER
t 3 months old, Alexandra Orechkin of Bloomfield Hills
endured her first ear infection. The pain made sleeping a
nightmare. Flying on planes was even worse.
"My little one screamed from the moment the pres-
sure doors closed until the time we landed," says her mother,
Robin Orechkin. "It was apparent that this poor thing was not
just being a cranky baby. She was sick."
Ear infections are the second-most common reason for visits
to pediatricians, according to a 1992 National Ambulatory Med-
ical Care Survey. The National Centers for Disease Control re-
port that in 1988 nearly 670,000 surgeries to insert ear tubes
were performed in the United States, making it the most corn-
mon operation for children.
Generally, youngsters between the ages of 2 and 6 receive ear
tubes when they experience repeated build-up of fluid in the mid-
dle ear, behind the eardrum. The fluid, which often becomes in-
fected, puts pressure on the eardrum, causing pain and hearing
loss. This can be especially detrimental to young children just
learning to talk.
Doctors usually first treat the condition with antibiotics. But
if infections and fluid build-up persist, they recommend ear tubes.
The tubes look like tiny plastic beads, only millimeters in
length and a fraction of that in diameter. They form an opening
through the eardrum allowing fluid to drain.
When she was 2, Alexandra received the tubes. Her hearing
improved. Her crying decreased. She hasn't had an ear infection
since.
"If she had to have the surgery done again, I wouldn't hesi-
tate," her mother says.
Recently, however, the Journal of the American Medical As-
sociation published a study contending ear tubes can actually
endanger children's hearing. More specifically, the study stated
that 25 percent of all ear-tube operations are inappropriate, and
one-third are of questionable benefit.
These findings have elicited a backlash from many surgeons
who argue the whole study was nothing more than an attempt
by insurance companies to cut expenses.
"I think it's in their best interest because it keeps their costs
down...but hearing damage is significantly greater in the pa-
tients you leave untreated," says Dr. Jeffrey Leider, a otolaryn-
gologist in Farmington Hills.
Dr. Leider works with Dr. Benn Gilmore at the American Ear,
Nose and Throat Institute on Orchard Lake Road. Each year,
he performs many dozens of ear-tube operations.
A
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