AIDS TREATMENT NEWS Issue # 76, March 24, 1989
John S. James
But despite the widespread use in Japan, there have long been questions of whether dextran sulfate is absorbed from the intestines into the bloodstream well enough to be effective.
Recently, new data has increased these doubts about the "bioavai- lability" of the drug. The new information has been widely reported in the press, beginning with a story in the February 19 Los Angeles Times.. But experts disagree on how certain or conclusive the new data is.
At least until recently it has not been possible to measure dex- tran sulfate levels in the bloodstream. So at first an indirect test was used. Six people took 1800 mg each of the drug, and then were given before and after measures of a blood-clotting parameter known to be affected by dextran sulfate. Later, a direct chemical test was devised. Both studies concluded that less than one percent of dextran sulfate taken orally was absorbed into the bloodstream.
All seem to agree that these findings cast doubt on dextran sul- fate. But questions remain. Was a single dose of 1800 mg enough for the test? Could even a small amount absorbed be of some benefit -- especially if combined with AZT or other drugs? Is the new blood-level test accurate? Could the Japanese have been taking a useless drug for 20 years and not noticed? How do we explain the apparent benefit seen in some of the data collected by physicians whose patients are using dextran sulfate? And even if the drug is not absorbed into the bloodstream, might it still benefit some people by treating HIV infec- tion in the intestinal lining itself, by direct contact?
At this time, the case for oral dextran sulfate seems weak. But confusion remains because solid answers are not yet available. We hope that the clinical trials now in progress will be completed so that physicians can answer the bottom-line question: Does the drug help patients?
There has been some controversy about the early release of prel- iminary information on dextran sulfate absorption, before formal pub- lication. We think it was right to tell people early. Final analysis and publication of the results may take months -- and meanwhile thousands of people are making vital decisions about their health care. They need the best information available. We hope that this controversy does not deter other scientists and officials from releas- ing unpublished results when there is an urgent need to do so.
For more information, see: the Los Angeles Times, February 19, 1989 (home edition), page 1; statement by Martin Delaney of Project Inform, to be published in PI Perspectives this month (415/558-9051 to be added to Project Inform's mailing list); and an investigative arti- cle by Tim Kingston to be published in Coming Up! newspaper in San Francisco, April 1989.
890324
ATN07603
Copyright © 1989 - AIDS Treatment News. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used. Subscription lists are kept confidential. AIDS Treatment News, Subscription and Editorial Office: 1233 Locust St., 5th floor Philadelphia, PA 19107 800/TREAT-1-2 toll-free email: aidsnews@critpath.org http://www.aidsnews.org
Subscription Information: Call 800/TREAT-1-2: Businesses, Institutions, Professionals: $270/year. Includes early delivery of an extra copy by email. Nonprofit organizations: $135/year. Includes early delivery of an extra copy by email. Individuals: $120/year, or $70 for six months. Special discount for persons with financial difficulties: $54/year, or $30 for six months. If you cannot afford a subscription, please write or call. Outside North, Central, or South America, add air mail postage: $20/year, $10 for six months. Back issues available. Fax subscriptions, bulk rates, and multiple subscriptions are available; contact our office for details. Please send U.S. funds: personal check or bank draft, international postal money order, or travelers checks. VISA, Mastercard, and purchase orders also accepted. ISSN # 1052-4207
AEGiS is made possible through unrestricted grants from Boehringer Ingelheim, the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 1989. This material is designed to support, not replace, the relationship that exists between you and your doctor.
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Copyright ©1980, 1989. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .