NEWS FLASH 6/28: UNOFFICIAL "COMPOUND Q" STUDY

A so-called "secret study" of trichosanthin, the experimental AIDS treatment also called Compound Q, became a focus of national controversy after one of the patients died. All indications so far are that the drug did not contribute to the cause of death. But the controversy has furthered a much- needed national discussion over the design and implementation of clinical trials during a public-health emergency.

The project, a treatment program organized by Project Inform of San Francisco, included very thorough monitoring of laboratory test results and the clinical condition of over 30 patients in four U.S. cities, treated by their physicians with trichosanthin. The drug was obtained from China, where it has been widely used for almost two decades. All patients received the lowest dose used for any purpose in China; this dose was repeated three times at weekly intervals. The patients selected were very ill and had failed all other treatments. No one was charged anything to participate; all labor and expenses were donated by the physicians, or by Project Inform or others.

While early indications are promising, Project Inform emphasizes that it is too early to tell if trichosanthin will be useful as an AIDS treatment; the organization hopes to make a full report available in one to two months. Also, the drug is similar to chemotherapy and can cause severe side effects in some patients; it must not be used without proper medical supervision. A major reason for organizing this monitoring project was that people were already using the drug as an AIDS treatment, with unknown and potentially serious risks.

We will cover the trichosanthin monitoring study (and the debate around it) in depth in future issues. Meanwhile, readers can learn the basic facts from newspapers such as the San Francisco Chronicle, San Francisco Examiner, The New York Times, and the Los Angeles Times.

Comment

This monitoring study is as thorough, professional, and careful as any trial we have seen, and it promises to be a turning point in efforts to control the AIDS epidemic. It shows that clinical trials can develop useful information very quickly when they are organized to do so, and when patients are well informed of the unavoidable risks and willing to accept them.

If trichosanthin turns out to be valuable as an AIDS treatment, then this project could save thousands of lives. Everyone involved deserves our gratitude and support.