http://bmj.com/cgi/content/full/323/7308/299/a
BMJ 2001;323:299 ( 11 August )
Deborah Josefson
Inhaled hexamethonium, the drug implicated in the recent death of Ellen Roche,
a previously healthy 24 year old woman who volunteered in an
asthma study at Johns Hopkins University, Baltimore, Maryland (BMJ
2001;322:1565), may have made subjects ill in experiments 23 years
ago.
Researchers at the University of California in San Francisco are
re-examining data from a 1978 study on the basic physiology of
asthma in the wake of Ms Roche's death.
Dr Alkis Togias, the principal investigator and designer of the Johns
Hopkins study, reportedly relied in part on earlier work done at the
University of California in San Francisco in arguing the safety of
inhaled hexamethonium. Like his study, the earlier study used
inhaled hexamethonium to induce bronchoconstriction and simulate
asthma.
Two of five test subjects in the Californian study became ill during the
experiment, but their illnesses were not ascribed at the time to the
inhaled irritant and therefore went unreported.
According to the university, one participant in the study presented to the
university hospital's emergency department four days after inhaling
hexamethonium with complaints of dyspnoea and tightness in the
chest. The patient described his participation in the research
experiment to the examining physician, but his symptoms were
diagnosed as compatible with viral pneumonia.
The second participant complained of headache and malaise and withdrew from
the study. Neither of the participants died. The side effects,
though easily overlooked, were similar to those of volunteers in Dr
Togias's asthma study at the Johns Hopkins University.
The
Office for Human Research Protections has agreed research involving humans may
go ahead at Johns Hopkins University if it is in the "best
interests" of the subjects involved. Researchers have to submit
a summary of their project's protocol and justify its continuation.
Any new research involving humans must meet strict criteria.
© BMJ 2001
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