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Medicine United States Science

FDA Considers First CRISPR Gene Editing Treatment That May Cure Sickle Cell 39

The U.S. Food and Drug Administration is reviewing a cutting-edge therapy called exa-cel that could potentially cure people of sickle cell disease, a painful and deadly disease with no universally successful treatment. "If approved, exa-cel, made by Boston-based Vertex Pharmaceuticals and the Swiss company CRISPR Therapeutics, would be the first FDA-approved treatment that uses genetic modification called CRISPR," reports CNN. From the report: CRISPR, or clustered regularly interspaced short palindromic repeats, is a technology researchers use to selectively modify DNA, the carrier of genetic information that the body uses to function and develop. [...] The new exa-cel treatment under FDA consideration can use the patient's own stem cells. Doctors would alter them with CRISPR to fix the genetic problems that cause sickle cell, and then the altered stem cells are given back to the patient in a one-time infusion.

In company studies, the treatment was considered safe, and it had a "highly positive benefit-risk for patients with severe sickle cell disease," Dr. Stephanie Krogmeier, vice president for global regulatory affairs with Vertex Pharmaceuticals Incorporated, told the panel. Thirty-nine of the 40 people tested with the treatment did not have a single vaso-occlusive crisis, which means the misshapen red blood cells block normal circulation and can cause moderate to severe pain. It's the top reason patients with sickle cell go to the emergency room or are hospitalized. Before the treatment, patients experienced about four of these painful crises a year, resulting in about two weeks in the hospital.

The FDA sought the independent panel's advice, in part, because this would be the first time the FDA would approve a treatment that uses CRISPR technology, but Dr. Fyodor Urnov, a professor in the Department of Molecular and Cell Biology at the University of California, Berkeley, reminded the committee CRISPR has been around for 30 years and, in that time, scientists have learned a lot about how to use it safely. "The technology is, in fact, ready for primetime," Urnov said. With this kind of genetic editing, scientists could inadvertently make a change to a patient's DNA that is off-target, and the therapy could harm the patient. [...] The FDA is expected to make an approval decision by December 8.
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FDA Considers First CRISPR Gene Editing Treatment That May Cure Sickle Cell

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  • lives worth living (Score:4, Insightful)

    by pitch2cv ( 1473939 ) on Tuesday November 21, 2023 @03:04AM (#64020671)

    Finally an actually useful application to improve people's lives.

    So far, the only genetic modifications the world has seen is to plants so they can spray more poison on them aka RoundUp-Ready crops.

    So while I'm very much in favor of the former, the latter is why so many are opposed to gene editing.

    I'm looking forward to more applications of CRISPR that can make very sick peoples lives worth living again.

    • by ShanghaiBill ( 739463 ) on Tuesday November 21, 2023 @03:36AM (#64020707)

      Finally an actually useful application to improve people's lives.

      This is far from the first: Applications of CRISPR in medicine [biocompare.com]

      So far, the only genetic modifications the world has seen is to plants

      Not true. There are many GMO animals.

      so they can spray more poison

      Not true. Glyphosate tolerance reduces the amount of herbicide needed since it can be applied during the seedling stage instead of trying to kill weed seeds, which requires more and more potent herbicides.

      Nearly all glyphosate that enters the food supply comes from its use as a pre-harvest desiccant, which is only used on non-GMO crops. Want less herbicide in your diet? Eat only GMO.

      • There really is no point to arguing with chemophobes about glyphosate. Might as well argue with chemtrailers or fluoride in drinking water; they're on the same level.

    • Finally an actually useful application to improve people's lives.

      Since Greed in the Medical Industrial Complex greatly prefers supporting perpetual treatments instead of cures, I would sit down before reading the eventual price tag. Sadly I cannot even begin to imagine how expensive it will be.

    • It has been slow in coming to people because the first attempts at gene therapy failed badly.

    • by ceoyoyo ( 59147 )

      Golden rice is engineered to produce vitamin A. It's saved the sight and lives of a lot of children. Many other plants have been engineered for pest resistance (so you need to use less insecticide and herbicide), hardiness, production, virus resistance, etc. If you're going with "genetic modification" then everything you eat is genetically modified and civilization couldn't exist without it.

      CAR T Cell therapy is used to treat blood cancers, again prominently in children.

      Genetic engineering is also used to p

      • Golden rice is engineered to produce vitamin A. It's saved the sight and lives of a lot of children.

        It has?

        Seems like a good idea but it sounds like it's still trying to make it into the market [goldenrice.org].

        • by ceoyoyo ( 59147 )

          Ah, you're right, apparently they're still arguing about it in the Philippines. It was approved in 2019 IIRC but it seems there's been some backsliding.

          Still an example of beneficial genetic modification. Also salt-tolerant rice. White rice itself is a mutation bred and propagated by humans.

  • The UK approved this last week. Too many articles to include by link, but a simple Google search will show it.

    As usual the US FDA is behind the times, disallowing anything to help people heal, and propping up big pharma's "work around the symptoms for recurring monthly revenue" vs "fix the problem for good." Same holds true for MS, diabetes, etc. We like to call it a free market, but it's not free, and it's a market where our masters tell the slaves what they're willing to offer today and the government

    • by gtall ( 79522 )

      You know nothing of the regulatory process. It exists because those nice corporations will put a price on grandmothers' lives and use the free market to sell what they can without an "excessive" number of deaths, which are bad for the bottom line.

      • by Entrope ( 68843 )

        The FDA imagines that every new drug is thalidomide, and so it tries to kill them all by default. The result is that lots of Americans die of diseases that could be treated but the treatments are blocked. It's hard to get traction with the problem because people who die due to FDA roadblocks are buried in an invisible graveyard (to borrow [marginalrevolution.com] a phrase).

        • by ceoyoyo ( 59147 )

          This is bullshit.

          People imagine that every new drug is a miracle drug that's going to save lives. In reality, about 90% fail clinical trials, most because they simply don't work.

          • Comment removed based on user account deletion
            • by ceoyoyo ( 59147 )

              The FDA is the US agency that regulates clinical trials. This includes setting standards for them and evaluating the results before granting an approval. FDA approval boards are generally composed of scientists in the relevant fields whose day jobs are in labs or hospitals around the world. The FDA does employ some quite good scientists directly in labs researching things mostly not directly related to pharmaceuticals.

              I don't know exactly what you think the FDA is, but it's not that.

              • Comment removed based on user account deletion
                • by ceoyoyo ( 59147 )

                  If you think the NIH regulates clinical trials I'm going to have to seriously question your experience in medical research. Maybe at the bench stage?

                  Various funding agencies in the US fund some clinical research, but the vast majority of clinical pharma trials, particularly the big, expensive, phase III ones, are funded by, surprise, pharma. And their ain't no way they'd be doing that if the FDA (and other countries' health agencies) didn't make them. In fact, before the creation of those health agencies, t

                  • Comment removed based on user account deletion
                    • Not sure what you actually do, but you have no idea how this works. That is exactly what the FDA does. If a sponsor wants to enter clinical trials in the US, they submit an IND to the FDA for review, which details everything about it: what it is, how it works, how its made, nonclinical safety evaluations, product testing, and representative data from multiple clinical lots demonstrating the sponsor can make it consistently and safely. The FDA will then decide if the sponsor can initiate a phase 1 trial to e
                    • Comment removed based on user account deletion
                    • I did not describe a bureaucratic process. The FDA has researchers and clinicians on its payroll, including the director of CBER. They conduct the review to ascertain the merits of any regulatory submission. It is not filing paperwork. Just stop. You have no clue how this works.

                      The FDA may not be staffed by people on the cutting edge, and sponsors have to invest time in demonstrating to the agency that any new tech is justified. Those wheels can turn slowly, and they have acknowledged this. I can't speak ab

                    • Comment removed based on user account deletion
        • This is not true. There are hundreds of clinical trials for investigational cell and gene therapy in the US, which means they were reviewed by the FDA and given a safe to proceed to dosing patients. The FDA wants to see better therapeutic options for patients, but still has a mission to preserve patient safety.
      • You know nothing of the regulatory process. It exists because those nice corporations will put a price on grandmothers' lives and use the free market to sell what they can without an "excessive" number of deaths, which are bad for the bottom line.

        As always, have it. Clearly you know more than the people who have spent their entire lives developing and testing medical procedures. Surely an advanced degree and decades of experience isn't needed when dealing with manipulating human genes. So go out and get our splicer and start "curing" those diseases. $10 a pop, right?

        • by skam240 ( 789197 )

          Clearly you know more than the regulators put there to make sure corporate profits don't come at the expense of human lives.

          If you have any kind of point I would imagine you'd be able to support it with some proper examples with citations.

    • There's a new MS treatment in the pipeline - an 'inverse vaccine' that trains your immune system to ignore myelin.

      It's from the University of Chicago and it looks very promising.
        It's not gene editing, but I believe it is a child of COVID vaccine technology.

      While the FDA can be annoying, it's not generally conspiring to watch you suffer and slowly die - a lot of the things you want medicine to do are exceptionally difficult.

    • Peter Marks, Director of CBER, was challenged on this topic recently by several in the cell and gene therapy space: our main weapons against cancer are things which themselves are known to be risk for causing cancer, so why is the agency so slow to support investigational gene therapies which may offer a much better safety profile. He conceded the FDA has been slow in this area, but looking to address this lag. There is a lot of interest in curative therapies, and "pharma" is definitely not preventing the
  • by Motleypuss ( 10291831 ) on Tuesday November 21, 2023 @05:57AM (#64020861)
    Glad to see this, as I mentioned on a dupe. Now, can CRISPR also be used to fix a premature stop codon on COL2A1? Sign me up!
    • Unless you're a child, I don't think fixing such an issue will have much effect later in life unfortunately.

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