Experts from 15 countries tell regulation needed to prevent vulnerable patients pursuing unproven and potentially deadly treatments
Medical and legal experts from around the world have unified to call for more stringent regulation of stem cell therapies to prevent people pursuing unproven and potentially deadly treatments overseas.
In a perspective piece for the US journal Science Translational Medicine, 15 experts from countries including the UK, the US, Canada, Belgium, Italy and Japan wrote that national efforts alone would not be enough to counter an industry offering unproven therapies to vulnerable patients.
Stem cell-based interventions are classified under diverse and potentially incompatible national regulatory frameworks, the authors wrote.
Approaches for international regulation not only need to develop consistent regulations over the commercialisation of medical practices and products but also need to give them teeth by developing cross-border partnerships for compliance.
Stem cells found in bone marrow and umbilical cord blood have long been used to successfully treat blood cancers including leukaemia and some immune illness. But those are among the few proven therapies. Legitimate and ethics-approved clinical trials by academic centres are also resulting, investigating the potential of stem cells to treat a wider range of diseases.
But some physicians are directly offering to the general public stem cell treatments for illness still under clinical trial or for which no evidence exists and for which the safety and efficacy is as yet unproven.
Deaths as a result of stem cell treatments have already resulted. In 2013 Sheila Drysdale died in a New South Wales nursing home after undergoing an unproven liposuction stem-cell therapy at a western Sydney clinic. Following Drysldales death, her doctor, Ralph Bright, gave a statement to police in which he claimed that stem-cell therapy could improve comorbidities and that stem cells could move from joints to other parts of the body to improve illnes in distant sites including lungs and brain, vision, mentation and pain.
In his report into Drysdales death, the coroner Hugh Dillon wrote that he could not say what motivated Dr Bright to perform this unproven, dubious procedure on Sheila Drysdale.
But regardless of his motivating, Dr Brights performance as a medical practitioner was, for the reasons outlined above, poor and resulted in Sheila Drysdales death.
The Medical Council of NSW investigated Bright and placed a number of restrictions on his right to practise. Bright is still authorised to practise stem cell therapy for patients with osteoarthritis or who are taking part in research studies approved by an ethics committee. He is also still allowed to treat patients returning for remaining injections of stored cells.
In 2013 a Queensland woman, Kellie van Meurs, died when she travelled to Russia to undergo stem-cell treatment for a rare neurological disorder. She died of a heart attack as a result.
Australias drug regulator, the Therapeutic Goods Administration, last year sought feedback on the regulation of autologous stem-cell therapies but is yet to publish those submissions. A TGA spokeswoman said the Administration was still examining the options for changes to the legislation to reflect public and industry opinions. The TGA currently considers autologous therapies, which involve treating someone with their own tissue or cells, to be a therapeutic good and, hence, does not govern them. Stem cells used for medical practise and therapeutic purposes are covered by different regulatory frameworks.
Associate Professor Megan Munsie, a University of Melbourne stem cell scientist and a co-author of the paper, said: The notion that stem cells are magical holds court in the community, along with this idea the advances in treatment are being held up by red tape.
Unethical health practitioners exploited this, she said, along with the vulnerability of patients with difficult-to-treat or incurable conditions.
There is a precedent for international regulation of this industry because regulations already exist around narcotics the way they are manufactured, she said.
This could be extended to the regulation to the stem cell and tissue-based therapies. This international stance would then force or foster stronger local regulations.
There have been successful endeavors by scientists to push back against unscrupulous physicians. In Italy scientists and regulators highlighted the unproven yet government-subsidised treatments being offered by the entrepreneur Davide Vannoni and fought to stop him. He was convicted of criminal charges but the sentence was subsequently suspended.
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