With death toll rising, bowel drug is pulled

By LAURAN NEERGAARD

Associated Press

WASHINGTON — The maker of a popular new treatment for women’s irritable bowel syndrome pulled the drug off the market Tuesday after it was linked to a growing number of deaths and hospitalizations.

The withdrawal comes just nine months after the prescription drug Lotronex began selling with great fanfare. The problem: Lotronex can cause severe side effects, including a life-threatening intestinal inflammation called ischemic colitis, and constipation so severe that some patients needed parts of their intestines surgically removed.

A review of Food and Drug Administration records by The Associated Press indicates the agency knows of at least eight women who died with intestinal side effects while taking Lotronex. The agency also has 124 reports of Lotronex patients experiencing hospitalizations, disabilities or urgent medical treatments, and so far has classified 70 of those 124 cases as probably caused by the drug. Two-thirds of those women were sick enough to be hospitalized, the FDA says.

Manufacturer Glaxo Wellcome Inc. contends Lotronex is safe when used by the right patient, and calls it no more risky than some other big-selling medicines. But, saying it was under orders from the FDA, the company announced Tuesday that it would cease distribution of Lotronex immediately and recall the drug from pharmacies. About 150,000 people use Lotronex, and those who have supplies remaining can contact Glaxo about a refund at (888) 825-5249.

The FDA says it wanted to keep Lotronex on the market but restrict sales to just a few women with severe irritable bowel syndrome who are treated by specialists, but Glaxo called that option unworkable and decided on its own to pull the drug.

Lotronex initially was welcomed as the first new therapy in decades for irritable bowel syndrome, a mysterious disorder that affects up to 15 percent of Americans, mostly women. It is not life-threatening but can cause misery. It involves chronic or recurrent abdominal pain, the sudden and urgent need to go to the bathroom and either frequent diarrhea, constipation or both.

In studies, Lotronex offered only modest relief to women whose main irritable bowel syndrome symptom was diarrhea. It did not work for men, and was declared dangerous for anyone with constipation.

The FDA warned the day it approved Lotronex last February that it might cause serious side effects, because four women in clinical trials suffered ischemic colitis. But the agency approved the drug anyway, saying the mild cases healed once the women stopped taking Lotronex and that irritable bowel syndrome sufferers needed a new option.

But within months, the FDA was receiving numerous reports of increasingly serious reactions. By August, it ordered Glaxo to attach special safety warnings to every bottle of Lotronex sold, urging doctors not to prescribe it to patients with constipation or other risk factors and telling women to stop using it at the first sign of trouble.

Weeks later, FDA learned of the first death.