Weekend Argus (Saturday Edition)
‘Miracle drug’ helps patients at death’s door
Costly, groundbreaking biologics are used at leading state hospitals
AS DOCTORS fought furiously to keep him alive, Franklin Joseph never believed he would wake up three days later to celebrate his birthday.
His miraculous survival, in turn, prompted Dr Mouroed Manie, head of Tygerberg Hospital’s Rheumatology division, and consultant rheumatologist Dr Riette du Toit to give Joseph biologic treatment which changed his life.
In 2009 Joseph was diagnosed with Wegener’s granulomatosis, a rare condition which causes inflammation of an organ’s blood vessels. He was 31, newly married, and thought he had a sinus infection.
But he had a life-threatening illness which affects only about one in every 5 million South Africans a year. His symptoms began with nose bleeds and headaches and sinus treatment did not help.
He struggled to swallow, and little pink spots appeared on his painful joints.
“I was so weak. My immune system was so bad, it was weaker than a baby’s and they put me in isolation. The doctors were forced to go back to their books because they couldn’t tell me what’s wrong with me,” he recalled this week at his Belhar home.
His wife Deniel said things deteriorated rapidly. “From there it was just chaos, he struggled to breathe and for four months he couldn’t walk.”
He could no longer work, suffered “excruciating” pain, and nearly three years ago faced death when, three days before his November 17 birthday, his airway began closing.
That was when Manie and Du Toit urged hospital management to approve the use of biologics, a costly “first-generation” treatment.
Manie explained that this involved the use of vaccines and blood- related products which, in most cases, involved biologic processes or DNA technology.
“It entails manipulating the genes to produce DNA sequences, which in turn produce a specific protein either in an organism like a virus, or otherwise in a test tube. The role of the protein is to counter destructive processes such as the inflammation characteristic of diseases such as rheumatoid arthritis, or to counter the malignant processes involved in cancers such as lymphoma.”
But they come at a high price; administered via a drip or by injection, the treatment
‘I would wake up in the middle of the night and then cook
can cost up to R16 000 a month.
Manie said the arrival of biologics in the early 2000s offered a vital breakthrough.
Fortunately for Joseph, hospital management agreed to the treatment. His airway inflammation was rapidly resolved, and there have been no further flare-ups.
Tygerberg hospital was among the first state health institutions to provide biologics to patients who cannot afford them, but they’re now available at other academic hospitals, including Groote Schuur and Joburg’s Chris Hani Baragwanath Hospital.
Patients are selected on the basis of the severity of the disease, whether employed or studying, have dependents or aid society through voluntary social work.
Manie said the costs start from R4 500 per year.
“From having almost no patients on biologics a few years ago, we now have space for 15 patients, although the demand is way higher than what we can offer,” he said.
Another patient, lupus sufferer Donna van Schalkwyk, described the biologics drip as a “miracle drug”.
Last November the lupus began affecting her brain:“I would wake up in the middle of the night and cook tomorrow night’s supper,” the 34-year-old mother of three recalled.
Booked off from work for two months after receiving the drip, Van Schalkwyk was back at work in January, and says she feels even more healthy than she did before she got the disease.
Joseph is now self- sufficient, able to bath himself, drive and has even taken up fishing.