Los Angeles Times

Stem cell clinic is warned

In a scathing letter, FDA says marketing by StemGenex of unproven stem cell treatments is illegal.

- MICHAEL HILTZIK

The Food and Drug Administra­tion has come down hard on StemGenex, a La Jolla clinic pitching stem cell treatments for multiple sclerosis, diabetes, Parkinson’s and other conditions.

In a warning letter made public Tuesday, the FDA says that StemGenex’s marketing is illegal, and that its manufactur­ing procedures are “putting patients at risk.” The agency also said that there’s no evidence that StemGenex followed up or investigat­ed “multiple complaints involving possible adverse effects” of its treatments experience­d by patients.

The agency says that StemGenex could be subject to further action including “seizure, injunction, or prosecutio­n” if it doesn’t correct roughly 20 “objectiona­ble conditions” or deviations from acceptable practice that its inspectors discovered during visits to the facility in January.

The FDA’s action against StemGenex appears to be one of the more stringent in its developing campaign against clinics hawking stem cells as therapies for a host of medical problems, invariably without scientific­ally valid evidence to back them up. The headline on its announceme­nt of the action, accusing StemGenex of “illegally marketing” an unapproved treatment, is unusually blunt.

StemGenex hasn’t responded to our request for a comment.

The FDA’s announceme­nt also placed its action against StemGenex squarely within its campaign against clinics making bogus claims about stem cell therapies. “We continue to see bad actors exploit the scientific promise of this field to mislead vulnerable patients into

believing they’re being given safe, effective treatments,” FDA Commission­er Scott Gottlieb said in the announceme­nt, “when instead these stem cell producers are leveraging the field’s hype to push unapproved, unproven, illegal, and potentiall­y unsafe products.”

In its warning letter, the FDA points to the way these treatments may move from being innocuous (albeit expensive) to being actually harmful — “use of these unapproved products may cause users to delay or discontinu­e medical treatments that have been found safe and effective.”

We’ve reported on StemGenex numerous times. We’ve detailed how it charges roughly $15,000 per session — almost never covered by insurance — for treatments that lack any scientific basis. We’ve reported allegation­s that it told prospectiv­e customers it had a 90% success rate, a statistic for which it had no evidence. And we’ve reported on the proliferat­ion of other clinics luring desperate patients with scientific­ally unsupporta­ble claims based on the public impression that stem cells are some sort of miracle cure for almost anything that ails them.

Typically, these clinics liposuctio­n fat cells from customers’ body and purportedl­y extract stem cells from the tissue. They then inject the stem cell solutions back into the customers’ bodies at the site of an injury, intravenou­sly or through some other pathway.

The FDA’s warning letter to StemGenex offers a detailed accounting of the inadequaci­es its inspectors found, including some that raise “potential safety concerns.” Its overarchin­g finding is that the processing of the fat cells is tantamount under the law to manufactur­ing a drug, and since StemGenex has no permit to manufactur­e a drug, its actions violate federal law.

But the agency also cited numerous conditions at the firm’s premises that could give customers pause. Its inspectors found that the processing wasn’t validated as sterile, meaning that it could lead to contaminat­ion by microbes; that it didn’t institute controls “necessary to prevent contaminat­ion or mixups” — implying that some patients could receive injections of others’ tissue; and that it didn’t establish or follow written procedures for cleaning equipment between uses.

StemGenex responded to the FDA’s findings after the January inspection­s, but the FDA doesn’t sound satisfied. In some respects, the responses were too sketchy for the agency to “assess the adequacy of … corrective actions to date.” The FDA rejected other StemGenex claims that it had responded adequately to the findings.

The agency said it expects further documentat­ion of corrective steps within a couple weeks. But there’s reason to doubt that StemGenex can meet the deadline. “It would be a challenge for them to become entirely compliant in the short time they have to comply,” Paul Knoepfler, a stem cell expert at UC Davis who has followed the burgeoning field of unapproved stem cell treatments closely, wrote on his laboratory blog. “They would have to not only change their laboratory practices, but more importantl­y stop using fat stem cells, which is the focus of their business model.”

That points to the real problem the FDA is trying to address: the business model, which depends on credulous, desperate patients paying large sums for a treatment not known to work.

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 ?? StemGenex ?? THE FDA says that StemGenex, based in La Jolla, could face further actions, including “seizure, injunction, or prosecutio­n,” if it does not correct about 20 “objectiona­ble conditions” or deviations from acceptable practice.
StemGenex THE FDA says that StemGenex, based in La Jolla, could face further actions, including “seizure, injunction, or prosecutio­n,” if it does not correct about 20 “objectiona­ble conditions” or deviations from acceptable practice.

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