«Dallas Buyers Club (2013)» clinical research with drugs for the AIDS epidemic 80

  • Marian de Haan-Bosch
    Universidad Pompeu Fabra ?[at]eusal.es
  • Josep?E Baños
    Universidad Pompeu Fabra
  • Álvaro Gómez?tomás
    Universidad Autónoma de Barcelona
  • Magí Farré
    Universidad Autónoma de Barcelona

Abstract

Dallas Buyers Club (2013), inspired by true events, tells the story of Ron Woodroof, a middle?aged elec? trician from Dallas (Texas), who is diagnosed with AIDS in 1985. With few treatment options, he estab? lishes the Dallas Buyers Club in order to provide unapproved drugs to the AIDS community. This results in constant business travels, disputes with the FDA and problems with the law and the IRS. The article analyzes the buyers’ clubs phenomenon in the US, the drugs cited in the film and the clinical trial with zidovudine shown in the movie. The film could be useful as a teaching tool providing an introduction to the AIDS epidemic, clinical research and drug development, bioethics of human research and the agen? cies that regulate drug approval and their availability. Finally, the article presents a possible guideline for the use of the film in a teaching environment.
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FARRÉ M, ARRIBAS S, Pérez J, BAÑOS J. El uso de películas comerciales para com? prender los principios bioéticos en la investigación clínica. Rev Med Cine [Internet]. Diciembre 2013 [Consultado el 2014 Jul 14]; 9:151?155. Disponible en: http://fundacion.usal.es/revistamedicina/nuevo/component/docman/doc_dow nload/doc_download

FARRÉ M, BOSCH F, ROSET PN, BAÑOS JE. Putting clinical pharmacology in context: the use of popular movies. J Clin Pharmacol. 2004; 44:30?36.

BAÑOS JE, BOSCH F, PÉREZ J et al. Al cruzar el límite/Extreme Measures: cine, prin? cipios bioéticos e investigación clínica. Rev Med Cine [Internet]. 2011 [Consultado el 2014 Jul 14]; 7:95?99. Disponible en: http://revistamedicinacine.usal.es/ index.php/es/vol7/num3/661

VENTURA S, Onsman A. The use of popular movies during lectures to aid teach? ing and learning of undergraduate pharmacology. Med Teacher. 2009; 31:662?64.

RON WOODROOF BIOGRAPHY. The Biography.com website [Internet]. 2014 [Consultado el 2014 Jul 18]. Disponible en: http://www.biography.com/people/ ron?woodroof?21329541

DOCKTERMAN E. The True Story of Dallas Buyers Club. Time [Internet]. 2013 Nov 8 [Consultado el 2014 Jul 18]. Disponible en: http://entertainment.time.com/ 2013/11/08/the?true?story?of?dallas?buyers?club

MINUTAGLIO B. The real legacy of the real Dallas Buyers Club is that it didn’t real? ly have one. The Guardian [Internet]. 2 de marzo de 2014 [Consultado el 2014 Jul 17]. Disponible en: http://www.theguardian.com/commentisfree/2014/mar/02/ real?dallas?buyers?club?matthew?mcconaughey?character

MULLARD A. Underground drug networks in the early days of AIDS. Lancet. 2014; 383:592. Disponible en: http://www.thelancet.com/journals/lancet/article/ PIIS0140?6736(14)60208?7/fulltext

MINUTAGLIO B. Buying Time, How Dallas got to be a center of the black market in unapproved AIDS drugs. Dallas Life Magazine [Internet]. 9 de agosto de 1992 [Consultado el 2014 Jul 15]. Disponible en: http://buyersclubdallas.com

TRILLO P. Los otros Dallas Buyers Club. El Mundo [Internet]. 23 de marzo de 2014 [Consultado el: 2014 Jul 21]. Disponible en: http://www.elmundo.es/inter? nacional/2014/03/22/532dcb90ca47417a278b457e.html

BRODER S. The development of antiretroviral therapy and its impact on the HIV? 1/AIDS pandemic. Antiviral Res. 2010; 85:1–18. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2815149

MITSUYA H, WEINHOLD KJ, FURMAN PA, St Clair MH, Nusinoff?Lehrman S, Gallo RC, et al. 3??azido?3??deoxythymidine (BW A509U): an antiviral agent that inhibits the infectivity and cytopathic effect of human T?lymphotropic virus type III/lym? phadenopathy?associated virus in vitro. Proc Natl Acad Sci USA. 1985; 82:7096–7100. Disponible en: http://www.pnas.org/content/82/20/7096.full.pdf

YARCHOAN R, KLECKER RW, WEINHOLD KJ, MARKHAM PD, LYERLY HK, DURACK DT, GELMANN E, et al. Administration of 3??azido?3?deoxythymidine, an inhibitor of HTLV?III/LAV replication, to patients with AIDS or AIDS?related complex. Lancet. 1986; 1:575–580.

FISCHL MA, RICHMAN DD, GRIECO MH, GOTTLIEB MS, VOLBERDING PA, LASKIN OL, et al. The efficacy of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS?related complex. A double?blind, placebo?controlled trial. N Engl J Med. 1987; 317:185–191.

FISCHL MA, PARKER CB, PETTINELLI C, WULFSOHN M, HIRSCH MS, COLLIER AC, et al. A Randomized Controlled Trial of a Reduced Daily Dose of Zidovudine in Patients with the Acquired Immunodeficiency Syndrome. N Engl J Med. 1990; 323:1009?1014. Disponible en: http://www.nejm.org/doi/full/10.1056/NEJM199010113231501

DOURNON E, MATHERON S, ROZENBAUM W, MICHON C, PERRONNE C, DE TRUCHIS P, et al. Effects of zidovudine in 365 consecutive patients with AIDS or AIDS?related complex. Lancet. 1998; 2:1297?1302.

PERT CB, HILL JM, RUFF MR, BERMAN RM, ROBEY GW, ARTHUR LO, et al. Octapeptides deduced from the neuropeptide receptor?like pattern of antigen T4 in brain potently inhibit human immunodeficiency virus receptor binding and T? cell infectivity. Proc Natl Acad Sci USA. 1986; 83:9254–9258. Disponible en: http://www.pnas.org/content/83/23/9254.long

POLIANOVA MT, RUSCETTI FW, PERT CB, TRACTENBERG RE, LEOUNG G, RUFF MR, et al. Antiviral and immunological benefits in HIV patients receiving intranasal peptide T (DAPTA). Peptides. 2003; 24:1093–1098.

KOECH DK, OBEL AO, MINOWADA J, HUTCHINSON VA, CUMMINS JM. Low dose oral alpha?interferon therapy for patients seropositive for human immunodeficiency virus type?1 (HIV?1). Mol Biother. 1990; 2:91?95.

KAISER G, JAEGER H, BIRKMANN J, POPPINGER J, CUMMINS JM, GALLMEIER WM. Low?dose oral natural human interferon?alpha in 29 patients with HIV?1 infection: a double?blind, randomized, placebo?controlled trial. AIDS. 1992; 6:563?569.

ROZENBAUM W, GHARAKHANIAN S, NAVARETTE MS, DE SAHB R, ROUZIOUX C. Long? term follow?up of 120 patients with AIDS?related Kaposi’s sarcoma treated with interferon alpha?2a. J Invest Dermatol. 1990; 95(6 Suppl):161S?165S.

AMERICAN Thoracic Society. Fungal infection in HIV?infected persons. Am J Respir Crit Care Med. 1995; 152:816?822.

SONNABEND JA. Review of AZT multicenter trial data [Internet]. 1987 Oct [Consultado el 2014 Jul 22] Disponible en: http://aidsperspective.net/ articles/AZT_TRIALA.pdf

WORLD MEDICAL ASSOCIATION. World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA. 2013; 310:2191?2194.

IOANNIDIS J. Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials?. Philos Ethics Humanit Med. 2008; 27;3:14. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2412901
FARRÉ M, ARRIBAS S, Pérez J, BAÑOS J. El uso de películas comerciales para com? prender los principios bioéticos en la investigación clínica. Rev Med Cine [Internet]. Diciembre 2013 [Consultado el 2014 Jul 14]; 9:151?155. Disponible en: http://fundacion.usal.es/revistamedicina/nuevo/component/docman/doc_dow nload/doc_download

FARRÉ M, BOSCH F, ROSET PN, BAÑOS JE. Putting clinical pharmacology in context: the use of popular movies. J Clin Pharmacol. 2004; 44:30?36.

BAÑOS JE, BOSCH F, PÉREZ J et al. Al cruzar el límite/Extreme Measures: cine, prin? cipios bioéticos e investigación clínica. Rev Med Cine [Internet]. 2011 [Consultado el 2014 Jul 14]; 7:95?99. Disponible en: http://revistamedicinacine.usal.es/ index.php/es/vol7/num3/661

VENTURA S, Onsman A. The use of popular movies during lectures to aid teach? ing and learning of undergraduate pharmacology. Med Teacher. 2009; 31:662?64.

RON WOODROOF BIOGRAPHY. The Biography.com website [Internet]. 2014 [Consultado el 2014 Jul 18]. Disponible en: http://www.biography.com/people/ ron?woodroof?21329541

DOCKTERMAN E. The True Story of Dallas Buyers Club. Time [Internet]. 2013 Nov 8 [Consultado el 2014 Jul 18]. Disponible en: http://entertainment.time.com/ 2013/11/08/the?true?story?of?dallas?buyers?club

MINUTAGLIO B. The real legacy of the real Dallas Buyers Club is that it didn’t real? ly have one. The Guardian [Internet]. 2 de marzo de 2014 [Consultado el 2014 Jul 17]. Disponible en: http://www.theguardian.com/commentisfree/2014/mar/02/ real?dallas?buyers?club?matthew?mcconaughey?character

MULLARD A. Underground drug networks in the early days of AIDS. Lancet. 2014; 383:592. Disponible en: http://www.thelancet.com/journals/lancet/article/ PIIS0140?6736(14)60208?7/fulltext

MINUTAGLIO B. Buying Time, How Dallas got to be a center of the black market in unapproved AIDS drugs. Dallas Life Magazine [Internet]. 9 de agosto de 1992 [Consultado el 2014 Jul 15]. Disponible en: http://buyersclubdallas.com

TRILLO P. Los otros Dallas Buyers Club. El Mundo [Internet]. 23 de marzo de 2014 [Consultado el: 2014 Jul 21]. Disponible en: http://www.elmundo.es/inter? nacional/2014/03/22/532dcb90ca47417a278b457e.html

BRODER S. The development of antiretroviral therapy and its impact on the HIV? 1/AIDS pandemic. Antiviral Res. 2010; 85:1–18. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2815149

MITSUYA H, WEINHOLD KJ, FURMAN PA, St Clair MH, Nusinoff?Lehrman S, Gallo RC, et al. 3??azido?3??deoxythymidine (BW A509U): an antiviral agent that inhibits the infectivity and cytopathic effect of human T?lymphotropic virus type III/lym? phadenopathy?associated virus in vitro. Proc Natl Acad Sci USA. 1985; 82:7096–7100. Disponible en: http://www.pnas.org/content/82/20/7096.full.pdf

YARCHOAN R, KLECKER RW, WEINHOLD KJ, MARKHAM PD, LYERLY HK, DURACK DT, GELMANN E, et al. Administration of 3??azido?3?deoxythymidine, an inhibitor of HTLV?III/LAV replication, to patients with AIDS or AIDS?related complex. Lancet. 1986; 1:575–580.

FISCHL MA, RICHMAN DD, GRIECO MH, GOTTLIEB MS, VOLBERDING PA, LASKIN OL, et al. The efficacy of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS?related complex. A double?blind, placebo?controlled trial. N Engl J Med. 1987; 317:185–191.

FISCHL MA, PARKER CB, PETTINELLI C, WULFSOHN M, HIRSCH MS, COLLIER AC, et al. A Randomized Controlled Trial of a Reduced Daily Dose of Zidovudine in Patients with the Acquired Immunodeficiency Syndrome. N Engl J Med. 1990; 323:1009?1014. Disponible en: http://www.nejm.org/doi/full/10.1056/NEJM199010113231501

DOURNON E, MATHERON S, ROZENBAUM W, MICHON C, PERRONNE C, DE TRUCHIS P, et al. Effects of zidovudine in 365 consecutive patients with AIDS or AIDS?related complex. Lancet. 1998; 2:1297?1302.

PERT CB, HILL JM, RUFF MR, BERMAN RM, ROBEY GW, ARTHUR LO, et al. Octapeptides deduced from the neuropeptide receptor?like pattern of antigen T4 in brain potently inhibit human immunodeficiency virus receptor binding and T? cell infectivity. Proc Natl Acad Sci USA. 1986; 83:9254–9258. Disponible en: http://www.pnas.org/content/83/23/9254.long

POLIANOVA MT, RUSCETTI FW, PERT CB, TRACTENBERG RE, LEOUNG G, RUFF MR, et al. Antiviral and immunological benefits in HIV patients receiving intranasal peptide T (DAPTA). Peptides. 2003; 24:1093–1098.

KOECH DK, OBEL AO, MINOWADA J, HUTCHINSON VA, CUMMINS JM. Low dose oral alpha?interferon therapy for patients seropositive for human immunodeficiency virus type?1 (HIV?1). Mol Biother. 1990; 2:91?95.

KAISER G, JAEGER H, BIRKMANN J, POPPINGER J, CUMMINS JM, GALLMEIER WM. Low?dose oral natural human interferon?alpha in 29 patients with HIV?1 infection: a double?blind, randomized, placebo?controlled trial. AIDS. 1992; 6:563?569.

ROZENBAUM W, GHARAKHANIAN S, NAVARETTE MS, DE SAHB R, ROUZIOUX C. Long? term follow?up of 120 patients with AIDS?related Kaposi’s sarcoma treated with interferon alpha?2a. J Invest Dermatol. 1990; 95(6 Suppl):161S?165S.

AMERICAN Thoracic Society. Fungal infection in HIV?infected persons. Am J Respir Crit Care Med. 1995; 152:816?822.

SONNABEND JA. Review of AZT multicenter trial data [Internet]. 1987 Oct [Consultado el 2014 Jul 22] Disponible en: http://aidsperspective.net/ articles/AZT_TRIALA.pdf

WORLD MEDICAL ASSOCIATION. World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA. 2013; 310:2191?2194.

IOANNIDIS J. Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials?. Philos Ethics Humanit Med. 2008; 27;3:14. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2412901
Haan-Bosch, M. de, Baños, J., Gómez?tomás, Álvaro, & Farré, M. (2015). «Dallas Buyers Club (2013)» clinical research with drugs for the AIDS epidemic 80. Journal of Medicine and Movies, 11(2), 73–81. Retrieved from https://revistas.usal.es/cinco/index.php/medicina_y_cine/article/view/13143

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Author Biographies

Marian de Haan-Bosch

,
Universidad Pompeu Fabra
Facultad de Ciencias de la Salud y de la Vida. Universidad Pompeu Fabra (España)

Josep?E Baños

,
Universidad Pompeu Fabra
Departamento de Ciencias Experimentales y de la Salud. Universitat Pompeu Fabra. Dr. Aiguader 88. 08003?Barcelona (España).

Álvaro Gómez?tomás

,
Universidad Autónoma de Barcelona
Facultad de Medicina. Universidad Autónoma de Barcelona (España)

Magí Farré

,
Universidad Autónoma de Barcelona
Farmacología Clínica. Universitat Autonòma de Barcelona y Hospital Universitario Germans Trias i Pujol. Carretera de Canyet s/n, 08916 Badalona (España).
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