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Suramin: the sleeping sickness drug tested in autism

by on 2017/06/23

There has been considerable media interest in a study that examined the impact of an African sleeping sickness drug, suramin, on children with autism spectrum disorder (ASD). Some media reports take a very hopeful view of the drug and its ability to treat children with autism with headlines evident such as ‘New autism drug shows promising results’ and ‘Century-old drug, suramin may provide hope for autistic kids’.  Headlines such as these merit a closer look at the research behind them and what this means for those with autism.

What did the researchers do?

The study, published in the Journal the Annals of Clinical and Translational Neurology, was conducted by a group of researchers based at San Diego School of Medicine. The researchers gave 5 children aged 5-14 with ASD a single dose of suramin while 5 children matched on age and gender received a placebo (a saline injection). The researchers reported improvements in autism scores using a well validated autism measure (the ADOS-II), and also in other measures of language and social interaction in the group who had received the suramin but not the placebo group.  The group who had received suramin also showed reduced repetitive movements known to be a feature of autism.  At face value, this finding suggests that the drug may be useful in treating some of the key difficulties faced by children with autism.

What limits the findings?  

The children who had received the suramin showed a side effect relating to the drug in the form of a skin rash which was not observed in the placebo group. This means that the study can’t really claim to be blind to the treatment type received by the children. A visible rash may have made the parents making the ratings aware of the treatment condition the child had been assigned to, and could have potentially biased the results. The study was also conducted in a very small sample of children across a wide age range.  The researchers note these limitations in their discussion of their results.

How did the media handle reporting of this study?

In general the media focused on the potential of this drug for treating autism with much less focus on the limitations that require future research to resolve. For example, one health website described 2 children who had received suramin as having spoken for the very first time – one of whom was one of the oldest in the study aged 14 years.  Within that particular reporting there was no mention of the rash that may have unconsciously influenced parents ratings or the total sample of the study. Findings like this are naturally of high interest to parents with children with ASD but it is important also that the strength of the evidence can be assessed.  Reporting on studies with such a small sample size and confounds (other possible explanations of the findings such as the rash) should always describe these aspects to the study and how they may have limited the interpretation of the results.  It is also imperative that reporting on small scale research of this kind refers to the need for future larger scale research. In this case further research is needed to appropriately address whether the drug may be useful in treatment of the condition.

Other media outlets such as the Independent, sought the opinion of relevant experts, for example a representative from the National Autistic Society.   This is a practice we at Research the Headlines have repeatedly emphasised in helping the public receive a balanced view of the findings of research that may affect them. To their credit, the Independent included a reference to the need for future research within their actual headline ‘Autism experts call for future research into 100-year-old drug that could hold key to treating condition’. As we have previously spoken about; no study stands alone.  This is particularly important in understanding the results of a study that has been conducted with a very small sample. The lead researcher, Robert Naviaux, has been reported in the media to be conducting a larger trial. These findings, and those from other independent groups, will be of interest to families and those working in the area in order to be able to identify if there are any positive effects of this drug for those with autism.

 

 

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