It’s not a cure for ALS or cancer, but the pharmacists who just developed a “game-changer” treatment for frostbite deserve plenty of congratulations nonetheless.
On February 14th, the FDA approved Aurlumyn (iloprost) injection to treat severe frostbite in adults to reduce the risk of finger or toe amputation.
Frostbite can occur in several stages, and severe frostbite occurs when both the skin and underlying tissue are frozen and blood flow is stopped, sometimes requiring amputation. Iloprost, the active ingredient in Aurlumyn, is a vasodilator (a drug that opens blood vessels) and prevents blood from clotting.
“This approval provides patients with the first-ever treatment option for severe frostbite,” said Norman Stockbridge, M.D., Ph.D., director of the Division of Cardiology and Nephrology in the FDA’s Center for Drug Evaluation and Research. “Having this new option provides physicians with a tool that will help prevent the life-changing amputation of one’s frostbitten fingers or toes.”
Cold is often described as being like a “vice” or as having a “grip” in so small part because once a human’s hands or feet are frostbitten, it’s a bit like a hostage situation. One can’t simply immerse them in nice hot water, because if the ice crystals forming in the blood and tissues are warmed too fast, they will burst, causing intense pain, swelling, tissue damage, and internal bleeding.
However, warm blood from the body’s core can’t arrive at the frostbitten extremities due to the presence of frozen blood and tissue, and the only option is to slowly rewarm the frostbitten area with body heat, but even this may not be able to reverse the damage.
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“It’s a game-changer, in my opinion,” Dr. Peter Hackett, a professor of medicine at the University of Colorado Anschutz Medical Campus who specializes in high-altitude and wilderness medicine, told CNN. “It’s a major step forward in frostbite treatment in the United States.”
Existing clot-bursting medications come with high risks of causing internal hemorrhaging, and CNN reports them as being effective for only around 24 hours post-frostbite.
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Canada, Nepal, and Europe have been using iloprost to treat frostbite for years, as it is generally safe, and effective even 3 days after frostbite has set in.
A small clinical trial showed that no frostbitten participants required amputation compared to 60% in those receiving only other medications.
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