In the wake of a vicious nationwide fungal meningitis outbreak that has killed 24 and sickened at least 293 others, the U.S. Food & Drug Administration (FDA) has announced that it is investigating possible cases of the disease in patients who were administered another drug that was processed by the New England Compounding Center (NECC). Although the vast majority of the attention has been on the steroid pain reliever methylprednisolone acetate, a similar medication known as triamcinolone acetonide is now being suspected in at least one case of fungal meningitis linked to the outbreak. In response to these developments, NECC has recalled all medications it processes nationwide, and put its day-to-day operations on hiatus until the investigation into the source of the contamination can be completed.
Fungal Meningitis Update 1/30/13: This week, a federal judge ruled that assets of the company at the center of last year’s unprecedented fungal meningitis outbreak will be frozen indefinitely. An emergency injunction was placed on the New England Compounding Center (NECC) after the owners were accused of funneling more than $21 million out of the company’s assets before filing for bankruptcy in December.
What’s the problem?
On October 15, 2012, the FDA issued a warning about triamcinolone acetonide manufactured at NECC’s processing plant in Framingham, Mass. The administration said it was investigating a report of fungal meningitis in a patient who was administered an epidural injection for back pain with the drug. This marks the first meningitis case associated with the outbreak not to be linked to methylprednisolone acetate.
Triamcinolone acetonide is a corticosteroid hormone used to treat a variety of conditions including allergic disorders, arthritis, blood diseases, breathing problems, certain types of cancer, eye diseases, intestinal disorders, collagen and skin disease. The drug is designed to work by decreasing the body’s immune response to these conditions, thereby reducing accompanying symptoms. Triamcinolone acetonide is administered by a doctor intravenously into different locations such as a muscle (intramuscularly), a skin lesion (intradermally), or a joint (intra-articularly).
In addition to the investigation into triamcinolone acetonide, the FDA is also now checking reports of fungal infection in a heart transplant patient who was treated with a cardiac solution that was processed by NECC. According to the administration, the solution is used to paralyze the heart muscle to prevent coronary injury during an operation. The investigation into whether the solution was contaminated is ongoing, and the FDA will report more information as it becomes available.
The administration has advised healthcare professionals to follow up with all patients who were given an injectable medication that was produced by NECC. These drugs include methylprednisolone acetate, triamcinolone acetonide, as well as the heart solution and medications used in eye surgery. All drugs distributed by the company after May 21 have been recalled nationwide.