Diabetes is an enormous social and economic problem in Sri Lanka

Heberprot-P offers hope to patients with diabetic foot ulcers

by Suresh Perera

Diabetes is a huge social and economic problem in Sri Lanka as the debilitating disease could lead to foot ulcers resulting in amputation, leaving whole families devastated when the breadwinner is rendered immobile, Dr. Rezni Cassim, Specialist in Angiology and Vascular Surgery, cautioned last week.

He said that 10% of Sri Lankans suffering from diabetes risk developing foot ulcers and could end up losing a leg. "It all starts with a small ulcer and 66% of patients of amputation, either below or above the knee, won’t live for five years",

The eminent medical specialist was speaking at the launch of Heberprot-P, an innovative injectable drug in the treatment and cure of advanced diabetic foot ulcers, at the Ramada Hotel in Colombo.

This specialized Cuban product has broken new ground in Sri Lanka in the sphere of therapeutic care for the most complicated and recalcitrant chronic wounds usually associated with high amputation risk.

"As a Vascular Surgeon, I have seen a lot of foot ulcers. I am neither a part of the Cuban company which manufactures this drug nor the importer in Sri Lanka. My task is to alleviate the misery by healing foot ulcers of diabetic patients", Dr. Cassim noted.

There are 40,000 new diabetic foot ulcers at any given time and 100,000 diabetics have foot ulcers in Sri Lanka, the medical specialist said, quoting estimates from global statistics.

"There are so many techniques to treat foot ulcers and in Sri Lanka, we do have an amputation rate. During a visit to Cuba, we learnt that the amputation rate can be reduced if we add a new tool. This hopeful tool Heberprot-P will help diabetic patients to lead a healthy life", he explained.

Sir Michael Hirst, President, International Diabetes Federation (IDF), said the National Institute of Genetic Engineering and Biotechnology in Cuba has played a pivotal role in the treatment of diabetic foot ulcers.

"Diabetes is a dreadful disease with many complications. As neuropathy causes numbness in their feet, they risk foot injury, which becomes recalcitrant and gangrenous resulting in amputation. With mobility disrupted, the patient is unable to earn and provide for his family. Then, the cycle of poverty sets in", he elaborated.

"In many cases of foot ulcers I saw in my country and most other countries resulted in amputation. In Cuba, it had been possible to save more than 70% amputations, thanks to Heberprot-P, which cures the wound for follow-up skin graft", Sir Michael said. "At IDF, we welcome any therapy which advances the cause of diabetic patients".

Florentino Batista, Ambassador for Cuba in Sri Lanka, said that this new product could help save the lives of many Sri Lanka afflicted with diabetes now and in the future.

Cuba’s biotech industry is second to one. It is highly developed, the envoy noted. "I am happy that we were able to put together this effort for the wellbeing of the people of Sri Lanka".

Dr. Sergio Perez representing Heber-Biotec S. A., Cuba, said the Biotechnology industry was started in Cuba by former President Fidel Castro as a way to push the country towards development. People worked hard to achieve impressive results.

Dr. Pedro Cesar Goicoechea Diaz, MSC Specialist in Angiology and Vascular Surgery, Cuba, said the results of 15 clinical trials done in Sri Lanka proved the efficacy of Heberprot-P. "The use of this drug can prevent 75% - 80% of amputations. We are doing this not as a business, but as a social responsibility".

He said that he teamed up with the College of Surgeons, Prof. Mandika Wijeratne, Dr. Cassim and Dr. Diaz to conduct the clinical trials at the Colombo National Hospital. "Unlike heart attacks and cancer, the grave issue of diabetic foot ulcers has not received much media attention".

Q: How many patients around the world have been treated with this drug?

Dr. Sergio Perez: Around 150,000. Sri Lanka is the first country to launch this product in South Asia. Omacx Healthcare will also cover the Indian market. We have 150 other diverse products.

Nuwan Fonseka: As the agent here, we can distribute to the whole of South East Asia. In Sri Lanka, the product will be channeled to government hospitals at a concessionary price through the MSD (Medical Supplies Division). Private hospitals can also purchase it for their patients. Rs. 15 million was spent on clinical trials.

Dr. Cassim: It’s a course of injections ranging from 10 over three to four weeks and a maximum of 24.

Q: Is there the possibility of a foot ulcer recurring after treatment?

Dr. Diaz: Statistics show that when a patient is treated with this injectable medicine, the ulcer heals and the frequency also diminishes. Asked whether there are any adverse effects, he replied, "Any medication has adverse effects.

There is pain as the drug is injected into the ulcer, and there is shivering, but it’s not significant. The drug accelerates the process of healing and depending on the severity of the wound, age of the patient and related conditions it could take anything between 45-60 days.

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