Although it hardly seemed possible when Nature Medicine reported the story last year (Nature Med. 4, 1095; 1999) the battle between Nancy Olivieri, a senior scientist at the Hospital for Sick Children, Toronto, and the Canadian pharmaceutical company Apotex, has intensified. The reason—the drug at the center of the fight, Deferiprone, was approved in Europe this August and is now headed for Olivieri's backyard, Canada.

Deferiprone is a drug for the treatment of the blood disorder thalassemia. Thalassemia patients require transfusions every 2–4 weeks, which cause an accumulation of iron in the body. Unless they are treated with an iron chelator, they develop iron-induced toxicity and die, typically in their late 20s. The only chelating drug now available, Desferal, must be given by infusion-injection five nights a week for 8–12 hours. Thus, Deferiprone, has the considerable advantage that it can be given orally.

However, in 1997, Olivieri published findings that the drug causes severe liver toxicity and is ineffective. She is supported in this belief, which has now turned into a campaign, by David Nathan, president of the Dana-Farber Cancer Institute, and Sir David Weatherall, Regious Professor of Medicine at the University of Oxford—both experts on thalassemia. "The leading thalassemia experts in the United States have cautioned on the use of the drug," says Nathan.

But according to Eli Betito, director of public affairs at Apotex, Olivieri's claims have "no scientific basis." Betito told Nature Medicine that "one hundred and fifty physicians are using the drug in Italy with no evidence of toxicity." And Apotex' vice president, Michael Spino, counters that both Nathan and Weatherall are personal friends of Olivieri and have no experience with Deferiprone. "Weatherall and I probably have more experience of thalassemia treatment with iron chelators than anyone in the world," replies Nathan. "I have used [Deferiprone] only once and it was incredibly toxic."

In short, Apotex accuse Olivieri of turning the national media against the company to rally support for her cause. "She is trying to glorify her own image [with this]," says Betito. Meanwhile, Olivieri supporter and a senior investigator at the hospital, John Dick, says that Apotex has run a campaign geared at damaging Olivieri's reputation as a scientist from the start.

The drug is now being evaluated with regulatory body Health Canada, and Apotex is hoping for a decision on approval within the next three months.