Expanding Horizons: A Journey Through Clinical Research with Dr. Arif Khan
Summary:
In this episode, we welcome Dr. Arif Khan from Northwest Clinical Research Center. Dr. Khan shares his background, from growing up in post-independent India to his interest in chemistry and medicine, which led him to the United States. He details his career trajectory, and how he and his wife decided to focus on clinical research. Dr. Khan explains the intricacies of drug development, including the rigorous testing and approval processes by the FDA. He also discusses the challenges and successes in recruiting patients for clinical trials, notably in pediatrics, due to evolving perceptions about medical research. Finally, Dr. Khan emphasizes the importance of humility in his profession.
Find out more about the work Northwest Clinical Research Center is doing: https://www.nwcrc.net/
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Transcript:
This transcript is computer generated, please excuse any typos
[00:00:32] Laura: Welcome. Today we have Dr. Arif Khan from Northwest Clinical Research Center with us, and welcome Dr. Khan.
[00:00:41] Dr. Khan: Thank you very much. Pleasure to be here.
[00:00:44] Laura: Well, we're gonna talk a little bit about marketing today, but first we wanna hear a little bit about your background and how Northwest Clinical Research kind of got started and how you got started.
[00:00:58] Dr. Khan: Okay, so [00:01:00] I was born in post independent India six years after Independence. So. Ancestral. Our family was all landlords, you know, agriculture , but my father had moved to big City, then Bangalore. And so he had degree in engineering and, he was involved in state government. So when I started schooling and, college, obviously my interest was chemistry.
And biology. So medicine was an obvious choice. So medicine at that time, the most of the physicians and medical schools.
We're not training research into research, partly because India had missed on the industrial revolution. , But I certainly was interested in looking at new ways and developing things and developing new ideas because when you serve a group of patients, you only serve a group of patients.
When you do teaching, you [00:02:00] multiply that factor of 10 to a hundred. But when you do research, you multiply in hundreds of thousands to millions. So that's what, you know what always that's interested me. And so when I finished my medical school I came to the us there was some in between but came to Connecticut, university of Connecticut.
Did my postgraduate work, what's called a residency here. Then I came as a faculty to University of Washington. Wow. 40 years ago, 41 years ago. Was there for about a decade, something, and then academics, you cannot completely focus on research. I know it sounds paradoxical, but the problem is you have administrative duties, you have teaching duties, you have all kinds of other things, you know?
So we decided, my wife and I, she is a psychiatric nurse that we'd [00:03:00] be pursuing more research career. So we started off in Kirkland in 1995 with one trial, with a medication called Effexor for,
[00:03:12] Laura: Ah.
[00:03:13] Dr. Khan: for a new indication. And then we kept on adding. So with the 30 years, you know, we have grown to have about a dozen physicians plus lots of master's level clinicians and all that.
So we do a lot of clinical trial research. We work with big companies like Johnson and Johnson, Pfizer, Eli Lilly, just to name a few. And so we are sort of independent contractors with them. And we work with them to help develop new medications. As of now, in the last 30 years, we've been involved in medication research, out of which about 48 medications have come into market.
[00:03:57] Laura: I guess A huge part and how [00:04:00] we came in to know you is by helping recruit, patients for clinical trials.
[00:04:06] Dr. Khan: That's where we come in. We do the field testing.
[00:04:09] Laura: Field
[00:04:10] Dr. Khan: So the field testing essentially is basically to make sure that this drug is not gonna harm people.
[00:04:16] Laura: Mm-hmm.
[00:04:17] Dr. Khan: Do no harm is the first principle in medicine. So that's what we follow. And that's what we do. We do a lot of testing. We do a lot of journal evaluation to see if any sort of medicine that you're looking at makes sense for the person.
[00:04:33] Laura: Mm-hmm.
[00:04:34] Dr. Khan: knowingly you're not going to expose somebody right, to understand the risk.
So you have establish that. That's what we call screening. That's why we recruit a lot of patients.
[00:04:46] Laura: right.
[00:04:47] Dr. Khan: Because we needed a lot of volunteers. And you know, it's important to say that in Seattle there's a lot of interest. The public is well educated, they understand medical research, they [00:05:00] volunteer, and altruism is one of the key things that drives them.
So once they do volunteer, we assess them. It may take a day, it may take a month to make sure that all the things are crossed. It depends on the indication. How long the trial is and whether it's x-rays and blood tests, all that. So then you look at basically, some people get the medication, some people get a controlled substance, either medicine that's controlled that's already used, or most of them, most of the ones we do are placebo or are drugs that look either the solutions, injections, pills, capsule, that look like the actual drug. Then you study the effects and then you measure. What the good and bad points. Okay. Then for, say for example, if you wanna get a new blood pressure medication, usually there are about five to 6,000 patients exposed to it. [00:06:00] Control group is about three to 5,000 and another, maybe three to 5,000 with the, the treatment existed, so it takes about, say, eight to 15,000 patients around the country.
[00:06:14] Laura: Now it's my understanding that you've had a great record of zero fatalities
[00:06:23] Dr. Khan: Yes.
[00:06:24] Laura: that's terrific. I mean, obviously. It is pretty vetted at this point, but people really have nothing to worry about because you have like this perfect record.
[00:06:33] Dr. Khan: Yes. By the time they come and we experiment and the things we have done in the last 30 years, we never had a fatality related to any drug. It just hasn't happened because the FDA, even though there's a lot of criticism as a federal agency, is extremely strict. And they monitor so closely. I mean, patients do die in trials like Alzheimer's disease.
[00:06:58] Laura: Mm-hmm.
[00:07:00] Well, yeah, that makes sense. I mean, natural causes
[00:07:02] Dr. Khan: Natural causes happen. People have accidents and die and that sort of thing. But something related to actual drug toxicity we, I haven't seen in 30 years.
[00:07:16] Laura: So question, from a marketing standpoint, what was the toughest trial to market, you think? Like to get people recruited in for what is the most difficult to find people for
[00:07:29] Dr. Khan: I mean that started of the easiest, easiest, are things like you know, high blood pressure, depression,
[00:07:36] Laura: weight loss?
[00:07:36] Dr. Khan: migraine headaches, weight loss is extremely popular. We have people that are just on waiting lists. We just don't have enough medicines or enough slots to do for weight loss drugs. But the most difficult part is that one of the difficult issues within the society itself, because most of the drugs that are approved for adults, most of the testing gets happens in adults.
[00:08:00] So the old. You know, trials that happened a while ago, the same medicines were given to children believing that they're small adults. But the problem is that they're not small adults. They metabolize very differently. So if you go back and look at your old Tylenol or aspirin, it said. There's no research on children, you know, below the eight something.
Talk to your pediatrician, but your pediatrician doesn't know. Yeah, he or she has never been told so in 97, the FDA passed a rule saying that all medicines that could be used for children that have approved for adults should have some testing done. So in the beginning, there was a lot of interest in it.
And we used to get, those are the hardest trials to recruit for, you know, adolescents or even eight year olds. But as time has gone by and there's been a sort of an anti-vaccine movement and anti research movement, [00:09:00] and certainly the social media has made it very difficult because they, I'm not saying that they're not horror stories, but that just sort of influences so.
Recruiting for these trials, which are very critical because you don't wanna give your kid the medicine that's never been tested. But if you don't volunteer, how can you know? You know what I mean? So it's just sort of a,
dilemma in our field,
[00:09:24] Laura: Yes. Right.
[00:09:25] Dr. Khan: how do you prescribe for children? So, in fact, a lot of the prescription children have gone down, certainly psychiatric medications and such things.
Simply because the pediatricians are just too nervous to prescribe.
[00:09:39] Laura: Can we talk at all Dr. Khan, about the trial that we're trying to do right now for autism, A DHD, like some of that stuff.
[00:09:48] Dr. Khan: Yeah, like I said, you know,
these are the, these are the medicines that are already in the market and that are being used, but not extensively in children and they should work, but there's not enough information. [00:10:00] So that's why we are looking at how to recruit patients, you know, certainly in the general media.
cause social media is not very effective in that. , So we have, you know, 30 years ago, 40 years ago, you put a small three line ad in Seattle Times or Seattle Pi. You got 30 or 40 patients signed up. And then it went to radio, then
TV for the last decade, I would say it's pretty much social media.
[00:10:30] Laura: Yep.
[00:10:31] Dr. Khan: And the social media. It's various forms, but certain conditions like pediatric studies, social media, there's so much negativity that it doesn't work as well.
[00:10:44] Laura: That makes sense. I, I mean, I get it. ' it's Become kind of political, which is unfortunate. And then so you get mixed up in that and they see it through that lens, right. Yeah, that makes sense. Yeah, I, I know 'cause we're, we're trying to talk to the parents , you gotta come at [00:11:00] it from places that are of trust of tr,
[00:11:02] Dr. Khan: Yes. But also the other problem is that in Washington state, if a school knows the problem that some one of the students is autistic
or has got a mood disorder, they cannot diagnose it or say, say, you should get this tested. You know why?
[00:11:21] Laura: Why?
[00:11:22] Dr. Khan: Because the school budget will have to pay for the management of treatment. they can say, go get a testing, don't make the diagnosis.
[00:11:29] Laura: just don't, yeah, that's a good point. Okay.
[00:11:32] Dr. Khan: So you can, that's why when you, whoever you're
talking about, they said, go get it tested. We don't know. So if they say that's why, in terms of according to the schools, school counselors is very difficult because once they sort of say, Hey, we think this is the problem, then the parents and all the advocates say the school budget should pay for it.
. So that's why we gotta go to, you know, for recruiting pediatric patients [00:12:00] and families or media, which is hopefully not too biased.
[00:12:03] Laura: Yeah, that is interesting. You can't go through the schools. So yeah, we are, we are faced with that challenge right now at Double Z, so we are helping you recruit right now. So
it's a challenge. It's a challenge, but we're up for it. Lisa, do you have the final question for
[00:12:20] Lisa: Yeah. So Dr. Kahn, if you could go back in time and give yourself, at the beginning of your career one piece of advice, what would it be?
[00:12:29] Dr. Khan: I think I told you last time, be humble, right?
[00:12:32] Lisa: Yes.
[00:12:33] Dr. Khan: Yeah. It's easy to get carried away. But yeah,
, I think it was John Kennedy who said, even us you have to put on pants one leg at a time.
[00:12:42] Laura: . Well, thank you so much Dr. Kahan. This has been great. And if you wanna reach Northwest Clinical Research, you,
[00:12:50] Lisa: Is N-W-C-R-C.
[00:12:52] Dr. Khan: Main one, NWCRC net. And the phone number is (425) [00:13:00] 453-0404.
[00:13:00] Laura: Awesome. Well, thank you so much. That'll also be in the show notes, so you'll see it there. Thank you so much, Dr. Kahan. We hope to talk to you soon.
[00:13:09] Dr. Khan: Thank you.
