By Sabine Vollmer
The News & Observer (Raleigh, North Carolina)
Copyright 2006 The News and Observer

More than 20,000 fires in private homes create a risk of cyanide poisoning every year, but emergency medical workers have no antidote that they can carry on ambulances.

A Durham drug development company is hoping to change that.

EMD Pharmaceuticals, the U.S. affiliate of German drug maker Merck KGaA, has asked for regulatory approval of Cyanokit, an intravenous treatment that has been shown to neutralize cyanide in the blood. If regulators say yes, the kit could become available in the U.S. in six months.

"It would be lovely to know that emergency medical personnel in ambulances and hospitals stock the kit," said Nancy Wysenski, EMD's president.

But it's not clear how much demand there will be for Cyanokit.

When the treatment became available in France 10 years ago, "it was quite a revolutionary and innovative step," Wysenski said. Since then, awareness in the medical community has increased about the risk of cyanide poisoning, she said. She declined to give sales projections for Cyanokit and said she did not know revenue from sales in France.

In Wake County, cyanide levels are not routinely checked after house fires, said Wake EMS spokesman Jeff Hammerstein. If regulators approve Cyanokit, local emergency responders would probably consider stocking it, he said. But a better risk assessment is needed first.

Cyanide, a colorless and odorless gas, can be produced when bedding, wood or paper catch fire but don't burn completely. The antidote in the kit is hydroxocobalamin, a chemical that binds with cyanide to form cyanocobalamin, a naturally occurring vitamin. The body can then excrete the vitamin in urine.

EMD tested Cyanokit on more than 120 healthy volunteers who did not suffer from cyanide poisoning, Wysenski said. Side effects included soreness at the infusion site and brief skin reddening. The safety data are part of the regulatory filing, she said.

It's the first drug EMD has asked regulators to approve since starting operations in Durham seven years ago. EMD employs about 100 in Durham, where it oversees research and development nationwide. The company is best known for its pipeline of experimental oncology and diabetes drugs; the most advanced is in late-stage testing.