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SAN DIEGO (AP) — Dust off your Captain Marvel cosplay, San Diego Comic-Con is here.The four-and-a-half day convention kicks off Wednesday when the show room floor opens to thousands vying for exclusive merchandise, from art to toys. Later, Warner Bros. will get things going with a ScareDiego event promising some hair-raising new footage from "It: Chapter Two.""We have some exciting footage but I can't go into details," said "It" director Andy Muschietti. "But I think it's going to be worth it for the fans to go and watch."Movie fans will also get a look at Paramount's "Terminator: Dark Fate" at a Hall H presentation Thursday, and on Saturday be treated to a Marvel Studios presentation with its president, Kevin Feige. Details for the Marvel show are being kept under wraps, but many expect Feige and his "special guests" will outline the plans for Phase 4 of the Marvel Cinematic Universe, which could include announcements about "Black Widow," ''Guardians of the Galaxy Vol. 3," ''Shang-Chi" and "The Eternals."The movie fare is lighter than usual, however. A few of the studios have chosen to sit this year out, like Sony, which is already cleaning up at the box office with "Spider-Man: Far From Home," and Universal Pictures, which doesn't have any superheroes on its slate at all. Although Warner Bros. is coming with "It: Chapter Two," it does not have a big Hall H presentation planned for any of its DC properties like "Joker" and the Harley Quinn spinoff "Birds of Prey." And there will be no "Star Wars" news either."If anything, the exiting of some movie studios has made more room for TV and TV is just the best of the best right now," said Perri Nemiroff, a senior producer for Collider.com and host of the YouTube series Movie Talk.Television enthusiasts will have their pick, whether they want one last go-around the cast of a show that's ended (like "Game of Thrones" and "Supernatural"), to check in with some old favorites ("The Walking Dead," ''The Good Place," ''Westworld," ''Arrow," ''Rick and Morty" and "Riverdale"), or get first look at a new property (such as "Snowpiercer," ''Star Trek: Picard" and "The Witcher").Occasionally this means throwing a Comic-Con newbie into the mix. HBO is bringing Lin-Manuel Miranda out for his first ever convention to promote the new show "His Dark Materials."Last month Miranda tweeted a modest request for fans: "Be gentle, it's my first Comic-Con." 2429
SALT LAKE CITY, Utah - Misinformation comes in many forms, but some can be harder to spot than others.Whether it's sharing a video clip or picture that doesn't tell the whole story, re-posting an article from a non-credible source, or commenting on a social media thread without reading the original post, chances are, most of us have been guilty of doing this at some point.Now, social media companies and the FBI are taking steps to prevent the spread of misinformation like this, especially when it comes to subjects like elections and COVID-19."We established a relationship with social media companies and other technology companies and maintain an open channel and ongoing dialogue with them to share threat information," said Casey Harrington, a supervisory special agent at the FBI's Salt Lake City Division.Here are a few tools that social media sites are making available to help you identify and prevent the spread of misinformation.Twitter is testing a prompt that comes up when you try to retweet an article that you haven't opened before.It will ask you if you would like to open it first.So far, they say they've found that people open articles 40 percent more often after seeing the prompt, and some people have chosen not to share it after opening the article."Make sure you’re getting your news from trustworthy sources, know the origin of your information, and seek out multiple sources so you’re making an informed judgment," said Harrington.Facebook is also doing its part by:Limiting the number of times you can forward a messageTelling you how old an article isSharing where the information is coming fromProviding links to trusted sources when information reviewed by fact-checkers is is found to be falseInstagram, which is now owned by Facebook, will also flag false information and provide an explanation as to why it's not accurate."They ultimately make the decision on the content and the users on their site," Harrington said. "I think the social media companies have recognized, based on past election cycles, what our adversaries and what cybercriminals are able to do, and have taken steps to try to counter that."The difficult thing about false information is it's hard to prosecute criminally."Fake news by itself is not illegal. The FBI cannot initiate an investigation based solely on speech protected by the first amendment. If a foreign adversary or if someone tied in with a foreign intelligence service is the one creating and pushing that information, that is something that we would take action on," said Harrington.So what can you do to prevent the spread of misinformation?Ask yourself these questions before posting or sharing something on social media:Has the story been reported somewhere else?Is it from a reliable source?Has the video or photo been taken out of context?If you're not sure, then there's a chance it's fake and it could do more harm than good if you share it.If you come across something that you think is false information, you can report it to the social media platform you found it on, which stops it from spreading further.This story was first reported by Jordan Hogan at KSTU in Salt Lake City, Utah. 3178

SAN DIEGO (AP) — It was called the "The Sewing Circle," an unlikely name for a secret subsect of Navy SEALs. Its purpose was even more improbable: A chat forum to discuss alleged war crimes they said their chief, a decorated sniper and medic, committed on a recent tour of duty in Iraq.The WhatsApp group would eventually lead to formal allegations that Special Operations Chief Edward Gallagher fatally stabbed a wounded Islamic State captive in his care and shot civilians in Iraq in 2017.Gallagher, 40, has pleaded not guilty to the charges.A jury of mostly combat Marines will ultimately decide the fate of the 19-year-veteran and Bronze Star recipient charged with murder, attempted murder and conduct prejudicial to good order and discipline for posing with the corpse for photographs.No matter the outcome, the court-martial at Naval Base San Diego has provided a rare view into the insular Navy SEAL community and likely will have a long-term impact on one of the military's most secretive and revered forces. It has pitted veterans against each other both inside the courtroom and out in a fierce debate over brotherhood, morality and loyalty."SEALs, it seems to me, have been seeing themselves as God-like on the battlefield, and there is a real danger in taking that view of one's unit or one's self," said Gary Solis, a former military judge and Marine Corps prosecutor who teaches law at Georgetown. "I think this will alert the SEAL community that the rules apply to them."The case has laid bare challenges among U.S. special forces as the United States increasingly relies on such troops, which make up only 2% of the military yet carry out most of its battles around the globe.A number of special forces members are on trial this year. A U.S. Navy SEAL last month pleaded guilty to hazing and assault charges for his role in the 2017 strangulation of a U.S. Army Green Beret in Africa.The scandals have prompted a review by the Navy's top commanders into the behavior of the special warfare teams. During Gallagher's trial, it was revealed that nearly all his platoon members readily posed for photos with the dead militant and watched as Gallagher read his reenlistment oath near the body in an impromptu ceremony.Lt. Jacob Portier, the officer in charge, has been charged separately for overseeing the ceremony and not reporting the alleged stabbing.The trial also has shown the struggles of military courts in prosecuting alleged war crimes. The lead prosecutor was removed after allegedly tracking the defense team's emails to find a news leak, and the lead investigator acknowledged on the stand making mistakes.Closing arguments are expected Monday. A jury of five Marines and two sailors, one a SEAL, will weigh whether Gallagher, on his eighth deployment, went off the rails and fatally stabbed the war prisoner as a kind of trophy kill, or if the boy died from wounds sustained in an airstrike and Gallagher is being falsely accused by junior SEALs trying to permanently oust a platoon chief they hate.Nearly a dozen SEALs have testified over the past two weeks. Most were granted immunity to protect them from being prosecuted for acts they described on the stand.Seven SEALs said Gallagher unexpectedly stabbed the prisoner on May 3, 2017, moments after he and the other medics treated the 17-year-old boy.Two SEALs testified they saw Gallagher plunge his knife into his neck, including Special Operator Corey Scott, who stunned the court when he said he was the one who ultimately killed the teen by plugging his breathing tube with his thumb as an act of mercy. The Navy has said it's considering perjury charges against Scott.An Iraqi general who handed the wounded prisoner to the SEALs testified that Gallagher did not stab the boy. And Marine Staff Sgt. Giorgio Kirylo said after the militant died that he moved the body to take a "cool guy trophy" photo with it and saw no stab wounds on his neck.Gallagher also took photos of himself with the corpse. In one picture, he's holding up his knife in one hand and holding the militant by his hair with his other hand. He later boasted in a text, "got him with my hunting knife." Defense lawyers say it was just a warrior's attempt at dark humor."The Sewing Circle," the WhatsApp group chat, formed with a select few members of Alpha platoon after they returned to San Diego from their deployment in 2017.In the thread, Gallagher was referred to as "El Diablo," Spanish for "the devil.""Not sure how to handle him," Scott texted. "But he is ready to fight and kill."Gallagher's lawyers say the group chat was used to orchestrate a smear campaign to bring down their demanding platoon chief. A SEAL troop commander told the court that the allegations, which he took no action on for months, were suspect because they came about as Gallagher was being considered for a Silver Star and a promotion. Platoon members testified that the team was fractured, and the running joke was that if something was missing from a care package, Eddie took it.But his accusers said it went beyond the theft of sunglasses and snacks. "The Sewing Circle" members tried to distinguish themselves as the "True Brotherhood" vs. the "Real Brotherhood," which supporters of Gallagher have coined for themselves."The Real Brotherhood is people who are OK with war crimes," said Dylan Dille, a former SEAL sniper from the platoon who testified that Gallagher took shots at civilians from the sniper tower, hitting an old man and young girl. He did not see him pull the trigger either time.Defense attorney Timothy Parlatore shot back that maybe the Real Brotherhood "are older guys who don't like you and other SEALs who tell lies."Special Operations Chief Craig Miller, who was also part of "The Sewing Circle," testified that he saw Gallagher stab the captive multiple times with a custom-made knife Gallagher would carry in the belt loops of his pants. Miller said he told the platoon's officer in charge about the stabbing during their tour but that nothing happened.SEAL sniper Dalton Tolbert told the court he did not recall who started the chat group but that the intent was to talk with others who were disturbed by what they saw on the deployment and decide what to do."I shot more warning shots to save civilians from Eddie than I ever did at ISIS. I see an issue with that," Tolbert texted others.After plans were discussed about going to the commodore, an investigation was opened and Gallagher was arrested.Weeks before the trial, Tolbert, who was accepted to the famed SEAL Team 6 that killed Osama bin Laden, sent a text urging his teammates to speak up no matter what was at stake.He told the court his dream of doing covert operations with Team 6 is likely over now that he's been publicly identified in the case. 6790
SAN DIEGO (AP) — As thousands of migrants in a caravan of Central American asylum-seekers converge on the doorstep of the United States, what they won't find are armed American soldiers standing guard.Instead, they will see cranes installing towering panels of metal bars and troops wrapping concertina wire around barriers while military helicopters fly overhead, carrying border patrol agents to and from locations along the U.S.-Mexico border.That's because U.S. military troops are prohibited from carrying out law enforcement duties.RELATED: Migrant caravan groups arrive by hundreds at US borderWhat's more, the bulk of the troops are in Texas — hundreds of miles away from the caravan that started arriving this week in Tijuana on Mexico's border with California after walking and hitching rides for the past month.Still, for many migrants, the barriers and barbed wire were an imposing show of force.Angel Ulloa stood on Tijuana's beach where a wall of metal bars more than 20 feet high cut across the sand and plunged into the Pacific. He watched as crews on the U.S. side placed coils of barbed wire on top.A border patrol agent wearing camouflage and armed with an assault rifle — part of a tactical unit deployed when there is a heightened threat — walked in the sand below where the men worked. A small border patrol boat hovered offshore.RELATED: CBP commissioner nearly clobbered with rock at while touring Friendship Park border"It's too much security to confront humble people who just want to work," said Ulloa, a 23-year-old electrician from Choloma, Honduras, who joined the caravan to try to make his first trip to the U.S.Now, he and his two friends were rethinking their plans. They tried to apply for a job at a Wal-Mart in Tijuana but were told they need a Mexican work permit. So they were considering seeking asylum in Mexico but were unsure of giving up their dream of earning dollars."We're still checking things out," he said.On Friday, people walking through one of the world's busiest border crossings into Mexico passed by a pair of Marines on a 20-foot lift installing razor wire above a turnstile.RELATED: Photos: Aerials of U.S.-Mexico border fenceNearby Army Sgt. Eric Zeigler stood guard with another soldier. Both were military police officers assigned to protecting the Marines as they work.The 24-year-old soldier from Pittsburgh spent nine months in Afghanistan. "It's very different over there, obviously. It's a lot more dangerous," Zeigler said.He said he was surprised when got his deployment orders sending him to the U.S.-Mexico border."But I'm happy to go where I'm needed" he added as a man walked by carrying shopping bags headed to Tijuana.The U.S. military has deployed 5,800 active-duty troops to the U.S.-Mexico border.RELATED: Video?shows people climbing on top of border fence near Friendship ParkSo far, more are not expected, despite President Donald Trump's initial assessment that 10,000 to 15,000 were needed to secure the border against what he has called an "invasion" of migrants. Most in the caravan of several thousand are families, including hundreds of children.Another 2,100 National Guard troops are have also been deployed since April as part of a separate mission. Like the military troops, they are not allowed to detain illegal crossers. Instead, they have been monitoring cameras and helping to erect barriers.Of the 5,800 soldiers and Marines, more than 2,800 are in Texas, while about 1,500 are in Arizona and another 1,300 are in California. All U.S. military branches, except the Coast Guard, are barred from performing law enforcement duties.That means there will be no visible show of armed troops, said Army Maj. Scott McCullough, adding that the mission is to provide support to Customs and Border Protection."Soldiers putting up wire on the border and barriers at the ports of entry will be the most visible," he said.Marines and soldiers share the same duties in California and Arizona. These include erecting tents, setting up showers and arranging meals for troops working on the border, and assigning military police to protect them.There are no tents or camps being set up to house migrants, McCullough said. Medics are on hand to treat troops and border patrol agents — not migrants — for cuts, bruises and any other problems.Combat engineers — whose duties on the battlefield include setting up tactical obstacles to prevent the enemy from moving freely — are using their expertise to string wire on border walls and erect temporary fencing, McCullough said.Construction engineers have been assigned to weld together barriers and move shipping containers to act as walls.In Laredo, Texas, about 100 soldiers have been installing three layers of razor wire along the Rio Grande, working on the banks during the day and on the bridges at night to minimize the disruption to cross-border traffic.The current mission is scheduled to end Dec. 15 for now. It's unclear how much it will cost and military leaders have refused to provide an estimate.Critics have questioned the wisdom of using the military on the border where there is no discernible security threat. Since the Nov. 6 elections, Trump has said little about the matter and no border threat has materialized.Some border communities fear the barricades will scare off Mexican shoppers. The city council in Nogales, Arizona, slashed a proposed bonus for all employees in half over concerns about how the military's presence would affect its sales tax revenue after the military closed off two lanes at its border crossing.Defense Secretary Jim Mattis defended the deployment during a visit to the Texas border this week, asserting that in some ways it provides good training for war.Suyapa Reyes, 35, said she was puzzled as to why she would be seen as a threat. Reyes, her mother, 12-year-old daughter and 16-year-old son left Honduras with the caravan on Oct. 13, fleeing violence and poverty in her hometown of Olanchito de Oro.She does not want to return after coming such a long way but if she cannot get asylum and the border looks too dangerous to cross, she said she'll have no other choice."I'm not going to risk my life or safety nor that of my children," she said. 6241
SAN DIEGO (CNN) - Two years ago, Brendan Tyne pleaded with the Food and Drug Administration to approve a drug that he was hopeful could finally bring his mother some peace.She could no longer move without assistance and had fallen victim to the debilitating and frightening psychosis that haunts many people with Parkinson's disease."She thinks there are people in the house and animals are trying to get her," he told an FDA advisory committee.He believed that a new medication called Nuplazid, made by San Diego-based Acadia Pharmaceuticals, was the answer.Nuplazid's review was being expedited because it had been designated a "breakthrough therapy" -- meaning that it demonstrated "substantial improvement" in patients with serious or life-threatening diseases compared to treatments already on the market. Congress created this designation in 2012 in an effort to speed up the FDA's approval process, which has long been criticized for being too slow. Around 200 drugs have been granted this designation since its creation.Still, to recommend approval, the advisory committee would have to find that the drug's potential benefits outweighed its risks for its intended patients.Some FDA officials concluded that Nuplazid's public health benefit was enough to merit approval of the drug. Their argument echoed the pleas of family members and caregivers like Tyne: It could possibly help patients with no other alternative. Several of the people who spoke said their loved ones had been transformed during the clinical trials, though some said there was no way for them to know whether they were on Nuplazid or a placebo.But the physician who led the FDA's medical review, Dr. Paul Andreason, warned that patients taking the drug during the company's clinical trials experienced serious outcomes, including death, at more than double the rate of those taking the placebo. The company's limited testing, he said, had not convinced him that the benefits outweighed the risks.While Tyne had heard about these risks, he said he "discounted death as a real statistical possibility" and was willing to try anything to help his mother."I have two young children who love their grandmother," he told the committee. "If nothing is done to bring her back to some semblance of normalcy, my children will never remember their grandmother for who she is: a loving, funny, caring woman who has improved the lives of all of the loved ones who surround her. Please, I beg you, do not deprive my children and their grandmother of experiencing that love."The committee voted 12-2 and recommended that the FDA approve Nuplazid for the treatment of Parkinson's disease psychosis based on a six-week study of about 200 patients. Three previous studies of the drug did not show that it was effective, Andreason said in his medical review, though they showed similar risk.Even some committee members who voted in favor of the drug expressed reservations, according to the hearing transcript. "I guess I'm hoping that the risks are going to be small, and I think the benefits for some of these people who are very sick and whose families are affected by this, I think they're probably willing to take that risk," one physician stated. Another committee member said she wouldn't have voted for the drug's approval if there had been a safe and effective alternative on the market. A third made a "plea" to the FDA to "consider a large observational study so we can ensure that, once it goes into real-world use, that the benefits will outweigh the risks."It hit the market in June 2016. As caregivers and family members rushed to get their loved ones on it, sales climbed to roughly 5 million in 2017.Tyne got his mother on the drug as soon as it became available. But after trying it for months, he says he was devastated to see that it was doing nothing to halt the awful progression of the disease, and her hallucinations became more frequent and harder to manage. "She has gone straight downhill to the point she really can't function at all," he said.Shortly after the drug's release, patients' family members, doctors and other health care professionals started reporting "adverse events" possibly linked to the medication -- including deaths, life-threatening incidents, falls, insomnia, nausea and fatigue. In more than 1,000 reports, patients continued to experience hallucinations while on Nuplazid.Creatures like cats and snakes can haunt patients with Parkinson's disease psychosis, as shown in Acadia's TV commercial.In November, an analysis released by a nonprofit health care organization, the Institute for Safe Medication Practices, warned that 244 deaths had been reported to the FDA between the drug's launch and March 2017. The organization also noted that hundreds of reports suggested the drug was "not providing the expected benefit" or potentially worsening the condition.Tracked by the FDA, these so-called "adverse event reports" document deaths, side effects and other issues, and can be made directly by consumers, caregivers and other medical professionals. Reports are submitted to either the FDA or to the drugmaker, which is required to pass along any it receives to the federal government. In some cases, the person filing the report is convinced the side effects were caused by the drug; in others, the reporter ascribes no cause but notes that the patient was on the drug.An adverse event report does not mean that a suspected medication has been ruled the cause of harm and is typically not the result of an official investigation. But the FDA uses the information to monitor potential issues with a drug and can take action as needed -- updating a medication's label, for instance, or restricting its use or pulling it off the market.After analyzing the adverse event data for Nuplazid, the Institute for Safe Medication Practices concluded that this batch of reports "reinforces the concerns of those who warned that (Nuplazid) might do more harm than good." Thomas Moore, senior scientist for drug safety and policy for the nonprofit, said the deaths are an "important warning signal" and warrant further review by the FDA -- and possible action, depending on what the review finds.Since the institute released its analysis, FDA data shows that the number of reported deaths has risen to more than 700. As of last June, Nuplazid was the only medication listed as "suspect" in at least 500 of the death reports.Physicians, medical researchers and other experts told CNN that they worried that the drug had been approved too quickly, based on too little evidence that it was safe or effective. And given these mounting reports of deaths, they say that more needs to be done to assess Nuplazid's true risks."This is almost unheard of, to have this many deaths reported," said Diana Zuckerman, founder and president of the nonprofit thinktank the National Center for Health Research, adding that because reports are voluntary, potential problems may be underreported. "You just don't see this with most new drugs -- you don't see all these reports -- so you have to take it seriously."Acadia and the FDA maintain that the medication's potential benefits continue to outweigh the risks and help fill a desperate need. Psychosis affects up to 50% of the roughly one million Americans suffering from Parkinson's disease, according to the FDA, and Nuplazid is the first drug to be approved to treat this specific condition.Acadia said there are a number of reasons for the higher volume of death reports. Parkinson's disease psychosis is more commonly seen in patients in the most advanced stages of the disease, meaning they are already at a high risk of death. Plus, the company distributes Nuplazid through a network of specialty pharmacies that allow them to be in more frequent contact with both patients and caregivers -- meaning it is more likely to receive reports of death, which it is required to pass along to the FDA."If you are actively and regularly engaging patients and/or caregivers, it is inevitable that you will see a higher number of adverse events reported, especially in an older, chronically ill patient population," the company said in a statement.It said its "benefit/risk assessment of Nuplazid remains unchanged," and it carefully monitors and regularly analyzes safety reports from both ongoing studies and adverse event reports. The company noted, for example, that since the drug's approval, two studies of a total of more than 300 patients with Alzheimer's disease did not find a difference in the number of deaths reported between Nuplazid and the placebo.The company also provided CNN with a statement from Dr. Joseph Jankovic, professor of neurology and an expert on movement disorders at Baylor College of Medicine. "I have accumulated a great deal of experience with this drug," Jankovic said in the statement. "While not all patients are completely satisfied, many of my patients have experienced marked improvement in their visual hallucinations, paranoia and other psychotic symptoms."In an interview this week, FDA commissioner Scott Gottlieb was asked by CNN's Dr. Sanjay Gupta about his thoughts on drugs that receive expedited reviews and then prompt concerns about safety once they become available, like Nuplazid. While Gottlieb didn't want to comment on a specific product, he said he is "familiar with the circumstances" and that it's very important for the agency to make sure it is "appropriately balancing" safety with medical need. He said this is a flexible standard, however, and there may be more tolerance for risk in situations where there is a significant need and patients don't have an alternative."You've seen us take regulatory action recently in the post-market setting to limit the use of drugs when new safety concerns became known," he said.The FDA told CNN it will continue to monitor the adverse event reports and review the drug's safety. It added that Nuplazid's "complex safety profile," recognized at the time of its approval, resulted in a requirement that the medication carry a number of warnings on its label so that doctors could analyze potential risks and benefits before prescribing the drug.The cases reported so far, according to the FDA, typically involved elderly patients with advanced-stage Parkinson's disease who suffer from numerous medical conditions and often take other medications that can increase the risk of death."Based on these data, the FDA has, at this time, not identified a specific safety issue that is not already adequately described in the product labeling," the agency said in a statement.The FDA has required antipsychotics to carry its most severe "black box" warning for the treatment of elderly dementia patients, after studies found that the medications increase the risk of death in this population. Between 50% and 80% of Parkinson's patients experience dementia as the disease worsens, according to the Alzheimer's Association. Because Nuplazid is a new kind of antipsychotic that targets a different receptor in the brain, its maker claims it comes with fewer toxic side effects. Even so, Nuplazid also carries a black box warning.Geriatric psychiatrist and former FDA medical officer Susan Molchan said that the number of deaths is alarming and questioned whether patients and their families are aware of the risks associated with the drug.To determine the true risks of Nuplazid, the researchers interviewed by CNN said, the FDA needs to require further scientific studies -- and not just rely on the reports, which are challenging to interpret and are not systematically collected. They also worried that, because the drug was already approved, these studies and any action by the FDA could take years.A CNN review of several hundred adverse event reports shows that the detail provided for each case varies widely and that thorough investigations are rarely conducted -- making it difficult to determine whether Nuplazid might have been involved in the deaths of already sick and elderly patients.In these reports, the physicians who prescribed the drug sometimes suggest that their patients likely died from complications from Parkinson's rather than because of Nuplazid. In other cases, it's unclear when exactly the patient started or stopped taking the medication. And in yet others, family members and sometimes doctors are convinced the drug contributed to the deaths.One report recounts the death of a 73-year-old woman in a long-term care facility who was taking Nuplazid. Just before 8 in the morning, a nurse noted that the woman was "sleepy." Shortly after, she was found unresponsive and without a pulse. Paramedics were not able to revive her and, less than an hour after the nurse's visit, she was pronounced dead. While her physician didn't believe her death was "related" to Nuplazid, her husband was convinced that it had played a role and paid for an autopsy. It showed only that she had pre-existing heart issues and died of cardiac arrest.In another report, an 89-year-old man was taken off the drug after experiencing a significant decline. His doctor blamed Nuplazid for his deteriorating condition. The patient died weeks later. In a third report, a woman flagged her husband's death to the FDA after he was taken to the hospital due to dehydration. After he passed away, she said, she was told by "someone at the hospital" that the death was connected to his use of Nuplazid.Acadia said it analyzed these reports and concluded that there "is nothing to suggest a causal relationship to Nuplazid." Acadia calculated a mortality rate for Nuplazid, which it said was lower than what you'd see in the general population of Parkinson's disease psychosis patients covered by Medicare. It calculated this using deaths reported to the FDA and what it considered a conservative estimate of patients on the drug, along with Medicare claims data. However, multiple experts interviewed by CNN said that this is an unreliable calculation since it is comparing apples to oranges.In the weeks after the Institute for Safe Medication Practices issued its report on the deaths, Acadia's stock price dropped by more than 20%. While many large investors remain bullish about the stock, some investment analysts have made public records requests to the FDA for the death reports.Currently, Nuplazid can cost nearly 0 a day, according to wholesale pricing data from First Databank. That can add up to more than ,000 a year for a single patient, though the amount a patient actually pays depends on factors including individual insurance coverage.Acadia expects sales of Nuplazid to at least double this year.Acadia's TV commercial shows how frightening Parkinson's disease psychosis can be.The company, meanwhile, is forging ahead with clinical trials in an attempt to get the medication approved for use in a larger patient population: patients who have dementia-related psychosis. In October, the FDA granted its coveted breakthrough designation for this potential use as well, meaning it will also undergo a speedier review process.While a doctor can legally prescribe a drug for any reason, insurance companies may not approve it for uses that are not FDA-approved. So FDA approval to treat dementia patients would likely result in Nuplazid being prescribed to a much wider population, concerned medical experts told CNN."You would certainly hope they don't approve it for anything else," said Zuckerman of the National Center for Health Research, based on the current research and FDA adverse event reports. "If they're going to approve it for another group of patients that is much, much larger -- that would be unconscionable."That is something they should absolutely not do given these unanswered questions about risk."Roughly two years have passed since that FDA meeting, where family members and caregivers -- some of whom traveled there on Acadia's dime -- gathered with medical experts to debate the merits and potential risks of Nuplazid.Andreason, the physician who led the FDA's medical review of Nuplazid, no longer works for the agency.He said that while he stands by the warnings he made at the time, he understands that other antipsychotics used to treat Parkinson's patients also come with an increased risk of death and that, when patients have a debilitating disease like Parkinson's, physicians and caregivers may choose a medication that improves quality of life even if it could also shorten life expectancy.He said that he was not surprised to hear about the reports of death."This is exactly what I thought was going to happen," he said. "We were going to get a burst of reports of serious adverse events and deaths."Dr. Stephanie Fox-Rawlings, a senior fellow at the National Center for Health Research who spoke against the drug's approval at the FDA committee meeting, recently told CNN she understands how desperate families in these situations are, but she does not think Nuplazid is the answer based on her review of Acadia's public research. She and Zuckerman said that, after previous studies didn't show it was effective, the drugmaker changed the way the medication's ability to improve psychosis was measured, which resulted in a positive outcome. Acadia said its studies have had different objectives and all of them have used "consistent, appropriate, and validated assessment methodology.""If patients know there is some level of benefit, they can judge their risk," said Fox-Rawlings. "But if we don't even know that it does work, how do you even judge that? It's kind of a false hope."Kim Witczak was the consumer representative on the FDA committee evaluating Nuplazid. She and the patient representative were the only two members to vote against its approval. She still can't believe it's on the market."I remember leaving really, really frustrated," she said.CNN reached two of the three family members who petitioned for Nuplazid's approval at the meeting, despite having had no experience with the drug or its clinical trials, to ask whether they tried the medication once it hit the market.One of these was Elaine Casavant. Despite the "staggering cost" of the medication, she said, she was quick to get her husband on it. But after three months, he showed no improvement and they stopped the medication. She has heard success stories, however, and remains optimistic that the drug could be helping certain people.The other person was Tyne.The 43-year-old New Jersey resident works in New York and visits his mother every weekend at a nursing home in the Bronx. Tyne has attempted to move on from the disappointment of Nuplazid, but he still gets frustrated talking about it."Knowing what I know now -- that it didn't work at all -- I wouldn't have gotten my hopes up," he said.But he doesn't regret trying."If there was something that could possibly help my mom and I didn't do it, I wouldn't be able to look at myself in the mirror." 18971
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