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It's Never Lupus? FDA Eyes Drug for Dr. House's Least Favorite Disease

The FDA has a chance to put to death an old web meme: the notion that on the Fox TV show House, the correct diagnosis is never "lupus." An advisory commitee voted to recommend that Benlysta, a drug developed by Human Genome Sciences (HGSI) and GlaxoSmithKline (GSK), should be approved to treat lupus.

The meme persists in part because lupus is untreatable (until now), making for bad drama since Dr. Gregory House likes to cure people. Benlysta isn't a cure either, it's merely a treatment, and that's part of its problem: the effects wear off after about 76 weeks. It also has a higher rate of mortality than for patients on the placebo, and it doesn't work as well for African-Americans, according to the FDA's briefing materials.

The lupus meme first surfaced (he said, making a bald-faced claim with no evidence) in a 1991 episode of NBC's Seinfeld in which George expresses an irrational fear of dying from lupus. The gag came up again in a 1992 episode also:

The gag in House is that no matter how unfathomable a patient's mysterious symptoms, one of his colleagues will guess lupus and House will dismiss the diagnosis:

There was one episode in which House does announce, "I finally have a case of lupus!":

If the FDA gives a green light to Benlysta, House will get a new set of variables to consider, especially on the issue of its side effects. In the clinical trials for the drug, 15 people died. Three of those were in the placebo arms; there was a 1.83 higher risk rate of death on the drug. Six of the deaths were due to infection (only one was in the placebo arm) and infection is the most serious adverse event or Benlysta.

So if you're playing the House drinking game and a female patient appears with a rash, sensitivity to light, oral ulcers, failing kidneys and sepsis, go ahead and make the call: It's a patient who has lupus and is also suffering from the side effects of Benlysta.


Image by MindJacket T shirts.