STAT+: ‘No magic bullet’: For drugmakers and the FDA, clinical trials on ultra-rare diseases pose thorny challenges

“You either accept the uncertainties around rare disease approvals — that a drug is not going to have the same kind of safety data as others — or not," said…

Walker Burger is beside himself with worry.

The 33-year-old relies on an experimental medicine to treat an ultra-rare disease called Barth syndrome that causes an enlarged heart, muscle weakness, and a shortened life expectancy. But the Food and Drug Administration last year refused to review the drug, despite prolonged efforts by its manufacturer, Stealth BioTherapeutics, to gather hard-to-come-by clinical data on such a tiny patient population.

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