Trial Lawyers Inc. Enters the Vytorin Fray

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  • 01/25/2008
Just a matter of time before the juggernaut switched gears from Vioxx to Vytorin. (How cool that they go in alphabetical order, it will make life easier for the paralegals at least.)

Now we at drugwonks get to play our version of connect the dots as the purists line up on the side of the bottom feeders offering their services as consultants, their opinions in the media, white papers, policy support through web sites and groups like the Soros funded Prescription Project and the Institute on Medicine as Profession. We already have two"dots": Susan Wood, recipient of silicone breast implant settlement cash (where no evidence of wrongdoing or harm existed)
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"Schering says there were problems with the way the data from the study were collected and analyzed, and that it needed all this time to fix those problems. Susan Wood, a professor at George Washington University and former Food & Drug Administration official, doesn't buy that. "You can't just say, 'Wait, we'll fix it,'" she says. "You have to get it out and let people decide."

The other dot is Steve Nissen who of course has been conducting (for pay) his own set of studies to determine whether increase HDL (regardless of genetic variation) can lead to plaque reversal and can correlate with a reduction in death using his own imaging studies. According to Matt Herper he is gunning for Zetia. (Here's a link to an article where Nissen gushes over the plaque reversing power of a drug he was working on but has never, ever made it into human trials.)
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The lesson here: Don't you dare do a plaque reversal study with imaging as your surrogate endpoint without using Steve Nissen. Oh, another lesson: Steve Nissen does no work on genetic sensitivity to statins or personalized medicine, the real future. The ENHANCE study in its backhanded way essential demonstrated that Vytorin is the drug which can lower cholesterol for a small genetic subset but not reduce plaque.

In any event, what people think about this matter -- and what to do about it -- will be shaped by their views of capitalism and medicine, not by the science. Will every large clinical trial of a drug on the market now become an opportunity to attack, expose, sue and investigate.

I think so. The "dots" profit from it in terms of publicity, consulting fees, foundation grants, their cut from class action suits and consolidation of control over the conduct of clinical trials, prescribing patterns, etc.

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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