Warning: clinical trials funded by drug companies may appear more truthful than they actually are

gabapentinWell, here’s a shocker: apparently, there appears to be a difference between internal drug company documents about the research trials that they fund, and the articles reporting that research that end up in medical journals. The New England Journal of Medicine calls this ‘selective outcome reporting’, but for the sake of clarity, let’s just call it ‘lying’.

At first blush, the process of getting drug research results published seems straightforward enough. Since 2005, the International Committee of Medical Journal Editors has even required all research investigators to register their clinical trials prior to participant enrollment as a pre-condition for publishing the trial’s findings in member journals.

So in a nutshell, researchers set out to run clinical trials, as they are legally required to do, on a particular drug. They have some specific purpose in mind before undertaking this research.  Will this drug ease pain? Reduce inflammation? Lower blood pressure? Treat cancer? That’s the primary outcome of the clinical trial they have in mind, which must be registered before they even begin recruiting people to participate in this study if they want to later submit their findings to a medical journal. Which of course they do.

In a study published today in the NEJM, researchers examined practices for clinical trials of a drug called gabapentin, better known by its brand name Neurontin, an epilepsy drug which was approved in late 1993 for use as an adjunctive medication to control partial seizures (meaning that it’s considered effective when added to other anti-seizure drugs). The research trials for this drug were all funded by Pfizer and Warner-Lambert’s sudsidiary drug company, Parke-Davis.

Researchers looked at 20 clinical trials of gabapentin for which there were internal Pfizer or Parke-Davis documents, 12 of which were ultimately published in medical journals. For eight of these 12 reported trials, the primary outcome defined in the ultimately published journal article differed from that described in the internal documentation protocol. Quelle surprise…  Continue reading

Doctors on the take: how to read the fine print in medical research reports

food nutsI was doing a little light reading in the Archives of Internal Medicine the other day. A study reported there in June looked at what researchers have inaccurately dubbed the Eco-Atkins Diet, which they claim replaces the low-carb, dangerously high-saturated fat meat protein of the old Atkins Diet with low-carb, low saturated fat vegetable-based protein such as soybeans, legumes and nuts.

The more I read, the better I liked what I was reading. The study showed that the vegetable-based protein-eating participants not only successfully lost weight on this new Eco-Atkins Diet, but they showed greater reductions in their LDL (bad) cholesterol levels than the control group.

Isn’t this fabulous news for those of us wanting to lose weight as well as improve our heart health? Well, maybe not.   Continue reading