Friday, April 9, 2010

More on the Avandia Saga

We've had several recent posts on the Avandia revelations, most of which emanated from the investigation of the staff of the Senate Finance Committee. Their report can be accessed in full at:
http://finance.senate.gov/newsroom/ranking/release/?id=bc56b552-efc5-4706-968d-f7032d5cd2e4
(see links-- the full report is more than 300 pages of which only about 15 is the report itself, and the bulk being the supporting documents)

Another helpful overview and summary is provided by the Australian journalist Ray Moynihan in BMJ (subscription required). Moynihan summarizes the Senate committee report findings, then gives GlaxoSmithKline's rebuttal, which includes charges that more recent studies are showing that Avandia creates no additional risk of heart attack. Moynihan responds by noting that these more recent studies are all being funded by GSK, and he refers to the study we already posted about in BMJ, showing that authors with financial ties to drug companies were three times more likely to be writing favorably about Avandia's risk profile than were financially nonconflicted authors. Moynihan also shrewdly goes to the real root of the matter--it is not that Avandia is such an all-fired-great drug for diabetes that we should be using it until it is definitely proved to be harmful. In fact Avandia has never been shown effectively to prevent any of the serious complications of diabetes, and so there is a real question as to why it ever should have become a widely used drug in the first place--were it not for overmarketing. In such an instance any hint that the drug might be unsafe should be sufficient grounds to yank it from the market.

Moynihan R. Rosiglitazone, marketing, and medical science. BMJ 340:785-789, 10 April 2010.

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