Wednesday, August 5, 2009

Ghost writers wrote the pro-hormone papers of the previous decade. Am I surprised? No.

Surprise, surprise. Ghost writers wrote the pro-hormone papers of the previous decade.
Natasha Singer for the NY Times:"Medical Papers by Ghostwriters Pushed Therapy"
NYT reports revelations emerging from court cases against Wyeth, marketer of hormone replacement therapy: many of the the pro-hormone articles published in the 1990s, and up to the end of the HRT fiasco in early 2000's, were ghost-written.

The pharmaceutical companies paid physician researchers to stick their name on articles written by unknown hired writers. It was not very difficult to find physicians to go along with this dishonesty.

The conflict-of-interest list for the HRT story is extensive. Most of the first-author physician/researchers who published peer-reviewed articles favoring HRT for its various purported health benefits, especially the now-debunked claims of cardiac health, were funded by Big Pharma, especially Wyeth.

While they were paying for articles promoting off-label prescription of HRT for cardiac health, they were not paying for the work to pinpoint the apparent bad health effects. I say apparent because it is very clear, if you review the prominent, easily-identifiable published research, that the cancer risk from these hormones was known from a long line of research back to the 1930s, and the trick that made HRT look good, the use of observational studies rather than controlled trials, had clear signals of the error in this strategy from AT LEAST four PUBLISHED studies.

If I get time, I may post this handful of literature. In the meantime, contact me if you seriously want to get hold of this handful of information. Medline and Google scholar are always available, too.

Now, in 2009, we finally get the kicker to this whole pharma scam: we know that, in some cases, these physicians did not even write the articles.

Now, we know: the whole HRT phenomenon was a scam. A marketing ploy. Never really based on decent science, and never really emerging from decent physician/researchers.

Has there been any change to make things better, since 2002, when a controlled trial of HRT for cardiac protection finally produced worthwhile, accurate results?

No. JAMA, and others including AMA, continue to argue that COI is not a big deal (see my posts with JAMA in the title). They continue to argue that we should trust physicians because they have those initials after their names.

This revelation will generate some discussion. The MD researchers will claim that there are a few bad eggs, or that the ghost-writing issue is not really all that bad, but provides a vauable service. Or whatever.

In the meantime, no one will calculate the number of women who have died from the damaging effects of HRT. Premarin, the trade name for Wyeth's HRT pill, was the most frequently prescribed medication in the U.S. for a matter of years. Millions of women took HRT regularly.
We know that HRT raises risk of heart disease, and of breast cancer. We know women were encouraged to take HRT not only for menopausal symptoms, but to protect their heart health, based on evidence from observational studies rather than controlled trials. It is obvious that some portion of women have suffered heart disease, breast cancer, and death from HRT.

The NYT quotes from the identified physician/researcher show the nonchalance. The disregard for these women. This physician, Dr. Bachmann, does not express regret over her role in these deaths.

Has she returned the money, on principle? Has she published a retraction of her authorship? Has she apologized to the women who have been mislead? Not yet, it seems.

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