Three Things You Don’t Know About Drug Trials
April 18th, 20081. It pays to be a middle-aged white male.
When it comes to new drug trials, white men under 65 seem to be in high demand. That’s despite the fact that other people develop deadly diseases – and more often than this population. One study found that ony about 10% of cancer-study participants were African American or Hispanic, despite the fact that these groups make up more than 25% of the general population. Or how about this: nearly 60% of cancer diagnoses are in people over 65…but cancer trials typically include no more than 25% people in that age range.
This information comes to us from Baylor College of Medicine, where researchers were concerned that older people are rarely included in trials, even though most of the drugs being tested will be used primarily by them. Older people can be more prone to side effects and drug toxicities, so even FDA-approved drugs are coming to with unknown consequences. Same for women, who generally weigh less than men, and who absolutely have different hormonal makeup – drugs may not impact them the same way, yet they are less likely to be included in trial groups.
But since drug companies are allowed to design their own trials and choose participants, this problem may not be solved in the foreseeable future. After all, if you were a Big Pharma executive, would you want to test your billion-dollar profitmaker on old sick people or younger stronger people?
2. Cutting them short may short-change us.
It sounds (on the surface at least) like a good thing – stopping promising trials for innovative cancer therapies early so they can get to patients sooner. But the ugly truth is that the practice definitely benefits the drug companies more than cancer patients. Especially with cancer drugs, cutting trials short means there is no data about long-term survival outcomes – and isn’t that what patients are really looking for?
Italian researcher Giovanni Apolone looked into prematurely-stopped trials conducted between 1997 and 2007. According to Apolone, “If a trial is evaluating the long-term efficacy of a treatment, short-term benefits, no matter how significant statistically, may not justify early stopping.” More disturbing, Apolone discovered an alarming trend: the results of trials are being increasingly used in marketing applications, suggesting “a commercial component in stopping trials prematurely.”
3. Drug companies “edit” their findings, then hide the original data.
Case in point, the new, improved Merck-Vioxx scandal. New evidence suggests that Big Pharma giant Merck knew as early as 2001 that Vioxx was deadly, but chose not to present that information to the FDA when they were trying to get their prescription painkiller approved. They skated a very thin ethical line when they decided to remove certain patients from the trial pool, including patients who died after they stopped taking Vioxx, even though their deaths may have been attributable to the drug.
The raw trial data showed deaths in the Vioxx group were nearly 3 times higher than in the placebo group. When Merck presented trial information in their FDA approval packet, they edited those findings. By excluding patients who died after their course of Vioxx treatment, the drug appeared much less dangerous.
The kicker: According to New Scientist (a British scientific magazine), public health researcher David Egilman uncovered another hushed-up study called Protocol 906. That experiment found that Vioxx caused nearly double the side effects of Celebrex (made by Pfizer), another drug in the same family. In that paper work, he actually came across an email from one Merck employee to another saying…
“…this is a very serious result and you will hardly be surprised by the idea of keeping this VERY TIGHT for the moment.”
As a researcher and reporter for HSI, I come across health news that you need to know about almost every day - natural medicine breakthroughs, FDA blunders, three-alarm drug catastrophes, and much more. Join me for an honest, unorthodox look at today's most relevant health breakthroughs.
