SciTech Daily: In a follow-up investigation into the multibillion-dollar drug ticagrelor, The BMJ has identified new concerns.
For more than a decade, the multibillion dollar drug ticagrelor (Brilinta in the US and Brilique in Europe) has been recommended in the treatment of patients with acute coronary syndrome. As generic versions of the antiplatelet drug prepare to launch this year, The BMJ has investigated the evidence underpinning the drug’s approval and continued use. In our first story we revealed serious data integrity problems in the PLATO study, the 18 000 patient randomised trial that brought ticagrelor to market.1
The BMJ now turns its attention to two key supporting AstraZeneca studies that convinced doctors of ticagrelor’s ability to rapidly and consistently inhibit platelets—critical for managing patients following percutaneous coronary intervention. Our investigation was based on interviews with trial investigators and platelet experts and access to the underlying trial data submitted to regulators, as well as readouts from laboratory equipment used in the studies. We found evidence that the trials were inaccurately reported. In one instance AstraZeneca’s trial failed to show statistical significance, but was published in a leading cardiology journal as significant. Extraordinarily, most investigators, including the principal investigator and the drug company, were unreachable or declined to be interviewed. The findings raise even deeper questions over the approval and decade long use of the drug.
Art imitates life …
https://youtu.be/KNk9a3TJEnw?si=b0NWd0Yu6YLKcvVt
And a great film it was
Cui bono.
What? A useless/dangerous medication? Well knock me dead and call me unexplained!
It might be that the initial trials were tainted. If so, the participants and AstraZeneca should be taken to task.
But that does not mean that Ticagrelor doesn’t work. There have been numerous studies since then by independent institutes that support its use. Here’s an evaluation of the evidence:
https://www.ahajournals.org/doi/full/10.1161/JAHA.123.031606
So we have a situation where there’s possible misbehaviour, but the drug is still valuable.
Vox bureaucatii, vox dei again?
So you don’t think scientific studies are worth anything — just dressed up Argument From Authority.
If looking at the evidence is fallacious, we’re not left with any connection to reality, are we? Everything is just politics. That’s very… postmodern.
“So you don’t think scientific studies are worth anything — just dressed up Argument From Authority.”
It helps to be able to -read- the studies and understand that just because it got into JAMA or NEJM does not mean it is worth the paper it is printed on.
Quite the contrary, many (not all, but easily a third by my guesstimate) of studies published in main-line journals are utterly without merit. Small samples, dodgy statistical methods, idiotic study designs, just plain fraud, there’s a lot of it. Publish-or-perish guarantees that tremendous amounts of guff is generated for every useful tidbit of scientific merit.
The “science” media is of course ridiculous. My favorite of the moment is the guy who decided time has three dimensions like space does. Because the math is prettier that way, I guess. He’s all over the “Science Media!” with this, and it is complete balderdash. No, time demonstrably (and obviously) does not have three dimensions. Once you look beyond the immediate argument with the pretty mathematics, the problems with the idea become insurmountable. Describe a magnetic field with three dimensional time. Doesn’t work.
Thus I view all new drugs and “Breakthroughs!!!!” with great suspicion. I’m content to let the masses of lemmings out there “Trust The Science” while I wait to see how many of them grow horns or whatever from it. Ozempic is what I would call a sign of the times in the medical/drug industry, the latest medical hula-hoop. A cautionary tale, told by an idiot.
What’s stopping you from reading them? I gave a link to the meta-analysis. It lists the 22 papers it was based on. I can’t guarantee that they’re all open access, but most large-scale studies are these days.
From the meta-analysis “This review provides a summary of the major ticagrelor randomized clinical trials with enrollment exceeding 400 participants”. Specifically which of the 22 studies the analysis was based on do you think was deficient?
I don’t know what you mean by “science media”, but if you mean popular media, that’s irrelevant to this particular discussion.
Given your suspicion of conventional medical research, you must have something better. What is that, exactly?
“What’s stopping you from reading them?”
I do read them. And when I see the words “meta-analysis” I know that can often mean that somebody scraped together 22 crappy papers and used them to make another crappy paper, because publish-or-perish. If any of those papers had been conclusive, would you need to do a meta? If the meta was conclusive, would we be having this conversation?
On the other hand when I see “billion dollar Astra_Zeneca drug” and “research irregularities” I nod my head and say “no kidding”. Obviously they leaned on/paid-off everyone they could. And you must assume that they will, as a baseline.
That’s supposed to be how science works anyway. Authority and reputation mean nothing. Results must be replicated by people who don’t like you and think you’re both wrong AND lying. If they -can’t- refute it, then and only then is it worth talking about.
“Given your suspicion of conventional medical research, you must have something better. What is that, exactly?”
The existence of deep-seated and obvious corruption in the medical science business is more than enough reason to view -every- study with vast suspicion, particularly new drug studies. One must assume the researchers, the journals -and- the government licensing boards are -crooked-. As a starting point. You pretend you are from Missouri and you say “show me.” Because a non-zero percentage of the time, they are crooked. Look. At. Covid.
That’s why listing journal articles is fancy-dress Argument From Authority, as you said. Listing articles means “SHUT UP!!!” in internet speak.
I used to do this with gun control articles all the time. Troll A pipes up “well actually, {study} says XYZ which means shut up, conservative liar.” I had in fact read -all- the studies and would then repeat all the fatal flaws in whichever one they quoted. TL/DR, as of roughly 2001 there were six (6) studies in the medical journals (all of them) which met the most basic requirements for a reputable public health study. Those six, not coincidentally, did not support the gun control thesis.
The drug literature is at least as dodgy as the gun literature, I very much expect it is far, far worse because of the sheer magnitude of the money involved.
It’s clear that any study whose conclusions are not aligned with your beliefs are to be dismissed out of hand as garbage. You’ve created a hermetically sealed chamber for yourself that’s impervious to scientific evidence. The trouble is you haven’t replaced it with anything except your own hunches and the claims of a lot of self-serving charlatans on blogs.
But life expectancy continues to rise and child mortality continues to drop. Modern evidence-based medicine is imperfect, but on the whole it works like a hot damn. It’s a gift we should be thankful for every day of our lives.
“It’s clear that any study whose conclusions are not aligned with your beliefs are to be dismissed out of hand as garbage.”
Uh huh. So what are your thoughts on the peer reviewed and journal published research from Delhousie “Personality traits and climate skepticism: evidence from Canada” that Kate posted? Reported on lavishly by the CBC, incidentally.
From the abstract: “Despite widespread scientific consensus regarding the evidence for climate change and its effects, some members of the general public remain skeptical (i.e., believe that climate change is exaggerated, due to natural variation in the climate, etc.). While much research has considered the demographic and political correlates of climate skepticism, less work has considered the psychological roots, including individual differences in personality.”
I’ll leave you to look up their conclusions on your own. For my part I simply skimmed the CBC headline, rolled my eyes and continued with my day, because it is self-evidently -false-. I don’t need to go and check their work, I know it’s a propaganda piece put together by high-school intellects. 40 years old, still operating at a Grade 9 level.
This is who’s doing your drug studies, big boy. Cheerleaders and football players who aged out.
“But life expectancy continues to rise and child mortality continues to drop.”
Does it? Who says? What’s their evidence?
Don’t I remember seeing some problems since 2021 and the Mad Science jab? How about China? They always say they have 1.4 billion people, but increasing evidence from things like agriculture and fuel usage are indicating it might be closer to half of that. They’re either lying or they managed to “lose” seven billion people somewhere.
So this is what I do. Marmot says “life expectancy continues to rise” as if that’s handed down from Heaven on a silver platter, and I say “show me.” I very much doubt life expectancy is on the rise in Canada and Britain given the state of socialized healthcare here and there. Flat at best overall, dipping hard for lower socioeconomic status. Drug deaths and MAiD can’t be ignored. It might still be rising in the USA, because less socialism.
Show me something like the demand curve for baby diapers and bottle formula. Don’t show me UN numbers, because they lie all the time. See China for elucidation.
My dog has no nose.
Really? How does he pass the smell test?
Oh, he has a rubber stamp for that!
Apparently marmots too have no independent sense of reality and rely entirely on the rubber stamp.