Just when it looked like this couldn’t get crazier ……

Just when it looked like this couldn’t get crazier ……

Today with little fanfare JAMA Internal Medicine published the corrected version of an editorial that was first published online February 25. As has been widely reported JAMA withdrew the original editorial as it contained a factual error. The editorial entitled “Glucagon Peptide 1-Based Drugs and Pancreatitis Clarity at Last, But What About Pancreatic Cancer?” written by Peter C Butler, MD and Belinda Gier, MD.

Looking over the original and now corrected version the error comes at the end of the second paragraph with the original version stating;

“Because both drugs already carry US Food and Drug Administration (FDA) black box warnings for the risk of pancreatitis, why is this study important?”

The corrected version states:

“Because both drugs already carry US Food and Drug Administration (FDA) warnings for the risk of pancreatitis, why is this study important? “

First off, one would think that someone at JAMA could have easily checked with the FDA, Merck (NYSE:MRK) the makers of Januvia or Bristol Myers Squibb (NYSE:BMY) or AstraZeneca (NYSE:AZN) who now own Byetta over what warnings these drugs have. Or they could have just gone on the web sites for either Januvia or Byetta and actually read the labels for these drugs.

Given Dr. Butler’s well known and well published anti-GLP-1 stance Diabetic Investor is not surprised by this error and we won’t even give the good doctor the benefit of the doubt that this was an honest mistake, as he or someone on his staff could have just as easily looked up this information.  The fact is Dr. Butler wants all GLP-1’s pulled from the market and could care less how this happens.

Another notable difference in the two versions comes at the end with the corrected version which contains the following new information;

“Dr Gier reports that, as of February 1, 2013, she is employed by Bristol-Myers Squibb, Munich, Germany.

Editor’s Note: At the time this commentary was solicited, submitted, reviewed, and accepted for publication, the editors were unaware that Dr Gier had any pending affiliation with Bristol-Myers Squibb.”

Yes that is the same Bristol Myers Squibb who along with AstraZeneca paid over $3 billion to acquire Amylin the makers of Byetta and Bydureon. According to Dr. Gier (who must have recently married as her LinkedIn page goes under the name Belinda Schludi, PhD) is now Bristol’s Medical Science Manager. Looking over her LinkedIn information, which is quite impressive, Dr. Gier is well acquainted with GLP-1’s and pancreatitis as she has authored or co-authored several studies on this very subject.

But this is just the beginning of the craziness, which for this situation is hard to believe, as guess were Dr. Gier worked prior to joining Bristol. That’s right the Larry L Hillblom Islet Research Center the very institution where Dr. Butler is the director. Something we’re sure Dr. Gier disclosed to Bristol, who for reasons unknown went ahead and hired the Dr. anyway even though her former employer has a well-known and very public stance against the drugs Bristol is selling.

The real question is does Dr. Gier share the views of her former colleague or does she hold a different view, perhaps it’s possible that unlike Dr. Butler she is not rigid in her views and is open to being reasonable.  Perhaps she saw the light after the editorial was written and actually left the Hillblom Center over a disagreement with Dr. Butler.

Fat chance, according to another study entitled “Pancreatitis, Pancreatic, and Thyroid Cancer With Glucagon-Like Peptide-1–Based Therapies” published in Gastroenterology July 2011, Dr. Gier and her co-authors concludedThese data are consistent with case reports and animal studies indicating an increased risk for pancreatitis with glucagon-like peptide-1−based therapy. The findings also raise caution about the potential long-term actions of these drugs to promote pancreatic cancer.”

So let’s see if Diabetic Investor has got this correct, in August 2012 Bristol and Astra buy Amylin for over $3 billion. Amylin’s main products are GLP-1’s, one of which could be a mega-blockbuster which is the reason Bristol and Astra bought Amylin in the first place. Byetta and now Bydureon has joined Bristol’s other diabetes drug Onglyza, which just so happens to be a Januvia copycat, the same Januvia mentioned in the study which prompted the editorial.

Five months later Bristol decides to hire Dr. Gier even though she has a well-documented history of believing the diabetes drugs Bristol sells cause pancreatitis and possibly pancreatic cancer. We assume that Bristol read her studies and knew she received her training at center run by a guy who would like nothing better than to put Bristol out of the diabetes business.

Diabetic Investor would like to say we’re surprised by this but given this is the wacky world of diabetes where anything can and usually does happen about the only thing that’s surprising here is that Dr. Gier was not hired to run the company’s GLP-1 team.  Perhaps the real craziness here is that we’re not making any of this up and everything we found is available to anyone who knows how to use the internet.

Why JAMA didn’t bother to fact check and editorial in the first place remains a mystery. Why Bristol hired someone who seems to believe the company is selling poison to diabetics is astonishing. Yet the real craziness here is that the only person’s actions we actually understand are Dr. Butler’s.  He knew full well what was written was factually incorrect he just didn’t care, as he also knew this so-called error strengthened his argument. While this may be morally reprehensible at least it’s understandable. What JAMA didn’t do and what Bristol did do is just plain crazy.