Makes one wonder

Makes one wonder

As the debate rages over whether there is a casual relationship between the use of GLP-1 therapy and pancreatic cancer, a bigger more important question is looming on the horizon. While researchers debate the GLP-1 issue, they are once again ignoring the real world consequences of their actions. It’s as if they have completely forgotten the aftershocks brought on by the Avandia controversy. In their zest to have their voices heard, they have conveniently forgotten about the millions of patients taking these medications and the millions more who will likely be on these medications in the future. Even worse they are ignoring what this unwinnable debate will do to the drug approval process, a process which is already painfully slow and extraordinarily expensive.

Now the anti-GLP-1 zealots will claim they are doing this to protect the public and save patients from a possible disaster. This is what zealots do, believing that if they come off as trying to protect patients the public will automatically stand behind them and not examine their dubious research too closely. This is what the crusading cardiologist Dr. Steven Nissen did with his now infamous meta-analysis which was the beginning of the end for Avandia. Basically the good doctor forced GlaxoSmithKline (NYSE:GSK), the makers of Avandia, to disprove a negative no easy task. The good doctor also knew that the majority of patients don’t understand the intricacies and nuances of a meta-analysis, heck most don’t even know what a meta-analysis is. What he did know is that when patients heard the drugs they are taking might increase their cardiovascular risk they would up in arms, which is exactly what happened.

Never mind that there was a well-respected set of diabetes researchers who believed that Avandia was being railroaded. A group that believed the evidence against Avandia was suspect at best and that even with further study on the matter there would be no conclusive proof that Avandia lead to increased incidence of cardiovascular events. Unlike the irrational zealots who wanted Avandia off the market, these level headed researchers basically felt that the decision of whether to continue using Avandia should be left to the patient and physician. They further believed should the decision be made to continue using the drug the patient should not just be made aware of the possible risk but also monitored for any possible risk markers.

Yet as so often happens, the zealots won out in the end as quite frankly they gained the upper hand in the debate when Congress got into the act. Looked at realistically Avandia really never had a chance as thanks to a convenient leak to the media the story made national news before GSK had any chance to tell their side of the story. In the eyes of the public GSK were the bad guys and the good doctor was the savior.

As we have noted on far too many occasions the fallout from the Avandia controversy continues to impact the diabetes drug. Worse it has emboldened others zealots like Dr. Peter Butler of the University of California Los Angeles, to come forward with their so-called evidence that GLP-1’s absolutely, positively cause pancreatic cancer. Using history as a guide Dr. Butler knows that it’s virtually impossible to disprove a negative. He’s also well aware that there is no personal glory or fame for the rational diabetes researchers who will come and defend the use of GLP-1’s. As rational researchers will acknowledge that they cannot conclusively and emphatically state that GLP-1 usage does not cause pancreatic cancer, rather they will state the evidence does not support such a claim. Being rational folk they will basically say what Diabetic Investor has been saying, this matter where the two sides will just have to agree to disagree.

The problem is that Dr. Butler and his followers that’s just not good enough. They cannot even consider the possibility that there are two sides to this issue and the two sides will never reach an understanding. Quite frankly looking at all available evidence we can understand why each side feels the way they do, what we don’t understand is what the anti-GLP-1 group hopes to accomplish with their irrational behavior.  About the only result this group of zealots will happy with is if the FDA decides to withdraw these medications from the market, patient impact be damned.

Nor do they care what impact this dogged pursuit of GLP-1’s will do to patients in their attempt to find a GLP-1 replacement or how the already ultra-conservative, glacially slow FDA will handle future new, heck even current, drug applications. Nope what these zealots really want is complete and utter capitulation from the other side, basically they want everyone to acknowledge they were right and everyone was wrong. Unlike rational researchers who can agree to disagree and move on, the zealots win or lose here will continue to be zealots.

Sadly in the end it’s the millions of patients who use these medications and the millions more using other medications that will get screwed. Their physician cannot offer a simple answer to a simple questions; “Are the medications I’m taking safe?” Many will decide, just as they did when the Avandia controversy broke, to stop taking their medications altogether which will only lead to disastrous results. Physicians will be left wondering what to do when the next new drug comes along, as using history as a guide it’s likely some other group of zealots will come along and say this new drug isn’t safe either.

The bottom line here is that these zealots refuse to acknowledge what any rational person knows; there is no such thing as a completely safe drug.  Nor do they seem to care that without these drugs the patient’s diabetes will likely get worse and complications will ensue. Nope all they care about is they are right and everyone else is wrong. This is not only childish, it’s just plain stupid.