Monday, October 15, 2007

Son of Risperdal Beats Seroquel

Janssen, manufacturer of Invega (son of Risperdal) funded a study comparing Invega, Seroquel, and placebo in the treatment of schizophrenia. Results were as follows:
"After two weeks, those on Invega had a greater reduction in symptoms as measured by a standard test called Positive and Negative Syndrome Scale for Schizophrenia, or Panss. The test measures symptoms such as disorganized thoughts and uncontrolled hostility. The score for Invega patients declined 23.4 points, 17.1 points for Seroquel and 15 points for placebo, according to J&J."
By the way, note the rather paltry advantage of Seroquel in comparison with placebo. These results fit nicely into a pattern. A study published in the American Journal of Psychiatry in 2006 found that clearly, the best predictor of which antipsychotic would be shown superior in a head-to-head comparison was who funded the study. Also feel free to examine their table in which they point out the biases in these various comparative studies.

Pharma claims to spend bazillions of dollars on research -- but these studies aren't research in the classic sense, which is a scientific endeavor undertaken to gain knowledge. These are exercises in marketing -- set up a study with some sort of bias favoring your drug, then hurry and rush out the drug reps with low cut blouses and fistfuls of reprints of studies showing your drug is superior to the competition. Then, the competition retaliates by setting up a study in which their drug is set up to win due to some sort of biased design. And the cycle goes on and on and on. Pharma then counts these "studies" as research expenditures and waxes on about their dedication to developing lifesaving medications. As if these studies done purely for marketing purposes have anything to do with developing lifesaving medications.

Background on Invega:

5 comments:

Mother Jones RN said...

Very insightful post. I found your blog via Pharmalot. You write some great stuff. I'll be back.

MJ

Daniel Carlat, M.D. said...

It's also important to mention that this study has not yet been published, but has only been presented as a poster at a meeting. Publication will require "peer review," meaning that experts in the field will go over the methodology carefully to make sure there aren't any obvious sources of bias. Without seeing the full report, it is impossible to tell how reliable these findings are.

Anonymous said...

Dr. Carlat-

But judging from the table in the Am. J. of Psych that is posted here, it doesn't seem like peer review means anything... even in the Archives.

CL Psych said...

I agree with both Dr. Carlat and the last commenter. Peer review is helpful (in most instances) but often fails to catch major problems in studies, which are then published and misinterpreted by the media and the medical community. For one prime example, consider the recent study on SSRI usage and suicide.

CL Psych said...

MJ,

Thanks for the kind words.