Blog entry by Meguid El Nahas

Picture of Meguid El Nahas
by Meguid El Nahas - Monday, 20 May 2013, 6:49 AM
Anyone in the world

Attending the 50h Congress of the ERA EDTA in Istanbul. I appreciated how beautiful this city is. I also appreciated or once more realised how important the pharmaceutical industry (Pharma) is to medical conferences, congresses and nephrological education.

Pharma supports heavily, even in times of recession, conferences and their infrastructure.

Pharma also brings planeloads of delegates to attend these meetings.

Pharma organises symposia and workshops.

Pharma is everywhere....great in the first instance with sponsoriships of events, delegates, speakers and social entertainment.

Then I listen to some speakers, attend some sessions and reflect how Pharma has permeated the medical psyche...slowly...insideously but surely....

Speakers who are also often those who have been generoulsy sponsored by Pharma and as Key Opinion Leaders (KOL) have financially been rewarded by Pharma, this has dented their independance, their scientific integrity and their portraying of Pharma sponsored research:

TREAT, EVOLVE, RITUXIVAS, etc....all negative and inconclusive trials....become beacons of hope....for subgroups...if only the poor delegate understood it correctly....that really thery were not negative trials, using potentially dangerous products...but instead hopeful endaveours to improve the lives and health of a small subgroups and sub-sub-groups worthy benefitors of these wonderful and expensive drugs...

I stand up and ask a RCT expert (prof David Jayne) whats the point of RCTs if negative results are discarded and we fall back on anecdotes and the answer is...in Lupus nephritis there has only been two drugs supported by RCTs....so my thought was why bother with RCTs...just dish out Rituximab to everybody and wait to stop more trials such as BELONG due to side effects or design them in such a way that they are underpoewred, like LUNAR, so that they continue to be used with the excuse....that the study was underpowered and the sample size too small....somebody could have told a Pharma company investing hundred of millions of dollars in a RCTs that it was underpowered...perhaps even one of their eminent clinicla advisors generously paid to advise....on RCT design???!!!!

Elegant and elaborate lectures are given to mask lack of evidence; elegance and powerpoint animation replacing and even covering form soft data, lack of evidence and lack of integrity....

Perhaps after all that is the way of medical life and research.

Perhaps, Nephrologists dont know better...

Perhaps, Pharma is smart and nephrologists greedy....

after all we are Nephrologists but also human beings....

BUT A WORD OF WARNING FOR THOSE WHO ATTEND THESE CONFERENCES, DONT LOOSE AS AN AUDIENCE THE POWER OF SKEPTICISM AND CRITICAL THINKING. 

It is not because such or such company payed your air fare and put you up in a 5 star hotel that you should leave your integrity as a critical mind at home....!!!!

BE CRITICAL, CHALLENGE AND BE SKETICAL....this way at least you attempt to find some of the truths amongst the Hype!

PS: I declare conflict of interest as I have also been sponsored by Pharma over the years and have as KOL often been generously paid for my participation in pharma advisory boards....!!!

 

 

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