GLG News by Cardiologists in Private Practice who Specialize in Lipid Management (US)

Dan StrejaClinical Professor of MedicineUNIVERSITY OF CALIFORNIA, LOS ANGELES

Actos has little to worry about Avandia lawsuits

May 10, 2011

Analysis of:Glaxo May Settle 1,000 More Lawsuits Over Avandia, Patients’ Lawyer Says | www.bloomberg.com

The FDA has practically eliminated Avandia based on either an analysis considered by everybody faulty or on data that were never released to the public. Actos has a different cardiovascular safety profile and Takeda should not and probably will not settle any lawsuits concerning risk of heart attack.

Dan StrejaClinical Professor of MedicineUNIVERSITY OF CALIFORNIA, LOS ANGELES

Aspirin cuts heart attack but not strokes, but not in everybody

April 24, 2011

Analysis of:Aspirin cuts heart attacks, but not deaths or strokes: study | www.reuters.com

Aspirin is a great drug to take for prevention of heart attacks but is not for everybody: - In women aspirin prevents strokes but not heart attacks - In patients with diabetes and no heart disease it does not seem to work - In patients with poor circulation to the legs it is not strong enoughThe lack of prevention of death might be due to the fact that the patient studied had less heart attacks but did not oblige the investigators by dying for them. Given the right patient aspirin remains a great drug.

Dan StrejaClinical Professor of MedicineUNIVERSITY OF CALIFORNIA, LOS ANGELES

Analysis of most prescribed drugs is no surprise

April 24, 2011

Analysis of:What Drug Did Doctors Prescribe Most Last Year? | blogs.wsj.com

In times of cost constrains this is no concern. There are additional factors to explain the numbers, some of them related to FDA wisdom:-       Multiple new drug applications in metabolic area have been turned down-       Propoxiphene was withdrawn increasing dramatically the use of hydrocodone-       Atorvastatin is already generic in other countries Others are related to strategy of the Pharmaceuticals:-       Lipitor keeps the market share against simvastatin by issuing $4.00 coupons-       Advair and Plavix are heavily advertized directly to the consumer As fewer drugs are approved and many drugs are getting old the overall picture is a logical consequence.

Ronald InnerfieldVice President of Clinical AffairsEvidence Based Medicine, Inc.

Metanalyses, Metapsychoses

September 30, 2009

Analysis of:Controls to blood sugar 'cuts stroke risk' | www.barchester.com

There have been many epidemiologic studies showing a very tight correlation between baseline A1c and cardiovascular mortalityDespite this, five major randomized prospective studies have failed to show any macrovascular benefit for tighter glucose controlThe logical conclusion is that glucose is, therefore, a marker for increased mortality but not a modifiable risk factor thereofThis is why FDA has mandated cardiovascular safety for new antidiabetic agentsData dredging persists, however

Dan StrejaClinical Professor of MedicineUNIVERSITY OF CALIFORNIA, LOS ANGELES

Outsourcing of compassionate use of drugs?

January 18, 2008

Analysis of: No right to experimental drugs for dying patients: Supreme Court | news.yahoo.com

The Supreme Court has rejected the use of experimental drugs by the dying patients on the grounds that "The framers (of the US constitution) understood that the pursuit of life is an inalienable right that should not be abridged without due process of law." Over the years our patients with terminal illness have traveled outside the US to purchase hope when our management was offering none. Although in the majority of cases the hope was unjustified, the current decision will encourage healthcare providers residing outside the US to advertise for their services through the internet. The issue should be addressed by the legislators sooner rather than later. Drugs who improve quality of life, awaiting approval for survival indication or drugs looking promising in early clinical trials could be made available to dying patients with informed consent addressing our limitations.  

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