Blog | Tuesday, March 3, 2009

Best drug info doesn't come over free lunch


It's tempting to embrace newer generation drugs that are either more effective or cause fewer side effects than older drugs, but there's also wisdom in waiting for the dust to settle, if the current controversy over the atypical antipsychotic quetiapine (Seroquel) is any indication.

Quetiapine made the news again recently in connection with a federal court case during which manufacturer AstraZeneca PLC revealed a previously undisclosed analysis of studies showing that the newer drug was less effective than the conventional antipsychotic haloperidol, which it was supposed to improve upon, according to the Wall Street Journal.

Court papers have produced other unsettling revelations, including that AstraZeneca apparently told its sales reps to downplay a possible connection between quetiapine and diabetes, even though its own physician had once stated that a link was probable, the Wall Street Journal also reported. The company now faces more than 9,000 lawsuits from people alleging that they developed diabetes after taking quetiapine.

Those reports come after a study published last month in the New England Journal of Medicine concluded that patients taking atypical antipsychotic drugs (clozapine, quetiapine, olanzapine, and risperidone) faced a higher risk than non-users of sudden cardiac failure.

The reports seem like a good reason not to rely on the sales rep for information about new drugs, and to turn to unbiased sources such as Rxfacts, a project initated by Jerry Avorn, MD, and colleagues at Harvard. (See a related ACP Internist article on the project.)