New Jersey Superior Court Judge Carroll Higbee, who oversees all the Vioxx litigation in New Jersey, recently granted a new trial in a Vioxx case won by Merck in 2005. The judge reasoned that Merck had withheld evidence of three deaths from an article that was published in the New England Journal of Medicine. This evidence skewed the article that may have influenced thousands of physicians when prescribing Vioxx. The New England Journal of Medicine issued an “Expression of Concern” in late 2005 when it found out about this issue. Of course, this is not the first example of drug companies’ use and abuse of medical journals. Medical journals seem to have a difficult time, no matter how hard they try, from protecting the credibility of their contents because of the disinformation put out by the pharmaceutical industry. If journals cannot stop printing articles by scientists with close ties to these businesses, they should at least force the authors to disclose their conflicts of interest publicly so that doctors and patients are fully warned that the articles may be biased.

Two disturbing cases were described in detail by the Wall Street Journal in the summer of 2006. One involved the American Medical Association and its Journal of the American Medical Association (JAMA); the other an obscure journal known as Neuropsychopharmacology, which is published by a leading professional society in the field. All makers of anti-depressant drugs had to love the article in JAMA. It warned pregnant women that if they stopped taking anti-depressant medications, they would increase their risk of falling back into depression. Unknown to the medical community and the public was the fact that most of the thirteen authors had been paid as consultants or lecturers by the makers of anti-depressants. Their financial ties were not disclosed to JAMA, which is impossible to justify.

The other example, which is actually worse, occurred at Neuropsychopharmacology, which published a favorable assessment of a new treatment for depression. The article failed to disclose that eight of the nine authors serve as consultants to the company that makes the device used in the therapy. The ninth author works directly for the company. The lead author of the study, who is the journal’s editor and a consultant to the company, has been accused in the past of promoting therapies in which he had a financial stake. It was reported by the Wall Street Journal that early drafts of this article were prepared by professional writers hired by the company. Nobody should be surprised that this therapy was judged a “promising and well tolerated intervention” for treatment-resistant depression.

The public must demand that disclosure and publications of conflict of interest be required. All leading journals should agree to punish authors who fail to reveal conflicts by refusing to accept further manuscripts from them. Surely, the journals can find authors who are free of conflict. If something isn’t done, the journals will lose credibility with the medical community.

Source: New York Times

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