Did the Avandia scare harm patients, and is Steven Nissen to blame?

The recent RECORD trial did not associate the diabetes drug Avandia with cardiovascular events.

Internist Matthew Mintz, a staunch defender of the drug, argues that because of the scare, “over 100,000 type 2 diabetic patients [needed] insulin, which could have been avoided.”

Who’s to blame? Dr. Mintz blames cardiologist Steven Nissen, whose questionable meta-analysis started the debacle, and The New England Journal of Medicine for fanning the flames. He questions whether the Journal followed its own rigorous peer review process, wondering how such an important study can be published only 3 weeks after receiving it. Indeed, Dr. Mintz speculates that “had the peer review process been followed strictly, the study may never have been published, or the results would have been modified and likely gotten much less publicity.”

Now that the cat’s out of the proverbial bag, should a full investigation be done, as Dr. Mintz suggests? It’s unlikely, given how the pharmaceutical industry is vilified both in the public and in political circles. And that may be too bad, especially if the accusations against Avandia have been conclusively proved false.

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