The idea that high levels of HDL (or good cholesterol) are associated with decreased risk of heart disease is well established. Much less clear, however, is whether targeting the HDL component alone with a drug could reduce the risk of heart diseae. In December 2006, The ILLUMINATE study, a large clinical trial of an HDL-targeted drug was terminated early due to increased deaths, cardiovascular events and elevated blood pressure among the participants. Published in this week’s New England Journal of Medicine, to coincide with the American Heart Association meeting, is the full report of the results of this trial. This story reports on these results, however, rather than focusing on what is known about what went wrong in this study, the story instead overhypes the hypothetical idea that other more "clean" versions of the drug could avoid the downsides of the failed drug.
The story could have done more to point out that many researchers are now questioning the HDL/heart disease hypothesis.
But the story does a good job of presenting the harms of the failed drug in terms of natural frequencies (actual numbers) instead of relative rates.
Although the story accurately describes the ILLUMINATE study presented at the meeting, the story repeatedly exaggerates the claims that there is a future for HDL-targeted therapeutics. Starting with the headline and throughout the story, the possibility that other drugs targeting HDL could be viable is consistently overhyped in this story. At this point there is no evidence that targeting HDL will be an effective strategy and hopes that a more "clean" version of the drug will not have the harms of the failed drug is nothing but conjecture.
Finally, the story does not quote any independent experts or researchers, a major flaw of this story. Perhaps an indpendent expert could have put into perspective for the reader the fact that this story focuses on a small, theoretical part of the overall story at the expense of the facts.
The story does not mention costs, or potential costs of the new drug. At least a general statement could have been made about costs of combination drugs.
The story does a good job of presenting the harms of the failed drug in terms of natural frequencies (actual numbers) instead of relative rates.
The story mentions the increased risk of death, heart disease and elevated blood pressure with the failed drug. However, in the absence of evidence, the story should not be suggesting that a more "clean" version of the drug would not have such harms.
Although the story accurately describes the ILLUMINATE study presented at the meeting, the story repeatedly exaggerates the claims that there is a future for HDL-targeted therapeutics. Starting with the headline and throughout the story, the possibility that other drugs targeting HDL could be viable is consistently overhyped in this story. At this point there is no evidence that targeting HDL will be an effective strategy and hopes that a more "clean" version of the drug will not have the harms of the failed drug is nothing but conjecture.
The story does not exaggerate the seriousness or prevalence of heart disease, the target of the new drug. However, the story could have done more to point out that many researchers are now questioning the HDL/heart disease hypothesis.
The story does not quote any independent experts or researchers, a major flaw of this story. It’s not clear that anyone was actually interviewed, since only a study and an editorial were cited. Perhaps an independent expert could have put into perspective for the reader the fact that this story focuses on a small, theoretical part of the overall story at the expense of the facts.
The story does not mention other, established ways to raise HDL, such as exercise, statins, moderate alcohol consumption, etc., even though these have modest effects on HDL.
The story clearly states that the HDL-targeting drugs are still in the early stages of development. The story does not make any claims about when a new drug would be available, however whether it will ever happen is still highly theoretical. However, atorvastatin was studied along with torcetrapib and a note that it is available commercialy and is the largest selling cholesterol lowering drug would have been useful to the readers.
The story correctly categorizes the drug as the first of its kind in this class.
There is no way to know if the story relied on a press release as the sole source of information.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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