Zantac Lawsuit

Researching drug company and regulatory malfeasance for over 16 years
Humanist, humorist

Saturday, April 25, 2020

Study 352 - Paxil & Bipolar Documents Released

Dozens of newly-publicised documents now give the full story of GSK’s ghostwriting campaign for a Paxil (paroxetine) clinical trial report on Study 352.

Charles "Bling Bling" Nemeroff

What is Study 352?

A Double-Blind, Placebo-Controlled, Comparison of Imipramine and Paroxetine in the Treatment of Bipolar Depression. The lead 'author' on the study was Charles B. Nemeroff, a psychiatrist who had close ties to GlaxoSmithKline and other drug companies.

Anyone familiar with GlaxoSmithKline and Paxil will know all about the Paxil 329 study where they [Glaxo] hired a PR firm to draft and, later, persuaded key thought leaders, mainly child psychiatrists to endorse and promote Paxil (paroxetine) at any given opportunity. The 329 study has been dissected by many who are in agreement that it's a piece of fraud. Read more about the Paxil 329 study here.

Not content with one study doing the rounds in various journals and paediatric clinics Glaxo, in their infinite wisdom, hired the services, once again, of a ghostwriting team to pimp out a paroxetine bipolar trial, known as Study 352.

"Study 352" was published in the American Journal of Psychiatry (158:906-912; June 2001) and suggested that Paxil may be beneficial in the treatment of bipolar depression. The study, as mentioned above, cited Charles B. Nemeroff as the lead author. The name Nemeroff is synonymous in the ghostwriting and kickback field. He's made a lucrative living out of speaker fees and pharmaceutical roundtables, although this is classed as 'honoraria' [ex gratia payment]

Glaxo hired the same PR outfit, Scientific Therapeutics Information, [STI] to misrepresent information from Study 352. STI also drafted the original Paxil 329 study, specifically Sally Laden. I've wrote extensively about Laden in the past, see here, here & here.

Just like Study 329, Study 352 also made unsubstantiated efficacy claims and downplayed the adverse event profile of Paxil.

Dr. Karl Rickels

The original 352 study made the following acknowledgement:

This study was conducted with the participation of the following collaborating investigators and sites: Jay D. Amsterdam, M.D. (University of Pennsylvania School of Medicine, Philadelphia)

Amsterdam was asked by Dr. Karl Rickels if he could help out a junior colleague, Laszlo Gyulai, on the study. Rickels had been working on pharmacological treatments for mental health since the 1950's and had previously worked alongside Amsterdam.

Rickels had also previously served in the German army under Rommel. He was captured and brought to America as a POW. After the war he completed medical school and postgraduate training in Germany. When a psychiatric residency position opened at a mental hospital in Iowa, Rickels accepted the opportunity and immigrated to the United States. Later he founded the Mood and Anxiety Disorders Section at the University of Pennsylvania.

Amsterdam, who accepted Rickels offer to work alongside Gyulai, was no stranger to industry sponsored studies. According to Peter Simons, a science writer for Mad in America, "Amsterdam was also on industry panels for over a dozen pharmaceutical companies, giving sponsored talks. It wasn’t until the early 2000s that industry representatives began urging him to deviate from his prepared talks. Once he began to experience pressure to “spin” his results in favor of the drug, he said, “I stopped giving talks.”"

Study 352 Newly-Publicised Documents

According to Los Angeles based attorneys, Baum Hedlund Aristei & Goldman, "Amsterdam was an investigator who treated the largest number of patients in Study 352. However, he was intentionally left off from the review of the data and the drafting of the manuscript because the study sponsor, GSK, and the other “so-called authors” knew Dr. Amsterdam’s professional ethics would not allow him to lend his name to a ghostwritten work, and more importantly, he refused to participate in the alteration and manipulation of data for the sake of marketing Paxil.

"In 2011, Dr. Amsterdam lodged a formal scientific misconduct complaint with the U.S. Department of Health and Human Services’ Office of Research Integrity.

"In the 2011 complaint, Dr. Amsterdam alleged the individuals named above allowed their names to be added to a manuscript that was drafted by a “medical communications company” (STI) hired by SmithKline Beecham (now GSK) and misrepresented information from Study 352, which was funded by GSK and the National Institute of Health (NIH).

"The published 352 article falsely concluded that paroxetine therapy is effective in bipolar depression without any meaningful manic or other side effects. According to Dr. Amsterdam’s complaint, the published results were manipulated and manufactured by GSK and STI employees."

Amsterdam alleged that Guylai, had taken his data from the 352 study in which he had recruited the majority of patients, and that Guylai and a team were about to publish an analysis of the data under their own names. In response, Karl Rickels, chief of the mood disorders section of the UPenn Medical Center, told Amsterdam GlaxoSmithKline (then SmithKline Beecham) was in charge of the study and that the authors hadn't even seen the manuscript (CBS News)

Baum Hedlund Aristei & Goldman has now released new documents pertaining to Amsterdam's complaint which include:

  • Sally Laden of Scientific Therapeutics Information Inc. (STI), a consulting firm hired by GSK, was the ghostwriter of a Paxil clinical trial report for Study 352 (and Study 329), which effectively spun negative study results into positive results. GSK paid academics to lend their names to the clinical trial report, published as “Double-Blind, Placebo-Controlled Comparison of Imipramine and Paroxetine in the Treatment of Bipolar Depression” by the American Journal of Psychiatry. GSK wrote and reviewed the report before any of the “official” named authors were contacted for their input. The article has never been retracted despite overwhelming evidence of scientific manipulation.

  • An American Journal of Psychiatry editor with financial ties to GSK abetted the alleged fraud by intervening to ensure “Double-Blind, Placebo-Controlled Comparison of Imipramine and Paroxetine in the Treatment of Bipolar Depression” was published after the manuscript was initially rejected.

  • The University of Pennsylvania, which employs two of the study’s “official” authors, continues to further stonewall investigation into the malfeasance of its faculty in this matter despite numerous attempts on our part to conduct a thorough investigation. The correspondence letters posted on the Baum Hedlund Aristei & Goldman site between the firm, the U.S. Department of Health and Human Services’ Office of Research Integrity (ORI) and the University of Pennsylvania trace the history of events surrounding the alleged scientific fraud of Study 352. It is unclear whether Penn actually submitted the new evidence to ORI as their responses to Baum Hedlund Aristei & Goldman have been ambiguous. Baum Hedlund Aristei & Goldman believe that had ORI reviewed the evidence contained in the 40 STI documents, rather than having relied upon Penn’s investigation, ORI would have come to the conclusion that the academic consultants involved in the 352 trial committed serious scientific misconduct and would have decided in favor of Dr. Amsterdam’s complaint.

Once such document shows how the PR firm, Scientific Therapeutics Information, [STI] has worked on approximately 100 Paxil related projects for GlaxoSmithKline. Another shows a letter from Sally K. Laden to Cornelius (Neil) Pitts who, in 2001, was the Assistant Director, Clinical Research Development at GlaxoSmithKline. In this particular document we see Laden set out the cost of STIs work on the project. The final invoice for ghostwriting Study 352, according to Laden, was $13,286,81.

This letter from Laden to Nemeroff, the nominated lead 'author' for Study 352, shows how Nemeroff would liaise with GlaxoSmithKline whenever Study 352 was criticised.

If you don't feel sick yet then wait until you read the correspondence between Baum Hedlund Aristei & Goldman and the Office of the General Counsel at the University of Pennsylvania, who, it appears, deny there is any wrong-doing!

"The University recognized 
that the authors collaborated with professional writers when drafting the paper and the University concluded that such collaboration in 2001 did not constitute research misconduct. "

All new documents can be found here, GSK Paxil Clinical Trials | Court Documents.

Fid Rant

Sally K. Laden

Regular readers already know my thoughts on GlaxoSmithKline, Charles "Bling Bling" Nemeroff and Sally K. Laden. Three subjects whom, I feel and believe, are totally void of empathy when it comes to the safety of patients.

Payments from GlaxoSmithKline to Nemeroff run into millions of dollars, he is, in my opinion, nothing more than a despicable human being who cares only about the size of his bank balance, he, seemingly, cares not a jot about the safety of patients. Money, and lots of it, has blinkered his rational.  Jay D. Amsterdam, on the other hand, saw the light. He saw how money influenced decisions and put patients at risk. He did the right thing by turning his back on the never ending supply of dollar bills that ultimately meant turning something shit into something smelling of roses.

Laden, and her team at STI, should hang their heads in shame. The 352 Study, which she and her team spun from shit to roses, has been cited many times and used as some kind of half-arsed informed consent to prove that Paxil is safe and effective in the treatment of Bipolar, when in actual fact Laden, at least, knew there were problems. Remember, this isn't the first time Laden has turned Glaxo's shit into roses. She and her team have been paid handsomely time and time again. She has never learned from her mistakes and, like Nemeroff, was never able to see passed the Benjamins. For that sole reason, and the fact that she and her STI team continued to work on projects with GSK, I hold her in complete contempt.

If GSK, Nemeroff and Laden are rotten eggs then what of the University of Pennsylvania? After reading their denials of any wrong-doing, I, personally, have to put them in the same boat as the aforementioned. Protecting their prestigious University name seems to be the issue here, once again it's all, seemingly, about the image rather than protecting the safety of patients.

Drug companies have also paid institutions, such as the University of Pennsylvania, in the past. Pfizer's disclosure report for the University of Pennsylvania, for example, shows Pfizer-sponsored research, totaling $1,199,378. Karl Rickels, who remember persuaded Amsterdam to work alongside Gyulai, on the 352 study, was listed as the principal investigator for a research project with a cash payment of $73,791.

Although there is no evidence to suggest Rickels worked with GlaxoSmithKline on Study 352, it does leave me with my jaw on the floor that a former German POW works amongst the field where patient safety should be paramount.

According to his memoirs, Rickels claims he had no choice but to join the German military. This may be true but having bore witness to one catastrophic event, be it after the event or not, he, seemingly stood by and watched another catastrophic event unfold. It was Rickels who told Amsterdam that GlaxoSmithKline was in charge of the study and that "the authors hadn't even seen the manuscript."

For the second time in his life he, seemingly, stood back and said/did nothing.

GlaxoSmithKline, of course, are the main culprit here but as long as individuals and entities such as Laden, Nemeroff, Rickels and departments within the University of Pennsylvania
 have a desire for money rather than a desire for patient safety, Glaxo and other drug companies will always be able to turn shit into roses.

It's all rather incestuous isn't it.

Bob Fiddaman

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