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Researching drug company and regulatory malfeasance for over 16 years
Humanist, humorist
Showing posts with label Sally K. Laden. Show all posts
Showing posts with label Sally K. Laden. Show all posts

Wednesday, September 23, 2015

Seroxat - Project 1059 Laden With Withdrawal Problems






GlaxoSmithKline are defending allegations that it's antidepressant, Seroxat, known as Paxil in the US, causes severe withdrawal reactions when patients have tried to taper of of it. They have settled similar allegations in the US with over 3,000 claimants, all of whom went on to sign confidentiality agreements - the official line of that particular case was that it was "resolved."

Later this year sees GlaxoSmithKline defend the same allegations, this time in the UK. The case has been running for 8 years plus and at no time have GlaxoSmithKline, via their representative lawyers, Addleshaw Goddard, made any offer of settlement to the 105 plaintiffs in the case.

So, there's a kind of stale-mate. 105 claimants allege they suffered severe withdrawal reactions when trying to wean themselves from Seroxat - Glaxo have maintained that "We believe the product is not defective and that there is therefore no merit in this litigation."

No merit?

Let's go back in time, to the year 2000.

James Ballenger, MD, was chair of the Medical University of South Carolina’s Department of Psychiatry, and he had been carrying out a long-term panic disorder study in 2000, Seroxat was the choice of drug. The study was cancelled by GlaxoSmithKline (then SmithKline Beecham) after they learned that Ballenger's findings had found something that they wanted to keep quiet - Severe withdrawal effects in adults that take them!


"There are some data that no amount of spin will fix."

As with most clinical studies, Glaxo had, just like they did in Study 329, hired a ghostwriter to draft the positive results from Ballenger's study.

Once again, just as in Glaxo's infamous 329 study, Sally K. Laden was handed the job of turning bad into good. Sadly, for Glaxo at least, even Laden couldn't spin the results of Ballenger's study, (known as "project 1059")

Internal emails between Laden and Daniel Burnham of SmithKline Beecham show Burnham write the following...

"The issue of discontinuation sx [side effects] vs. relapse is obviously a concern of the J Clinical Psychiatry reviewers... Thus we have decided to terminate further work on this manuscript."

The industry prefer to call withdrawal issues "discontinuation problems".

What is striking about this correspondence is Laden's response to Burnham...

“We understand your reasons for cancelling this project. There are some data that no amount of spin will fix, and these certainly fall into this category.”

This, to me at least, suggests that Laden was familiar with spinning poor results into bad.

Laden then told her bosses at Scientific Therapeutics Information, Inc. (STI)...

“Yes, Virginia, there is a God. SB cancelled our project 1059 (long term panic disorder study). Reason: the side effect data was terribly unfavorable to our favorite antidepressant. And we hate when that happens!”

Definition of 'terribly' -  very, extremely, hugely, intensely, immensely, dreadfully, incredibly, extraordinarily, seriously.


In a 2012 interview with investigative journalist Dyan Neary, Ballenger said...


“What that study in retrospect probably showed for the first time was that there’s withdrawal from the medicine…your body might miss it.”


Hmm, dependency anyone?

Question we really should be asking here is why didn't GlaxoSmithKline, when they knew of the severe withdrawal problems, carry out their own study into these problems raised in Ballenger's study? Why did they sit on this information? Myself, and others, would then not have had to endure the horrific withdrawal problems - had myself, and others, had previously know about these "terrible" side effects, we would never had taken Seroxat.

The prosecution rests, m'lud.

Here's the emails. (Click to enlarge)






Something for Glaxo's UK lawyers, Addleshaw Goddard, to mull over, perhaps.


Bob Fiddaman.



Competing interests

I am one of the 105 claimants in the UK group action.







Thursday, August 27, 2015

Study 329: The Final Chapter



"Truth will come to light; murder cannot be hid long." 
William Shakespeare - Merchant of Venice (1596)



Let's make no bones about it. Study 329 is, and always has been, a ghostwritten publication based on deception and intended to result in financial gain.

The putrid stench of deception has been obliterated, redesigned and is now a sweet smelling single rose, a small token gesture of truth for all those harmed by GlaxoSmithKline's fraudulent 329 study, of which there are many (children and adolescents)

Study 329 is, without doubt, the most infamous of all antidepressant studies. It reeks of deceit, of greed, of dishonesty, of financial kickbacks and has left a slimy trail of death and destruction in its wake.

I have, for my part, written and published many articles on this blog regarding 329. Three of which, Sally K. Laden, The Paxil Ghostwriter Part I, and Sally K. Laden, The Paxil Ghostwriter Part II - Emotional Lability, ending the trilogy in this series with, Sally K. Laden, The Paxil Ghostwriter Part III - Summation. being amongst the most popular.

329 highlights how one company saw a niche in the child depression market and, without due care and consideration, made unfavourable clinical trial results into favourable results.

329 is the spin of all spins, the retraction of which from The Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), has been called for many times.

Now, a group of tenacious researchers have shone a very bright light on what 329 should have revealed. Their findings will be published in the British Medical Journal (BMJ) next month.

Meantime, the Study 329 website has been launched and offers some interesting facts about the fraud behind GlaxoSmithKline's darkest hour.

The Restoring Study 329: Efficacy and harms of paroxetine and imipramine in the treatment of adolescent major depression: restoration of a randomised controlled trial, should shock all who care about integrity in drug safety.


Bob Fiddaman.



Monday, November 18, 2013

Sally K. Laden, The Paxil Ghostwriter Part III - Summation








"So Sally can wait, she knows it's too late as we're walking on by
Her soul slides away, But don't look back in anger, I heard you say."

"Don't Look Back In Anger" - Noel Gallagher



My summation is based upon two previous entries.

PART I

PART II




Raw data is like raw sewage. Dive into it and you'll be able to taste a lot of shit.

Fellow blogger and ex-psychiatrist, Mickey Nardo, who writes the 1boringoldman blog, hit the nail on the head a couple of days ago.

Nardo, like many others, has been writing about Study 329. He's dissected it bit by bit and thrown up some valid points. One such point, which really sums 329 up, came about after he read the depositions of both Sally K. Laden and Marty Keller.

"Neither the first author nor the ghost·writer looked at the actual data. I find that remarkable…", Nardo writes.

My  previous two posts highlighting Laden's deposition show that she was handed a summary of the clinical trial GlaxoSmithKline carried out in depressed kids. The actual clinical trial findings were bundled into a 1400 page document. Laden worked from just 200 pages that Glaxo gave her.

Keller, who was paid by Glaxo to add his name to Laden's work, had this to say when he was deposed:

"I've reviewed data analytic tables. I don’t recall how raw it was. Huge printouts. You know, that list items by item number. Item numbers and variable numbers. And don’t even have words on them. I tend not to look at those. I do better with words than I do with symbols."

Let's imagine for one minute that Laden and Keller are airline crash investigators and GlaxoSmithKline are an airline company. [GSK Airlines]

One of Glaxo's aircraft, Flight 666, goes down, killing all passengers on board. Laden and Keller are called upon to investigate the crash. The black box is found, it contains an hour of audio that is vital to the investigators but Glaxo, for some reason, deleted 40 minutes of that audio before handing it over to Laden and Keller.

Laden and Keller then work from the 20 minutes of audio that they have. As experienced investigators neither ask Glaxo if there is any more audio, they are happy to work from just 20 minutes of audio.

With the investigation complete Laden and Keller lay no blame on GSK Airlines, they blame pilot error.

Just before the press release GSK Airlines contact other experts in the field of aviation. They show them the findings of Laden and Keller and ask them if they would lend their names to the report. The following internationally respected air crash investigators add their support to the findings of Laden and Keller, like Laden and Keller none of them have had access to the original 60 minutes of audio from the black box.

Boris Birmaher, Gabrielle Carlson, Gregory Clarke, Graham Emslie, David Feinberg, Barbara Geller, Owen Hagino, Rachel Klein, Harold Koplewicz, Vivek Kusumakar, Stan Kutcher, James McCafferty, Rosemary Oakes, George Papatheodorou, Neil Ryan, William Sack, Michael Strober, Michael Sweeney, Karen Wagner, Elizabeth Weller and Nancy Winters.

This, for me at least, is the perfect analogy but there's a further twist...

Some years down the line GSK Airlines are sued by a passenger. John Doe slipped on an apple peel whilst walking to his seat on Glaxo's 747.

During the trial, John Doe v GSK Airlines, items of disclosure reveal secret emails between GSK Airlines, Keller and Laden that pertain to the crash investigation. Doe's law team have stumbled upon something that they weren't supposed to. They learn that GSK Airlines have covered-up the crash, they learn that the principle investigators, Laden and Keller worked from 20 minutes of audio and not 60. Further investigation shows that the missing 40 minutes of audio highlights what really happened aboard Flight 666. It was not pilot error, the airline company [GSK Airlines] were at fault. Ground control at GSK Airlines had put in the wrong flight coordinates causing Flight 666 to crash into a hillside killing all on board.

These findings are handed over to the Civil Aviation Authority who, after a 4 year investigation, find that GSK Airlines withheld vital information. However, the Civil Aviation Authority announce that no criminal charges will be brought against GSK Airlines, instead they send a letter to GSK Airlines CEO telling him that they are not happy with the cover-up/fraud [See GSK investigation concludes]

In one final twist, it is learned that the Civil Aviation Authority have two ex-employees of GSK Airlines on their board, one of whom, Ian Hudson, was a former airline safety expert during his time at GSK Airlines, he also worked very closely with overseeing the safety of Flight 666.

Perversely, and some years down the line, Ian Hudson accepts the role of CEO of the Civil Aviation Authority [See Former Glaxo Safety Officer Becomes Head of MHRA]


You smell corruption here?

There are a number of reasons why I chose, back in 2006, to create this blog. There are many more reasons why I continue to write.

You see, I was prescribed Paxil and I had a number of adverse reactions to it. I became addicted to it, I couldn't get off it, any attempt to do so was met with severe electric head zaps, feelings of aggression and, more importantly, one suicide attempt.

The more I dug, the more I learned.

A hat tip goes out to investigative journalist Evelyn Pringle. It was only through reading her work that I continued to push for answers from both GSK and the UK Medicines Regulator, the MHRA.

Another hat tip must go to BBC journalist Shelley Jofre. Four Panorama investigations into GSK, Paxil and the MHRA put fire in my belly.

Alison Bass, who wrote Side Effects: A Prosecutor, a Whistleblower and a Bestselling Antidepressant on Trial, also deserves a lot of credit for highlighting the fraud behind Study 329.

There's also the work of David Healy, originally chastised by fellow psychiatrists for speaking out about the suicide link between kids and Paxil and other antidepressants.

Plaudits must go to John Jureidini and Leemon McHenry. Their tireless pursuit in trying to get Study 329 retracted from the Journal of the American Academy of Child and Adolescent Psychiatry should be met with a standing ovation.

The guys and gals over at Healthy Skepticism, who really started the ball rolling when they published 329 study documents online. A huge thanks should go to the team there.

The Citizen's Commission on Human Rights, have been banging the drum since God knows when regarding the suicide link and antidepressants, they too should take credit here.

Former US Senator Charles Grassley for giving GSK many headaches deserves, at the very least, an honourable mention as do the team at Baum, Hedlund, Aristei & Goldman, California's top ranked law firm who have spanked Glaxo and King & Spalding on numerous occasions.

There are many more who deserve credit, many of them bloggers...far too many to mention.



I walk alone across the outskirts of town
I can’t control what I’m going through now
Will you light the fire that I need to survive
Will you donate the life blood
Coursing through my veins
Will you open up the door & let me out of this place

"Strength" - The Alarm 1985




Further down the line I learned of the devastation Paxil had caused to families who were left to grieve the loss of their children, namely Sharise Gatchell and Sara Carlin, two young teens who both hanged themselves after being prescribed Paxil.

I have since met a number of families who have lost children and partners to a number of selective serotonin reuptake inhibitors [SSRIs] of which Paxil is one. As a parent I would just hate to utter those words, "my child killed himself/herself". It would be so hard for me to accept that one of my children had killed themselves, even harder to accept that they had suicided as a result of the drug they were taking. A pill that was meant to help them actually caused psychosis resulting in them killing themselves. The company/s that made the pills knew that this was a possibility but failed to warn because it would have affected their sales.

Death by hanging, death by jumping from a bridge, death by stabbing, death by overdose all because top pharmaceutical companies wanted to stay ahead of competitors.

It's the loss of life that carries me. It was so needless, particularly when we learn that these deaths could have been avoided if it wasn't for greed.

I am an extremely lucky person. My own experience at the hands of Paxil has, quite possibly, saved the lives of my three children. I was the guinea pig and I am thankful for experiencing Paxil induced suicide and the horrific withdrawal problems [addiction]. It was information that I was able to relay to my children. They, in turn, will relay the same information onto their children.

I'm lucky I can write about other people's kids killing themselves because I can always switch off and sleep at night, I don't have that overwhelming burden of grief to carry.

It's quite a position to be in. My heroes are not the academics, lawyers, journalists and human rights movement I listed above. My heroes are the parents of the dead children and partners. Neil and Rhonda Carlin, Steph Gatchell, Leonie Fennell and Tony Donnolly, Elaine Billings, Sara Bostock, Kim Witczak, Mathy Downing, Stuart and Claudette Jones, Celeste Steubing. And these are just the people I have met or corresponded with. My heroes are also those parents who lost their children because they were not warned about the risk of SSRI toxic poisoning during pregnancy. Christian and Matt Delahunty, Amery and Christiane Schultz, all of whom lost their babies to the antidepressant Effexor.

I've met many more in passing.

Each time I look at the list of my heroes I feel terrible sadness but a deep, underlying fighting spirit emerges from within. My sadness for their loss is insignificant. Why should I care about my own sadness when it is nothing compared to theirs? These parents and partners don't need my sympathy or empathy, they need answers as to why their children and partners were allowed to be given a drug that could induce their suicide and/or toxic poisoning. I want to embrace each and every one of them and somehow make their pain go away. I know that is an impossibility. Their loss will be with them forever, meantime I can sleep it off.

I will never be able to understand where they get their strength from to continue, they will probably tell me it's just a natural instinct to survive but as I sit here now and ponder... or at least try to ponder the unthinkable, I don't actually know if I could find the strength in me to survive after such a loss. All of the above have and continue to do so, each of them spreading awareness when it would have been so much more easier [and beneficial to the pharmaceutical companies] for them to accept death, deal with the rawness of the loss then try to move on in life as best as they could. For that they are heroes in my eyes. they are dealing with their own loss yet preventing, or trying to prevent the loss of others with the awareness they create. That's heroic by anyone's standards, it's a superhuman effort and they should each stand tall.

If I knew something was afoot about their deaths and did nothing about it then I, unlike the Paxil 329 Study authors, wouldn't be able to sleep at night.

If 329 was an airline crash study then the general public would, I'm sure, be outraged. At the very least there would be calls for a retraction of the findings from Laden, Keller et al. There would, I'm sure, be calls for the Civil Aviation Authority to be policed due to the blindingly obvious conflict of interest.

Alas, GSK are not an airline.

The MHRA are not an airline regulator.

Laden, Keller et al are not airline crash investigators.

They are all, in essence, part of a huge cover-up instigated by a British pharmaceutical company who sought profit before safety.

Sally Laden, Marty Keller, Boris Birmaher, Gabrielle Carlson, Gregory Clarke, Graham Emslie, David Feinberg, Barbara Geller, Owen Hagino, Rachel Klein, Harold Koplewicz, Vivek Kusumakar, Stan Kutcher, James McCafferty, Rosemary Oakes, George Papatheodorou, Neil Ryan, William Sack, Michael Strober, Michael Sweeney, Karen Wagner, Elizabeth Weller and Nancy Winters should all take a bow. They each have a responsibility to safeguard the public. Not one, to my knowledge, has called for Study 329 to be retracted. Not one, to my knowledge, has been angered enough to publicly chastise GlaxoSmithKline for duping them [if indeed they were duped]

All of the above should acknowledge that the study, initially drafted by Sally K. Laden, is misleading. By adding their names they have each persuaded a doctor to write a prescription for Paxil... for kids.

They should be utterly ashamed of themselves for duping fellow professionals and for putting kids in danger. They can each argue that they didn't know. Maybe so, but two points here.

1. They would have known if they would have asked for the full data

and

2. They know now but continue to defend their corners.


Finally, for now at least, there is one more twist in the tail.

The CEO of GlaxoSmithKline, Andrew Witty, was knighted back in 2012 for services to the economy and the UK pharmaceutical industry. For this he was given the title of 'Sir' and handed a medal from the Queen.

Witty has been asked, in a series of letters, to retract study 329 from the Journal of the American Academy of Child and Adolescent Psychiatry [see Witty's Era Still Smells of 329 Rotten Eggs]

Witty, via his spokespersons, does not agree that Study 329 was fraudulent and misleading.

Only John Grisham could come up with such a story.

I guess Witty has been instructed by Glaxo lawyers to never admit Study 329 is fraudulent. Deny, deny, deny is the rule of thumb here.

Glaxo's American lawyers, King & Spalding, who have defended Paxil on many occasions, have a Twitter account. If after reading Parts I, II & III of my Sally K. Laden series of posts you feel inclined to drop them a message then please feel free to do so. - @kslaw

They probably won't answer you but someone on their friend list may just get into debate with you. Glaxo, their lawyers and the likes of Sally K. Laden and Keller et al cringe at Study 329 debate, particularly when members of the public call for its retraction.

If, after reading this series of posts about Laden and 329 you feel compelled to share via Twitter and/or Facebook you, like me, will become frustrated at the lack of response from those on your friend lists who take little interest in antidepressants and suicide. I call these the 'fluffy  bunny brigade', although they are good people and great friends they much prefer not to involve themselves in your world of grief. A photograph of a fluffy bunny, cute kitten or puppy would get more responses if you were to post it on Twitter or Facebook.

These are the people that need educating because they too need to warn their children and their children's children that there's a bunch of adults who ghostwrite and add their names to published studies who really have no interest whether children or grandchildren live or die. We have, in GlaxoSmithKline, a company who have kept social media acquaintances in the dark about the safety of Paxil in children and adolescents, a company who refuse to retract 329.

I'll always strive to do my bit.

The rest is up to you.


Bob Fiddaman



Sally K. Laden's deposition can be downloaded here.






Sunday, November 17, 2013

Sally K. Laden, The Paxil Ghostwriter Part II - Emotional Lability






One, two, three, four, five,
Once I caught a fish alive,
Six, seven, eight, nine, ten,
Then I let it go again.
Why did you let it go?
Because it bit my finger so.
Which finger did it bite?
This little finger on my right.



Following on from Part I, today I am trying to decipher, along with Sally K. Laden, what the term 'emotional lability' means, more to the point whether or not Sally K. Laden knew as far back as 1998 if 'emotional lability' meant suicide attempts.

Before I move on I'd like to list Laden's qualifications again.

Laden graduated in 1981 from the University of Connecticut with a Bachelors degree in Pharmacy and in 1983 from the Kansas University with a Masters degree in Hospital Pharmacy.

In 1985 Laden became the Associate Editorial Director - Scientific Therapeutics Information [STI]

She has been self employed since 2003, working from home for the business she founded, MSE Communications LLC where she is a Freelance Medical Writer. According to her LinkedIn profile she is also a Developmental Editor for Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, and has been since January 2013.

Laden is also a member of the American Medical Writers Association.

So, a Bachelors degree and a Masters degree. Quite safe to assume then that Laden is quite well educated, in other words she's not stupid, the definition of which is; lacking intelligence or common sense.

In part I it was established (If Laden was telling the whole truth, that is) that GlaxoSmithKline handed over approx 200 pages of a clinical trial they had carried out using paroxetine [Paxil] to treat depression in children and adolescents. By Laden's own admission, "I believe it's considered a synopsis of the report rather than each individual patient's data".

In fact the entire clinical study report was over 1400 pages long yet Laden only saw 200 of these. Hardly the basis of drawing up such an important draft, particularly when it involved medicating children and adolescents. Here, I do question Laden's lack of intelligence or common sense. It's okay to question, right?

Nonetheless, Laden came to the conclusion [based upon the 200 pages] that Paroxetine is a safe and effective treatment of depression in the adolescent patient."

Maybe her conclusion was correct on the basis that Glaxo only gave her 200 pages. Maybe Glaxo omitted the other 1200 pages because Laden may have arrived at a different conclusion?

Key:

Q = George Murgatroyd (Baum Hedlund)
A = Sally K. Laden


Q: So you relied upon GSK in providing you with accurate information, correct?

A: Yes

Q: And to the degree that that information is inaccurate that's not your fault right?

A: It's not my fault?

Q: Yes. If you wrote something in the manuscript that's inaccurate, that was based upon information that was provided to you by GSK, it would not be your fault if you wrote something inaccurate, correct?

A: I guess, correct.

Q: Okay. Now I mean do medical writers have the responsibility to go back and look at the raw data to see if the interpretation of that data is correct?

A: I don't believe so

...

Q: Okay. You know GSK coded the suicide events in Study 329 as Emotional Lability. Are you aware of that?

A: Yes

Q: Were you aware of that fact at the time you prepared the first draft of the manuscript?

A: I don't know

Q: How did you become aware that that term was being used to cover suicide attempts?

A: It must have been in a document. In whatever document I was given.

Q: Okay. So when you prepared the first draft you knew that Emotional Lability was included?

A: Again, I don t know if I had this at the time of the first draft. I don't know. I cannot say that I had this document that is sitting in front of me at the time I wrote the first draft and I would have to look and see what is in here.

Q: Okay. Well let me maybe back up for a second. When you prepared the first draft of the manuscript were you aware of the number of adolescents who experienced events involving suicidality? Just suicidality events, suicide events?

A: Completed suicide?

Q: No just events involving suicidality?

A: I don t recall

At this point Murgatroyed tells Laden to look at her draft.

Q: Did you find something in the first draft that talks about suicidality?

A: There is the Emotional Lability

Q: Okay. How about suicidality?

A: No

Q: Okay. My question is do you know what the term Emotional Lability means?

A: Emotional means you have emotions. Lability means you re waxing and waning.

Q: Okay. And when you wrote the manuscript did you know that that was the topic that GSK stuck the suicide events under?

A: I don't know.  I don't remember.

Murgatroyed then asks Laden if she was aware that the FDA analysed Study 329 with regard to adverse events. Laden replied, "I am aware of that."

Murgatroyed then showed the results of the FDA to Laden.

Q: And it says drug, meaning Paxil 6.5%,  Placebo 1.1%, Risk ratio equals 5.9%, do you see that?

A: I see that

Q: Do you know what a risk ratio is?

A: My understanding is that it's statistical language comparing one thing with another of the probability of an event happening.

Q: Okay. In this instance an adolescent taking Paxil is almost six times at the risk of experiencing possible suicide related event compared to an adolescent taking placebo, correct?

At this point the attorney representing Laden, Stuart Margohs (Berdon Young & Margohs), interrupts...

"That is one question. The other question is whether or not you can tell if that is a depressed adolescent or not."
Murgatroyed points out that Study 329 was a study involving depressed adolescents.

Back to the questioning of Laden

Q: Do you think it s appropriate to promote Paxil as safe when over 5 percent of the adolescents taking Paxil during clinical trials of 329 attempted suicide?

A: I can't answer that question. I am not an expert to know whether 5 percent is a dangerous risk in a dangerous disease or 50 percent is a dangerous risk in a dangerous disease. An expert would know that. I'm not an expert.



Is it safe to assume that Laden is not answering the question put to her by Murgatroyed because she actually knows that over 5% of kids taking Paxil who attempted suicide is really an appallingly high figure?

Let's just take a look at Sally Laden's education once more.

Laden graduated in 1981 from the University of Connecticut with a Bachelors degree in Pharmacy and in 1983 from the Kansas University with a Masters degree in Hospital Pharmacy.

And yet Laden cannot seem to answer a simple question about whether or not she thinks over 5 percent of the adolescents taking Paxil during clinical trials of 329 who attempted suicide is appropriate.

One does not need to be an expert. All Laden needed to do here was hold up both hands, keeping one closed in a fist and the other fully open showing her five digits. Her closed fist representing placebo, her open hand showing her fingers and thumb representing the percentage of kids attempting suicide whilst on Paxil.

If this question was not answerable because Laden is 'not an expert' then her degrees in Pharmacy (a four-year course) really mean nothing.  The course would have given Laden a broad understanding of the pharmacy-related aspects of chemistry and biology. The course would have also covered the science behind the preparation, supply and monitoring of medicines.

Are we expected to believe that she could not answer the above question because she wasn't an expert or was there some other reason?

Laden knows how to read a prescription, she knows exactly how many pills she should put in a bottle but she cannot answer a question on whether it was appropriate that more kids attempted suicide on Paxil then they did placebo?

C'mon!

As I mentioned in Part I, Laden is married. What I failed to mention is that Laden has a son.

Here's my question to Laden. Her son is believed to be in his 20's. He would have been a small child around the time Laden prepared her first draft. If, during his teen years, let's say 13-18, he would have been dignosed with depression, would Laden have allowed a prescribing physician to give him Paxil to treat his depression?

I can only assume that the answer would be 'no' given that 5 percent of kids attempted suicide on the very same study that she wrote, "Paroxetine is a safe and effective treatment of depression in the adolescent patient."

Does she not feel that every parent has a right to know this information, if so, at what point did they need to know? 1998, 99, 2000?

Another way of looking at it is this.

Laden takes her son to see a child psychiatrist. The child psychiatrist tells her that her son is depressed. He informs her that he wants to try Paxil to help alleviate his symptoms of depression. He also tells her the results of the Paxil 329 study. "Mrs Laden, I have to inform you that five percent of kids attempted suicide during the clinical trials of Paxil, all of them were on Paxil at the time. I also have to tell you that none of the kids on placebo attempted suicide." Would Laden shrug her shoulders and say, "Ah well, I'm not really an expert, go ahead and write the prescription for my son."

I think not.

It's a luxury that many parents have never had. They were told it was safe. Doctor's prescribing it were told it was safe. Psychiatrists reading her ghost-written article have been told it was safe. The study has never been retracted from the Journal of the American Academy of Child and Adolescent Psychiatry. One would think, as a mother, Laden would be calling for its removal. Morally it would be the right thing to do. Her silence is, in my opinion, embarrassing.

Here's just one victim who died by suicide after being prescribed Paxil. Sadly, the young girl in this video never made it to her 20's. Glaxo denied that Paxil had anything to do with her death. Laden can bury her head in the sand and believe the same if she wants.




Bob Fiddaman

Part III HERE









Friday, November 15, 2013

Sally K. Laden, The Paxil Ghostwriter Part I

Sally K. Laden  The Paxil Ghostwriter



Much has been said about the fraud behind GlaxoSmithKline's Paxil 329 study, most of it negative. Fingers have been pointed at Marty "Bling Bling" Keller for putting his name to the study...or rather accepting money from GSK to have his name as the lead author. Glaxo themselves have been blamed, and rightly so.

I've yet to see anyone point the finger of blame on the ghostwriter, one Sally K. Laden.

Laden [no relation to Osama Bin] has pretty much come out of this unscathed, hey she was only doing her job - maybe so, but over the years she has had more than one opportunity to come clean or, at the very least, chastise Glaxo for duping her... if indeed she was duped?

So, who is Sally K. Laden?

Laden graduated in 1981 from the University of Connecticut with a Bachelors degree in Pharmacy and in 1983 from the Kansas University with a Masters degree in Hospital Pharmacy.

In 1985 Laden became the Associate Editorial Director - Scientific Therapeutics Information [STI]

She has been self employed since 2003, working from home for the business she founded, MSE Communications LLC where she is a Freelance Medical Writer. According to her LinkedIn profile she is also a Developmental Editor for Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, and has been since January 2013.

Laden is also a member of the American Medical Writers Association.

Her home and business address is situated in an affluent part of Cheshire, Connecticut, where she lives with her husband Michael.

The Deposition of Sally K. Laden

On March 15 2007 Laden was deposed (gave evidence under oath) by attorneys for the cases Cheryl J Cunningham et al versus SmithKline Beecham Corporation (GlaxoSmithKline), William P Williams versus SmithKline Beecham Corporation (GlaxoSmithKline) and Christopher Shibley versus SmithKline Beecham (GlaxoSmithKline). It's a fascinating deposition, particularly the way GlaxoSmithKline's defence attorney, Todd Davis (King & Spalding) is, on many occasions, shot down in flames by plaintiff attorney, George Murgatroyd (Baum Hedlund).

Representing Laden were Attorney Stuart Margohs (Berdon Young & Margohs) and Deanna Levine.

I'll address the 'shooting down in flames' later in this post. It's actually very satisfying to see a representative of King & Spalding being firmly put in their place.

Key:

Q = George Murgatroyd (Baum Hedlund)
A = Sally K. Laden


Q: Now you understand that you're here today in connection with lawsuits involving the drug Paxil?

A: Yes

Q: Okay, are you familiar with what the allegations are in any of the complaints?

A: Yes I am

Q: Okay, and what is your understanding of what they are?

A: Well my understanding is that the Plaintiffs children took their own lives while taking Paroxetine.

----

I think it's a good idea to read that last line of Laden's depo again. This deposition of Laden wasn't about her being paid to write the 329 study, it was about children taking their own lives whilst on GlaxoSmithKline's antidepressant Paxil.

The question is, did Sally K. Laden know that Paxil wasn't safe or effective in children before or during the time she wrote the study?



Let's move on...

Laden confirms to Murgatroyd that she was employed by Scientific Therapeutics Information [STI]


Q: Okay, is having articles published in peer review medical journals one way in which a drug company can promote it s drug to prescribing physicians?

A: No I don't consider that promotion.

Q: Okay, and would you agree that a journal article that you wrote that was positive in terms of the drug's efficacy and safety would help the drug company with the sale of it s drugs?

A: No I can't agree. I don t agree with that.

Q: Okay Well other than medical writing you said you were also involved in the business of setting up meetings?

Laden answers 'yes' and is then asked what type of meetings  she set up for GlaxoSmithKline...

A: Advisory boards Large CME (Continuing Medical Education) symposia at national meetings Such as the American Psychiatric Association (Laden later adds the American Academy of Family Physicians, Consulting meetings and consensus conference programs to her list)

----

Once I arrived at page 12 of the depo I was greeted with redacted text, this, as I understand, is due to the fact that Glaxo obtained a protective order. I may be wrong and there may be another reason for redaction. You can read about protective orders here, if so inclined.

The First Draft

Q: Do you know why it took you until December 18 1998 to prepare the first draft of this Study 329?

A: No

Q: Okay, where did the data come from that ended up in this first draft?

A: A clinical study report was provided to me.

Q Okay, who was that provided by?

A: I don't remember the person who sent it to me.

Q: Okay, but it came from GSK?

A: Yes


Murgatroyed then asks Laden if she received the entire clinical study report, which, he adds was "over 1400 pages."

Laden answers, "A clinical study report that STI would normally receive would probably be about 200 pages in length." She later adds, "I believe it's considered a synopsis of the report rather than each individual patient's data"


So, it's pretty crystal clear, to me at least, that Glaxo handed over a report to Laden that was condensed, watered down, cherry picked.


Lighting the Blue Touch Paper

Murgatroyed asks Laden to read the conclusion of her first draft. She reads:

"Paroxetine is a safe and effective treatment of depression in the adolescent patient. Further studies are warranted to determine the optimal dose and duration of therapy"


Q: Okay, and when you wrote those words were you aware that Paxil failed to achieve statistical significance in any but four of the 25 efficacy parameters that were analyzed by GSK?

A: I don't remember, you know, what I was aware of. This does not look outside the realm of what is standard. I reported the data accurately as far as I can tell in this result section that listed the items that were statistically significant.

Q: Well the final clinical study report clearly identifies two primary efficacy variables right?

A: Yes

Q: Yet your table three lists eight?

A: Yes

Q: How did that happen?

A: I don't know

Q: The primary study report lists five secondary efficacy variables. Your table four entitled Secondary Efficacy Variables lists three.

A: Yes

Q: How did that happen?

A: Again I do not remember those specifics.


Later Murgatroyed asks Laden the following:

"Prior to you preparing the first draft of the manuscript for Study 329 were you made aware of a position piece that GSK had internally developed that discussed the results of Study 329?"

Laden answers, "I don't remember". Murgatroyed replies, "Okay, then let me show you."


This seemed to cause great concern for the GlaxoSmithKline representative Todd Davis [King & Spalding]. Here's the dialogue between Murgatroyed and Davis.

DAVIS: I will object to the use of that document. This witness there wouldn't be any foundation that can possibly be laid that the witness is familiar with it or had any involvement with it And if you grant me a standing objection that will prevent me from having to object every time. Any problem with that?

MURGATROYED: I think we have already agreed Todd that all you have to object to is the form of the question. All other objections are reserved for the Court's ruling.

DAVIS: So will you grant me that objection both of you?

MURGATROYED: I'm not going to grant you any objection. We already agreed that all objections are reserved until time of trial with the exception to the form of the question.

Finally...

DAVIS: Let's move it along.

MURGATROYED: I know this document is very upsetting to you and GSK but that s tough.

DAVIS: It's not upsetting, It's just the fact that we are here talking about a document with a witness that doesn't know anything about it. It s not a very effective use of everyone's time.


Murgatroyed 1 Davis 0


Murgatroyed then discusses the document that Davis was, it appears, panic-stricken over.

Q: Were you made aware that GSK was disappointed about the results of Study 329?

A: No

Murgatroyed then asks Laden to read an internal GSK email from the document. She reads the following:

"As you well know the results of the studies were disappointing in that we did not reach statistical significance on the primary end points. And thus the data do not support a label claim for the treatment of adolescent depression."
King & Spalding attorney Todd Davis tries one more time to halt Murgatroyed from proceeding with his line of questioning...

DAVIS: Excuse me. And of course there has been no foundation laid by the questioning that this witness can answer any questions about this document.

Back to Murgatroyed questioning Laden...

Q: Let's take a look at the position piece that is attached to this email. What is that date?

A: October 1998

Q: And again that's two months prior to you submitting your first draft of the manuscript for Study 329?

A: Yes

Once again, Murgatroyed asks Laden to read the attachment. She complies:

"However the study failed to demonstrate a statistically significant difference from placebo on the primary efficacy measures."
Murgatroyed then asks Laden to read another paged of the attachment, once again she complies with his request:

"To effectively manage the dissemination of this data in order to minimize any potential negative commercial impact."

Murgatroyed then asks Laden, "Are you familiar with the term potential negative commercial impact?"

Once again, King & Spalding's Todd Davis seems to blow a gasket.

DAVIS: This witness cannot speak to that document and what it means. And you have already deposed somebody We are wasting our time.

MURGATROYED: I m sorry, you can object to the form.

DAVIS: I object to the form. I also object that this is just a complete waste of time to ask this witness questions about a document she knows nothing about.

MURGATROYED: Todd, just object to the form and let s move on. That's the rules.

DAVIS: When did you say you're going to be done because I'm going to hold you, this is silly. It's silly.

MURGATROYED: Todd, I'm sorry this is upsetting to you.

DAVIS: It's not upsetting, It's a waste of time.


Murgatroyed 2 Davis 0


I must remember that should I ever cross paths with George Murgatroyed to buy him a drink of his choice.



End of Part One


Part II HERE


Bob Fiddaman


















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