Lies, Damn lies and Drug Reps abusing statistics

Re: Lies, Damn lies and Drug Reps abusing statistics

Anthony Todd — Wed, 04 Feb 2015 18:39:01 GMT

Duplicated

Re: Lies, Damn lies and Drug Reps abusing statistics

Anthony Todd — Wed, 04 Feb 2015 18:37:43 GMT

Not being picky but how many how old etc.

Someone's got to collect the data and here is the easiest place.

As I said, there maybe loads more and do you think the manufacturer is going out looking for this sort of stuff?!

Re: Lies, Damn lies and Drug Reps abusing statistics

Martin Atkinson — Wed, 04 Feb 2015 17:48:50 GMT

[quote user="Anthony Todd"]

[quote user="Bob Russell"]I have heard anecdotes from vets who will never use meloxicam or carprofen because they tried it once on a dog that developed haemorrhagic gastroenteritis within 48 hours[/quote]

Mmmm, see what I mean!

Any more out there and it may be significant.

[/quote]Well 3 out of the first 6 cats I put on Meloxicam developed renal failure and these were all cats that had known normal renal parameters as they'd been tested prior to therapy. You can understand that it took a very long time for me to gain enough confidence to use it again. I prefer Onsior for my own cat for his OA but it is not as good for soft tissue pain and I use meloxicam on him for that. But although I have a number of cats on meloxicam long term with no side effects there is still the odd one that develops acute renal failure after one dose.

Re: Lies, Damn lies and Drug Reps abusing statistics

Anthony Todd — Wed, 04 Feb 2015 17:29:59 GMT

Mmmm, see what I mean!

Any more out there and it may be significant.

Re: Lies, Damn lies and Drug Reps abusing statistics

Thomas Johnson — Wed, 04 Feb 2015 17:17:23 GMT

[quote user="Gareth C."]

can highly reccomend "Bad Science" for a good read on how to spot dodgy representation of stats and medical trials. should be required reading. I have not read his follow up yet "Bad Pharma" but reccomended above

[/quote]

I'm about a third of the way through Bad Pharma; very good, and very worrying, reading.

Re: Lies, Damn lies and Drug Reps abusing statistics

Gareth C. — Wed, 04 Feb 2015 17:14:11 GMT

Re: Lies, Damn lies and Drug Reps abusing statistics

Virginia Campbell — Wed, 04 Feb 2015 16:41:54 GMT

[quote user="Bob Russell"]We have been told the story of 'it stays in the blood for a short time then localises in inflamed tissue' [/quote]

I thought that was Onsior? And that Trocoxil worked by tightly binding to blood proteins and only very slowly becoming unbound?

We use quite a lot of Trocoxil and have a lot of dogs doing very well. We use Pardale for the gap month, or just go ahead without a break if the dog really isn't managing, having informed the owner this use of the product is against manufacturers guidelines.

I do believe the theory that owners are bad at recognising arthritic pain and thus fail to recognise mild arthritis flareups and also stop treating too early during moderate flares, and thus a lot (most) of those chronic arthritics do best on continuous NSAID cover.

Re: Lies, Damn lies and Drug Reps abusing statistics

Bob Russell — Wed, 04 Feb 2015 16:10:53 GMT

We have introduced a more thorough blood testing regimen which would, arguably, be appropriate for other NSAI's as well.

We have been told the story of 'it stays in the blood for a short time then localises in inflamed tissue' which is clearly not the whole story. The EMEA document is rather more forthcoming but it is a product that has been around for a bit now so there should be a bit more of a track record of adverse reactions.

I have heard anecdotes from vets who will never use meloxicam or carprofen because they tried it once on a dog that developed haemorrhagic gastroenteritis within 48 hours and needed intensive care. I am reluctant to use cyclosporin routinely for atopic dermatitis because when I tried it on two early patients developed tumours within weeks!

I have a paranoid voice in the back of my mind that links Seresto collars to lymphoma because my collie developed aggressive lymphoma within a few months of wearing a collar and the practice has seen more lymphoma cases recently. Quite illogical but in the absence of large independent studies probably a side effect of an over-thinking mind!

I do use Atopica and we sell a lot of Seresto collars! Thankfully our experiences of Trocoxil have been very favourable!

Re: Lies, Damn lies and Drug Reps abusing statistics

james herriot lied — Wed, 04 Feb 2015 15:53:51 GMT

[quote user="Bob Russell"]

The world has moved on and so has pain relief. As with any medication some do better on one product than another but it seems a bit short sighted to rule out a very useful drug just because you are frightened by the dosing interval.

[/quote]

Quite so. What put me off was reading the EMEA approval document at the time (quite lengthy, so you can cut to the last page), the divisions of opinion in granting a licence and in particular some recommendations for further monitoring - which the company representatives tried to palm off to me as in-house ideas. When I mentioned the EMEA, the conversation went wobbly.

I don't trust it.

Re: Lies, Damn lies and Drug Reps abusing statistics

Anthony Todd — Wed, 04 Feb 2015 15:13:06 GMT

[quote user="Martin Atkinson"]

I put one dog on Troxocil and it developed severe HGE 2 days later requiring intensive treatment. Pfizer as they were then then tried to tell me it couldn't have been that because it is out of the blood within hours. I am not convinced and I won't use it again, I don't trust it and as far as I can see it is trying to solve a problem that doesn't exist in my experience.

[/quote]

Jeepers Martin if I'll said that there'd be an ''''it storm of dinosaureal excrement and comments about "anecdotes "and "evidence based medicine."

Mind you, a few other reports of the same and I'd take notice.

Re: Lies, Damn lies and Drug Reps abusing statistics

Hannah Wynne Richards — Wed, 04 Feb 2015 14:52:46 GMT

It's out of the blood in a few hours, yet the effects last a month!

Why am I confused?

Wynne

Re: Lies, Damn lies and Drug Reps abusing statistics

Glenn Hodgson — Wed, 04 Feb 2015 14:33:56 GMT

We have numerous dogs on it with no problems thus far, seems to be great stuff.. non the less fiddled information is not appropriate. Bad pharma is apparently a good read.

Re: Lies, Damn lies and Drug Reps abusing statistics

Martin Atkinson — Wed, 04 Feb 2015 14:06:38 GMT

Re: Lies, Damn lies and Drug Reps abusing statistics

Bob Russell — Wed, 04 Feb 2015 13:26:20 GMT

Trocoxil - brilliant stuff. My staffie has been on it for a couple of years. Still have the majority on meloxicam and some on onsior. Not had a single adverse reaction to Trocoxil.

These long interval painkillers are being used quite widely in humans (including my brother). Adverse reactions are rare and pain relief impressive. I accept that any salesman will put a positive spin on anything. Sad they decided to push their luck. What is wrong with saying .no more frequent side effects than meloxicam'?

Re: Lies, Damn lies and Drug Reps abusing statistics

Anthony Dennison — Wed, 04 Feb 2015 11:59:20 GMT

The whole talk smacked of them under pressure for not selling enough of the drug. I will happily entertain reps and listen to what they have to say, but HATE it when they use stats in the wrong way (or ignore them altogether)

Re: Lies, Damn lies and Drug Reps abusing statistics

Yantha Smyth — Wed, 04 Feb 2015 11:47:45 GMT

I don't care what the reps say about trocoxil, I don't trust it! The treatment gap is necessary because a proportion will get accumulation- but you don't know which ones, so some will have inadequate cover....what do you do if you need steroids for some other reason? And it's only anecdotal, but the two dogs I am aware of that had septic peritonitis due to a perforated duodenal ulcer were on Trocoxil....