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Monday, December 04, 2006

Knowing When to Not Prescribe

November 30, 2006 Commenting on torcetrapib/atorvastatin (T/A), Dr. LaMattina said, "We are first-in-class and we intend to remain best-in-class in a category that has the potential to change the face of cardiovascular medicine... To obtain a reliable picture of the overall safety and efficacy profile of T/A, the results of all these studies will need to be analyzed and reviewed together, and this will happen in the context of the American College of Cardiology Meeting in March, 2007."

NEW YORK, Dec. 2 /PRNewswire-FirstCall/ -- Pfizer Inc said that in the interests of patient safety it is stopping all torcetrapib clinical trials and that it has informed the Food and Drug Administration. The Company was informed today that the independent Data Safety Monitoring Board (DSMB) monitoring the ILLUMINATE morbidity and mortality study for torcetrapib recommended terminating the study because of an imbalance of mortality and cardiovascular events."

Dr. Philip Barter, Director of the Heart Research Institute in Australia and Chairman of the Steering Committee overseeing the ILLUMINATE study, said, "Based on all the evidence we have seen regarding torcetrapib and in light of prior study results, we were very surprised by the information received from the DSMB, the only body with access to the unblinded safety data. We believed that the study was coming along as expected, and this new information was totally unexpected and disappointing, given the potential benefits of this drug."

If only there were some way of predicting what a drug will do. Even "prior study results" cannot predict this Hindenburg-esque demise of a drug. Our science is incomplete. Studies cannot be trusted to predict the future. If only there were a way around this.

For the families of those who died, I hope they get more information on the prior studies and how this happened. It was a mistake. Now is the time to learn. The final word comes from the Pfizer CEO:

Pfizer's Chief Executive Officer Jeffrey B. Kindler said, "While the DSMB information we received today was both surprising and disappointing, our focus is on the best interests of patients and making sure all this information is communicated to appropriate medical and regulatory authorities as quickly as possible.

"With regard to our business, we understand the challenge that this represents and we will respond quickly and aggressively to it. It is important to put this information in the context of both our commitment to transform Pfizer and our overall product and financial strength," Mr. Kindler added.

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