Cowardice or icecold reckoning? A Glimpse into medical studies

Today I have read an article by R.G. Langley and colleagues on Secukinumab in Plaque Psoriasis (Link: http://www.ncbi.nlm.nih.gov/pubmed/25007392). I’m interested in Secukinumab (last blogpost is here: http://rheumatologe.blogspot.de/2014/07/secukinumab-at-eular-2014-meeting-in.html), but something came to my mind while reading. In this study secukinumab has been tested versus etanercept. Why? Why not adalimumab? Maybe because the sponsor thinks that adalimumab works better in psoriatic arthritis than etanercept? Cowardice or icecold reckoning?

M. Schiff and colleagues reported on the AMPLE trial (Link: http://www.ncbi.nlm.nih.gov/pubmed/23962455). The AMPLE trial is a head-to-head comparison of subcutaneous etanercept versus adalimumab for rheumatoid arthritis. Why not etanercept? Maybe because the sponsor thinks that etanercept works better in rheumatoid arthritis than adalimumab? Cowardice or icecold reckoning?

F. Buttgereit and colleagues published a study on modified release prednisone (Link: http://www.ncbi.nlm.nih.gov/pubmed/18207016) in rheumatoid arthritis. Under methods we read: “The modified-release tablet was taken at bedtime and prednisone was released with a delay of 4 h after ingestion. This treatment was compared with morning administration of immediate-release prednisone as an active comparator.” I don’t want to dwell on the fact, that “prednisone was released with a delay of 4 h after ingestion” has nothing to do with the method, but rather on the fact that the comparator was administered in the morning and not in the evening. Why not? Maybe because the sponsor thinks that an unequal comparison works better? Cowardice or icecold reckoning?

To sum it up, I think that we have to look at studies very carefully. In the above studies I don’t question the results but the design, which might influence the results. Cowardice or icecold reckoning? I think the latter one!