Category: Pharmaceuticals

Ethics in human experimentation in science-based medicine

Science-based medicine depends upon human experimentation. Scientists can do the most fantastic translational research in the world, starting with elegant hypotheses, tested through in vitro and biochemical experiments, after which they are tested in animals. They can understand disease mechanisms to the individual amino acid level in a protein or nucleotide in a DNA molecule. However, without human testing, they will never...

/ March 7, 2011
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Topical NSAIDs

I have a mental basket of drugs that I suspect may be placebos. In that basket were the topical versions of non-steroidal anti-inflammatory drugs (NSAIDs). When the first products were commercially marketed over a decade ago, I found the clinical evidence unconvincing, and I suspected that the modestly positive effects were probably due to simply rubbing the affected area, or possibly due...

/ March 3, 2011
Yes, it's true that placebos are just as powerful as homeopathy. Unfortunately, that doesn't mean what believers in integrative medicine think it does.

Placebo Effect for Pain

It has long been recognized that there are substantial multifactorial placebo effects that create real and illusory improvements in response to even an inactive treatment. There is a tendency, however (especially in popular discussion), to oversimplify placebo effects – to treat them as one mind-over-matter effect for all outcomes. Meanwhile researchers are elucidating the many mechanisms that go into measured placebo effects,...

/ March 2, 2011

Ear Infections: To Treat or Not to Treat

Ear infections used to be a devastating problem. In 1932, acute otitis media (AOM) and its suppurative complications accounted for 27% of all pediatric admissions to Bellevue Hospital. Since the introduction of antibiotics, it has become a much less serious problem. For decades it was taken for granted that all children with AOM should be given antibiotics, not only to treat the...

/ February 8, 2011

Old drugs, new tricks

What does honey bee colony collapse disorder have to do with a potential new cancer treatment? They both relate – in a convoluted manner – to an old antibacterial drug called nitroxoline. True to my devotion as a natural product pharmacologist, I’m proud to say that new life would not have come to nitroxoline had not a fungal natural product called fumagillin...

/ January 21, 2011

The risks of CAM: How much do we know?

Working in pharmacies where supplements are sold alongside traditional (over-the-counter) medications, I’m regularly astonished at the different perceptions consumers can have about the relative efficacy and safety of different types of products. Once, speaking with a customer about a medical condition she wanted to treat, I indicated that there were no effective non-prescription therapies — she needed to see a physician for...

/ January 20, 2011
Yes, it's true that placebos are just as powerful as homeopathy. Unfortunately, that doesn't mean what believers in integrative medicine think it does.

Placebo effects without deception? Well, not exactly…

In discussing “alternative” medicine it’s impossible not to discuss, at least briefly, placebo effects. Indeed, one of the most common complaints we at SBM voice about clinical trials of alternative medicine is the lack of adequate controls — meaning adequate controls for placebo and nonspecific effects. Just type “acupuncture” in the search box in the upper left hand corner of the blog...

/ December 27, 2010

Ososillyococcinum and other Flu bits.

Osillococcinum I keep half an eye on the medicine displays in stores when I shop, and this year is the first time I have seen Oscillococcinum being sold.  Airborne as been a standard for years, but Airborne has been joined by Oscillococcinum on the shelves.  Dumb and dumber.    It may be a bad case of confirmation bias, but it seems I am...

/ December 17, 2010

Dabigatran: A Promising Alternative to Warfarin

On October 19, 2010, the FDA approved a long-awaited new drug, dabigatran, expected to replace warfarin (Coumadin) as a better way to prevent blood clots in susceptible patients. This provides an opportunity to re-visit several issues that we have addressed before, including Big Pharma tactics, drug approval by the FDA, deciding what is adequate evidence, applying science to clinical practice, and making...

/ November 16, 2010

Corporate pharma ethics and you

Although I’m one of the few non-clinicians writing here at SBM, I think about clinical trials a great deal – especially this week. First, our colleague, Dr. David Gorski, had a superb analysis and highly-commented post on The Atlantic story by David H. Freedman about the work of John Ioannadis – more accurately, on Freedman’s misinterpretation of Ioannadis’s work and Dr. Gorski’s...

/ October 29, 2010