Friday, May 15, 2009

Common Sense: $1 Million Per Ounce

Now just how much do you think this little observation cost?

The obesity epidemic in the US is due solely to increased food intake

That's right, this "revelation" is based on reporting at the 2009 European Congress on Obesity and the combined genius and interpretation of no less than:

Deakin University, Melbourne, Australia
World Health Organization Collaborating Centre for Obesity Prevention
US Department of Agriculture
National Health and Nutrition Examination Survey
American Heart Association
American College of Cardiology

But, look at it this way. There was probably no chance McDonald's, KFC, Burger King, and Taco Bell were gonna break the news!

Would you like fries with that? Somtimes, ya just gotta laugh!


Thursday, May 14, 2009

Anti-Platelet Ad Nauseam

Why do I torture myself? Number 1 answer: I am a masochist, of course! I read a fair number of medical journals and reports and lately all I hear about are anti-platelet medications like clopidogrel, prasugrel (see my last post) and now ticagrelor (where the hell do they get these names - sounds like anime' characters - Ticagrelor, ruler of all Mythica!) . As I punned earlier - it's starting to get thin.

Like prasugrel, ticagrelor is not even out of trials, yet they are hyping the hell out of a product you cannot even buy. It's claim to fame (should it be determinined in Phase 3 that it does not kill more people like torcetrapib did) is that its effect is reversible - SO YOU CAN HAVE HEART BYPASS SURGERY FASTER AFTER STOPPING IT! I kid you not. Oh, and while it does not contribute to "major bleeds" to any greater extent than other agents it does show an increase in "minor bleeds." I don't know about you, but whenever I bleed I consider it a major event.

Given that the market for clopidogrel alone is $8 billion we can expect more of the same with everyone scratching for a piece of the action. Here is a clue for the rest of us.


Let me put it this way. An ounce of heart disease prevention (or a half ounce of heart disease reversal) is worth $8 billion of clopidogrel! Practice informed, self-directed healthcare instead of uninformed drug and surgery healthcare (Time to plug Track Your Plaque).


Tuesday, May 12, 2009

Clopidogrel vs Prasugrel: The Arguments are Getting Thin

Watching drug manufacturers duke it out over competing products is like watching a tragic comedy - you don't know whether to laugh or to cry. Witness the latest antics in the fight over the wildly profitable market for anti-platelet drugs currently dominated by clopidogrel.

Clopidogrel (Plavix most notably) has been around for years as a first line anti-thrombotic with indications for use in numerous cardiovascular conditions including post-surgically after stent implantation. Given its age it has also been studied extensively and all its warts are well-known.

Most comic is the fight for dominance between clopidogrel and prasugrel. I say comic for one major reason - prasugrel is still under investigation - you can't even get it in the US at this point. But this hasn't stopped the marketers from attempting to pit it against clopidogrel which goes off-patent in 2011.

The latest "hit job" on clopidogrel comes from analysis based on the TRITON-TIMI 38 trial. Researchers dicovered that there are several common gene variants among patients receiving clopidogrel that may reduce its effectiveness thereby increasing the risk of subsequent heart attack, stroke, and mortality. What was conveniently NOT CONCLUDED was whether simply taking more clopidogrel could overcome this reduced response.

Now guess who is a major sponsor of the TRITON-TIMI 38 trial? If you guessed Daiichi Sankyo and Lilly, the two co-developers of prasugrel, you win today's Sherlock Holmes award! Now, do you suppose anybody has studied whether certain gene variants affect the efficaciousness of prasugrel - not yet - but you have to wonder what the folks at Bristol-Meyers (the holder of the Plavix patent) are working on.

Now, don't get me wrong, I love a good fight. Let the druggies battle it out. But as consumers we need to cast a watchful eye over the message. Prasugrel is not even FDA approved yet and there are no long-term studies on it. Who know what warts may pop up. Your genetics may indeed sway you away from clopidogrel one day but don't think it is without its own, at present, hidden warts.

The devil you know may be better than the devil you do not. Of course, here is where I plug informed, self-directed health care programs like Track Your Plaque which offer tangible results in preventing and reversing heart disease. The ONLY real solution is to never need clopidogrel OR prasugrel in the first place!

Looking out for your heart health,


I'm Baaaa ... aaack!

Yes, the reports of my demise are greatly exaggerated. I'd like to say something artsy like, "I was taking a sabbatical to 'rediscover my voice'." - but that would be a load of crap. The truth is more akin to being really busy and not sure what to write. But, "being busy" is nothing but an excuse. People MAKE TIME to do what they like! And how can an arrogant and opinionated guy like me not know what to write? Here's my answer.

I write a lot. But every forum has it's boundaries and rules of decorum. Also, it is a little dishonest to post the same material on multiple blogs (not to mention that sites that have you under contract get a wee bit upset if you repost paid for material on free sites). So, where am I going with this - back to my roots!

On other blogs I have to be the "good cop." This blog is my outlet to be the "bad cop!" Expect my prose to be biting, opinionated, edgy, and designed to draw both complements and criticism. It is done from my heart (pun intended) and without apology. I may go after third parties but am ALWAYS respectful of commenters - so let's debate. If you are one of those third parties then comment back and watch my tone change. My opening shots are intended to get your attention - not wound! We may not always like it but we are in this together.

When I started this blog it was to be a no holds barred comment on the state of heart health care. I promised, "a hell of a ride" so hold on tight - be mad, be glad, be anything but but bored!



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