How should one feel about being quoted in the Wall Street Journal?
Nervous. That’s how.
Louisville cardiologist John Mandrola said, “I’m surprised that the drug has persisted. I don’t know any of my colleagues who would start a patient out on Multaq. It just doesn’t work.”
That seems like a pretty strong statement. If I was a real academic, I might have said something like this: “Multaq has been used less frequently of late due to concerns over its clinical efficacy in suppressing AF episodes.”
Other real experts had even stronger statements:
Steve Nissen, Chairman of Cleveland Clinic, said,
“I think the drug is dangerous.”
And Sanjay Kaul, a cardiologist at Cedars-Sinai Medical Center in Los Angeles, offered this,
“It seems like it’s not even safe in intermediate-risk patients.”
The rest of the story chronicled Multaq’a saga:
Dubious scientific trials, substantial (and persistent) marketing, inefficacy, and now safety concerns. Mr Burton left out that the drug is very expensive and frequently not tolerated because of gastro-intestinal symptoms.
One criticism of the piece was that there were no quotes from the societies or from prominent cardiologists (both American and European) who have been vocal advocates of the drug. I wonder what they would have said?
And I know you might be asking how Multaq got promoted to the first line of the Atrial fibrillation treatment guidelines?
This would be a very good question.
One answer that some might find reassuring: “Sorry, we are human, and humans make mistakes. We will rectify it; now let’s move on. We’ve learned from this saga.”
JMM
5 replies on “Multaq (and me) in the WSJ”
No quotes from “prominent cardiologists”? Dude- you ARE a prominent cardiologist! Especially now that you’ve been quoted in the WSJ…
Well, I have to say you are making me nervous. I have been taking Multaq for 4 months while waiting on my scheduled ablation in October and will be on it for an additional 3 months after. So far it has worked well and I have not noticed any ill effects from it. So, should I count my blessings and not worry or have a talk with my doctor?
I used to say Multaq had the same efficacy at maintaining sinus rhythm as eating a hot fudge sundae. But, I am not sure it is as safe as eating a sundae.
One of the problems of published guidelines is that it takes so long to get them changed after the science demonstrates they’re outdated.
Anybody in love with guidelines should keep this in mind.
-Steve
Unless I have a VERY vivid imagination, (good enough to fool my heart monitor and several EKGs over a year) Multaq does stop AFIB and restore normal sinus rhythm in my case. Now, the continuing safety concerns do worry me, and I hope whatever replaces Multaq is equally effective. Clearly, my Cardiologist and I need to discuss my treatment options sooner rather than later.