Hopeful After All?

I found this on a blog by Carrie Hill at About.com She brings up some excellent points about the clinical study involving Etanercept.

More on Etanercept Research, and Why Optimism and Critical Thinking are Compatible

My previous blog about a new study focusing on etanercept as a treatment for Alzheimer's has generated a lot of discussion. This is great, because all research should be evaluated for its merit and prospect for real solutions.

I was recently informed of another blog about this research that raised concerns about the validity and actual potential of the results. It implies that we shouldn't be too optimistic about etanercept because:

• the report was a case study of one person,
• the journal that published the study is not very well known or prestigious, and
• one of the researchers has ties to the company that makes the drug.

These are all legitimate concerns, so I did some more digging. Here's what I found out:

• Even though the study involved just one person, it was an attempt to clarify the results of a pilot study in 2006 in which the majority of 15 patients experienced the same results. The researchers chose to perform a case study this time around in order to better explain the mechanisms they had already witnessed.
• The Journal of Neuroinflammation is not very well known because it is new -- but new does not necessarily translate to low quality. The journal has an international review board of almost 50 editors in the field. It's also committed to publishing peer-reviewed (that means evaluated by experts) biomedical research that is open access. That means it's freely and universally accessible online to all of us. In fact, you can read the actual research report about etanercept right now if you want all of the details.

• It's true that one of the researchers owns stock in the company that makes etanercept and has a number of patents in the pipeline involving the drug. Corporate connections are always a concern. In this case, his connections certainly may have influenced his choice to study the use of etanercept to treat Alzheimer's. Did his connections influence the results? Not likely, considering that he was not the sole investigator and that the study was peer-reviewed.

I'm all for skepticism when it comes to remarkable claims. The last thing I'd want to see is the perpetuation of false hopes. Obviously, this study will need to be replicated and shown to produce the same results in many, many more individuals. But I think optimism is justified, as long as it's combined with patience and realism. What do you think? Are optimism and cricital thinking compatible?

Thursday January 17, 2008