E-drug: Old drug is found to have wide benefits (cont)
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Before everyone gets too worked up about the benefits of the "old
drug" (eight years old) ramapril, which the New England Journal
felt warranted early release over the internet (and thus enhanced
press coverage?), it should be pointed out this result -- a 3.6%
absolute reduction in risk of combined cardiovascular outcomes, from
17.7% to 14.1% -- applies only to patients who are going to be at
least 80% compliant (substitute your preferred term here) with
therapy and who are not going to have any side effects. This because,
of the 10,576 subjects who entered a 3 week treatment followed by
placebo run in period, a full 1,035 (10%) were excluded for the
previously mentioned reasons.
If only we could predict ahead of time which of our patients intended
to a) adhere to therapy, and b) not have side effects; we might then
be better able to apply these results to them.
Bob Goodman, M.D.
New York Presbyterian Hospital
622 W. 168th St.
New York, NY 10032
e-mail: Bob@nofreelunch.org
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