UPFRONT

Don’t Swing at Every Pitch

Peter K. Kaiser, MD

Recent press releases about the DRCRnet’s Protocol T and the subsequent buzz surrounding them illustrate how we are so easily swayed by what I call the “elevator pitch” — that two-minute bullet of information that can be delivered while riding between floors in an elevator.

Too frequently that is all we “know” about a study, and we base important decisions on this information and not on our own distilling of the entire published results.

The temptation is too great to remember only the CliffsNotes version of a study. Companies know this, and they give us the bullet they want us to remember. Depending on what press release you believe, your treatments for your patients could vary.

During Retina Subspecialty Day at the AAO’s annual meeting in Chicago, a press release about Protocol T was released, claiming one anti-VEGF drug had greater VA gains than its competitors. In addition, there were fewer injections, fewer Anti-Platelet Trial Collaboration arteriothrombotic events, and fewer “cardiovascular events.” Wow! What great news for our patients! The sound in the lecture hall was deafening.

The next day, there was another press release about Protocol T, this time from a competitor, which stated, “the primary endpoint showed a two-letter difference” between the two anti-VEGF drugs, “which is clinically comparable.” It also disputed the side effects data presented in the first press release. So now we were back to where we started. The press releases were 180º apart.

The press releases read so differently because, rather than coming from the actual study group, each release came from a company with its own vested interests in the results. So each media department spun the results in the best interest of its company.

As physicians, we found ourselves in a position in which we had only bits and pieces from these press releases and didn’t know what to do with that information.

Public companies have a fiduciary responsibility to release any data that may affect their stock price. However, the first press release appeared on the first day of the largest retina meeting of the year. Coincidence? Maybe.

In responding with its own press release, the second company was following its fiduciary responsibility to release more data to prevent a change in its stock price. However, if we rely on the two press releases as our sources of information, we are left more confused than ever.

Had the data release coincided with the presentation (as was done with the CATT results), we would not be in this confused state about what to use to treat our patients with DME.

For now, we must wait for the paper to be published and the actual DRCRnet presentation of Protocol T. The second press release put it best: “Caution is warranted with interpretation of the preliminary efficacy and safety results ahead of a full presentation and final peer-reviewed publication by the DRCR.net.” I totally agree.