The use of testosterone as an anti-aging therapy for men is controversial because of potential side effects and efficacy issues. A recent article discussed how physicians with ties to the pharmaceutical industry have been trying to influence a poll published by the NEJM (see: Doctors Try to Influence a Medical Journal Poll on Testosterone Treatments). Below is an excerpt from it:
Every few weeks, the New England Journal of Medicine publishes a hypothetical case about the use of a medicine or procedure and asks its readers...what they would recommend for the patient, sometimes in the form of a poll. ...[A recent] instance involves a 61-year-old man who complains of lower energy levels, concentration and sexual stamina. The bottom line question is whether he should be treated with testosterone therapy.....In an unusual development, a group of physicians who favor testosterone therapy are trying to influence the outcome of the poll. Testosterone treatments...have been widely promoted to help reverse aging, but safety is uncertain. Some studies have concluded the drugs are associated with cardiovascular risk, while other studies have not....The FDA is currently deciding whether to follow recommendations of an advisory panel that suggested drug makers study the risk of heart attacks and include language in prescribing information that the medicines have not been proven to reverse common effects of aging, such as low libido, fatigue and muscle loss....
[T]he poll in the widely read medical journal is an interesting temperature reading....In emails sent to journal readers, the Androgen Study Group writes that “this is a common, straightforward case where there is a good likelihood of symptomatic improvement with testosterone therapy. Yet at this point, the voting and the majority of comments are against testosterone therapy in this case. We urge you to read the article and then vote on line.” The physicians listed as being in the Androgen Study Group and its web site describes them as a “multidisciplinary group of clinicians and researchers dedicated to education and accurate reporting on the science of testosterone deficiency in men and its treatment.” But neither the email about the poll or the web site note several of the listed physicians have ties to drug makers that sell these treatments.
In a recent note (see: Social Bots Create Fake Friends on Twitter and Sometimes Profits), I noted that the FDA is moving toward regulating the use of social media by pharmaceutical companies, particularly through the use of financially supported third parties such as disease foundations. It appears that the Androgen Study Group may be another example of such a biased third party with financial ties to the drug industry but with the appearance of neutrality. Here a quote from the "About Us" section of the Androgen Study Group web page:
The Androgen Study Group is a newly formed multidisciplinary group of clinicians and researchers dedicated to education and accurate reporting on the science of testosterone deficiency in men and its treatment. The impetus for the formation of The Androgen Study Group was the publication of several flawed testosterone trials whose conclusions have already caused unnecessary concern and confusion among healthcare providers and their patients....It is our mission to ensure that the results of research regarding testosterone deficiency and its treatment is presented accurately and fairly within medical literature and to the public.
What I find most interesting about this story is that the editors of the NEJM were so naive as to expect that their polls would not be subject to spin by drug companies. Fortunately, such companies are now being forced by the federal government to disclose the names of physicians on their payrolls so this shell game can't last too much longer (see: Plan to Disclose Big Pharma's Payments to Doctors Hits Speed Bump).