Potential leaps forward in medical science are noteworthy. They should be peer-reviewed, disseminated, and developed – and those responsible, rewarded, to be sure. But, the medical literature is full of grey areas between science and advertising – including routine publication of sponsored trials, to a “Clinical Evidence Synopsis” composed solely by those with COI, to this latest egregious sample.
Enoximone is a phosphodiesterase inhibitor currently in clinical trials for advanced heart failure. However, the author of this report documents eight cases of its use in the setting of catastrophic status asthmaticus – three of which progressed to respiratory arrest. After initiation of medical therapy without improvement, the author gave each of these patients one or multiple doses of intravenous enoximone – with profound improvement. Anecdotally.
This is all very fine, and case reports are an important step in the chain of evidence. Enoximone very well may be an important future therapy for selected patients with severe bronchospasm. However, there’s one slight problem with this publication, stemming from the Declaration of Interest by the author (J.B.):
J.B. received lecture fees from the following companies: Carinopharm GmbH, Germany; Carinopharm, UK; Incapharm, Italy; and Devrimed, The Netherlands, distributors of enoximone. J.B. contributed to a syllabus concerning enoximone for which he received a fee from Carinopharm GmbH, Germany. Carinopharm GmbH filed an IP for the use of enoximone in status asthmaticus in which J.B. is named as the inventor, without financial consequence. J.B. is co-founder and shareholder of Advanced Perfusion Diagnostics at Lyon, France.
So, the publication ultimately represents unfettered promotion of a therapy for whom the author has multiple personal financial conflicts of interest.
Science? Advertising? Both?
“Emergency treatment of status asthmaticus with enoximone”