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Massey Magazine Issue 13 November 2002

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Controversial story has lessons for drug safety

The story of the asthma drug fenoterol highlights the issue of drug safety in New Zealand.

Beginning in 1976 deaths from asthma in New Zealand rose suddenly, tripling by 1979. In Adverse Reactions: The Fenoterol Story, epidemiologist Professor Neil Pearce tells the controversial story of how a group of researchers, which included Professor Pearce, discovered that the asthma drug fenoterol was the cause of this alarming epidemic.

Facing powerful pressures and hostile opposition from conservative medical opinion and from the drug industry, they persisted, and finally saw their conclusions accepted and the death rate falling. Dr Pearce recalls the years 1988–1990, the period of this struggle, as a personal story but he also draws attention to many issues about drug safety in New Zealand and internationally, and about the contest between money and science in medical research.

Prime Minister Helen Clark writes in her foreword, “In early 1989 in my first few weeks as Minister of Health, officials advised me that New Zealand research was soon to be published claiming safety concerns over a widely-used asthma drug called fenoterol.

“The evidence produced by Neil Pearce and others claimed to show a link between the use of fenoterol and the death rate among asthma sufferers in New Zealand. That death rate was much higher than that in comparable countries at the time. The work of Neil Pearce and his colleagues seemed to show that this “epidemic” of deaths had coincided almost exactly with the widespread use of fenoterol in New Zealand, starting in 1976.

“The lessons we can take from the fenoterol story are as relevant today as they were when the issue was in the news headlines seventeen years ago.”

Professor Neil Pearce, PhD, DSc, FRNZ, is a world renowned epidemiologist (a health researcher who studies the causes of epidemics). He is also Director of the Centre for Public Health Research, which he established in 2000. The Centre conducts a wide range of public health research including respiratory disease, cancer, diabetes, Mäori health, Pacific health and occupational and environmental health research.

Dr Pearce says the same problems have occurred many times when university-based researchers have discovered that a particular drug or chemical is dangerous.

“Other recent examples include the controversies about oral contraceptives and stroke, the toxicity of benzene, diesel fumes, passive smoking and chromium (the chemical featured in the Erin Brockovich film).

“The usual approach is for the company concerned to hire consultants to criticise the research publicly, either when it appears in print, or even prior to publication. In recent years, these efforts have been further developed and refined with the use of websites and publicity that stigmatises unwelcome research findings as ‘junk science’. In some instances these activities have gone as far as efforts to block publication.

“In many instances, academics have accepted industry funding which has not been acknowledged, and only the academic affiliations of the company-funded consultants have been listed. Thus, the fenoterol story is still relevant today.”

Adverse Reactions: The Fenoterol Story is published by Auckland University Press.

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