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Cancun Conflicts

May 5, 2014

14th World Menopause Conference

menopause cancun

Long term post-menopausal hormone therapy (HT*) increases the risk of breast cancer, cardiovascular disease and stroke. It reduces fractures and a few other risks, but overall the harms outweigh the benefits so it should not be used for health promotion. For symptoms, “the lowest effective dose should be used for the shortest time” – UK Medicines and Healthcare Products Regulatory Agency (MHRA), or “If you decide to use hormones, use them at the lowest dose that helps.  Also use them for the shortest time that you need them” – US Federal Drug Administration.

This good advice doesn’t sell much HT so manufacturers pay “experts” to sit on “advisory boards” and go on “expenses paid” trips to shindigs like this, to say that the FDA and MHRA are wrong, and that HT may actually reduce cardiovascular disease!

Click here for the full programme.  The titles suggest many thinly veiled attempts to downplay or throw doubt on the evidence that HT is harmful.  In case any speakers forgot to declare their conflicts of interest I’ve listed the publicly available ones.

WHI: An Evolving Understanding of the Clinical Evidence. Speaker Dr Nick Panay.

Dr Panay has received consultancy fees from Pfizer, Bayer, Abbott (click here) plus Baxter, Schering, Eli Lilly, Galen, Janssen Cilag, Merck, Novo Nordisk, Novogen, Organon, Orion, Procter & Gamble, Se-cure, Servier, Shire, Solvay, Storz, and Wyeth (click here).

State of the art HRT.  Speaker David Sturdee.

Dr Sturdee has had financial support from Amgen, Theramex, Procter & Gamble, Wyeth, Bayer Schering and Novo Nordisk (click here). In 2010 Athina Tatsioni and her colleagues exposed the 31 biased editorials he has written about HRT (click here).

HRT – Route of administration, dose, age at initiation and duration of therapy.  Speaker John Stevenson.

Dr Stevenson has financial conflicts with Schering Plough, Wyeth/Pfizer, Bayer, Meda and Merck/Theramex. I have written about his biased editorials here.

Cardiovascular Effects of Estrogens: Evidence and Hypotheses from Epidemiological Findings. Speaker Rogerio A Lobo

Dr Lobo “has provided consulting services for many large pharmaceutical laboratories” (click here). In 2011 Adriane Fugh-Berman and her colleagues exposed him as a biased editorialist (click here).

Relevance of cardiovascular diseases in menopausal women and their implication for clinical practice. Speaker Dr Peter Collins

Dr Collins served as a consultant to Eli Lilly, Berlex, Merck, Pantarhei, and Pfizer, and has been paid lecture fees by Berlex, Merck, Pfizer, Novo Nordisk, and Organon (click here)

Efficacy and safety of low dose E2/DRSP in postmenopausal women. Speaker Dr David Archer

David F. Archer has consulted for Agile Therapeutics, Bayer Healthcare, Merck, Novo Nordisk, Warner Chilcott, and Wyeth Laboratories (Pfizer), and received honoraria from Bayer Healthcare, Merck, and Wyeth Laboratories (Pfizer) (click here)

 Hormone therapy and cardiovascular disease – what is the risk? Speaker John Stevenson (GB)

See above

A cardiovascular guide for menopause physicians – An update. Speaker Peter Collins

See above

 BMS Recommendations on Menopause & HRT. Speaker Nick Panay

See above

Strategies to optimize cardiovascular health with HRT. Speaker John Stevenson

See above

What if WHI had just used Transdermal Estradiol and Oral Progesterone instead? Speaker Dr James A Simon

James A Simon has been on the advisory boards of Allergan, Amgen Inc., Ascend Therapeutics, Bayer, BioSante, Boehringer Ingelheim, Concert Pharmaceuticals, Corcept Therapeutics, Inc., Depomed, Inc., GlaxoSmithKline, KV Pharmaceutical Co., Lipocine, Inc., Meditrina Pharmaceuticals, Merck, Merrion Pharmaceuticals, Nanma/Tripharma/Trinity, NDA Partners LLC, Novo Nordisk, Novogyne, Pear Tree Pharmaceuticals, QuatRx Pharmaceuticals, Roche, Schering-Plough, Sciele , Solvay, Teva Pharmaceutical Industries Ltd, Ther-Rx, Warner Chilcott, and Wyeth. Click here.

The optimal new way confirmed by KEEPS. Speaker Nick Panay

See above. Two years after trial completion the KEEPS  results have yet to appear in a peer reviewed publication. But they still get presented at conferences to suggest the cardiovascular risks of HT have been overestimated (click here).

Menopausal hormone therapy and osteoporosis: have we completed a full circle? Speaker Tobias De Villiers, conference chair.

 Dr de Villiers – has received consultancy fees from Adcock Ingram and Pfizer; speaker’s fees from Servier, and travel support from Amgen, Pfizer, and Bayer (details here)

I don’t know what these speakers said in Cancun. Perhaps they all gave the same good advice as the MHRA and FDA. Perhaps they all paid their own air fares. Perhaps pigs fly.

Jim Thornton

*Hormone replacement therapy (HRT) changed to hormone therapy (HT) Jan 2016

 

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