Abstract
Dear Sir We read the article by Lipton et al. (1) carefully and were struck by the length of the article without any significant presentation of new information which might help the clinician better treat patients. We wonder why the investigators decided to report this as two separate studies rather than one study done with twice the patient population.
We see that there were a fair number of withdrawals from the study, but have difficulty understanding Figure 1 as there was no placebo arm but rather placebo was interspersed in the treatment sequence with active drug. The story of migraine and its disabling effects are well known to all who treat this disorder. The attempt to coin the expression CDEA is also not novel. The bar graphs depicted are all too familiar from previous studies of triptans.
What was also much too familiar was that the study was funded by GlaxoSmithkline (GSK), the data collected and analyzed by GSK, and, at least in part, written by a writer paid by GSK. Two of the authors, SEL and JDW, are also authors of a paper by Ninan Mathew appearing simultaneously in Headache regarding the use of ‘fixed-dose sumatriptan and naproxen’ (2). Those of us who attended last year’s American Headache Society meeting, may recall that Wolff’s Headache edited by Silberstein, Lipton and Dodick was given to all the participants at the meeting by GSK.
We cannot question the data presented but the obvious conflict of interest with three authors on the GSK payroll and two authors at least beholden to GSK cannot go unnoticed. We consider the article nothing short of a paid advertisement and wonder how it made its way to the pages of this prestigious journal.