More than just hype

[Louise Pilote](1) implies that physicians who prescribed ramipril to more of their diabetic patients after the results of the HOPE study were publicized did so primarily because of marketing hype rather than solid research evidence. As a clinical epidemiologist and diabetes specialist, I am baffled...

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Published inCanadian Medical Association journal (CMAJ) Vol. 168; no. 13; pp. 1646; author reply 1647 - 1646
Main Authors Yusuf, Salim, Dagenais, Gilles
Format Journal Article
LanguageEnglish
Published Canada CMA Impact, Inc 24.06.2003
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ISSN0820-3946
1488-2329

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Abstract [Louise Pilote](1) implies that physicians who prescribed ramipril to more of their diabetic patients after the results of the HOPE study were publicized did so primarily because of marketing hype rather than solid research evidence. As a clinical epidemiologist and diabetes specialist, I am baffled by this position. The HOPE study(2)(3) was by far the largest clinical trial evaluating an ACE inhibitor and enrolled a much broader clinical population than its predecessors. It included a prespecified subgroup of 3577 diabetic participants, possibly more than the total number of diabetic subjects enrolled in all previous ACE inhibitor trials. Diabetic (and nondiabetic) subjects assigned to receive ramipril had statistically and clinically significant risk reductions for major cardiovascular events.
AbstractList [Louise Pilote](1) implies that physicians who prescribed ramipril to more of their diabetic patients after the results of the HOPE study were publicized did so primarily because of marketing hype rather than solid research evidence. As a clinical epidemiologist and diabetes specialist, I am baffled by this position. The HOPE study(2)(3) was by far the largest clinical trial evaluating an ACE inhibitor and enrolled a much broader clinical population than its predecessors. It included a prespecified subgroup of 3577 diabetic participants, possibly more than the total number of diabetic subjects enrolled in all previous ACE inhibitor trials. Diabetic (and nondiabetic) subjects assigned to receive ramipril had statistically and clinically significant risk reductions for major cardiovascular events.
A headline appearing in the highlights section of the March 4, 2003, issue of CMAJ was "The hype around HOPE," in reference to an article by Karen Tu and colleagues(1) and an accompanying commentary by Louise Pilote.(2) This expression was an appropriate play on words to describe changes in the prescribing of ramipril after publication of results from the large Canadian-led HOPE trial. (1) Tu K, Mamdani MM, Jacka RM, Forde NJ, Rothwell DM, Tu JV. The striking effect of the Heart Outcomes Prevention Evaluation (HOPE) on ramipril prescribing in Ontario. CMAJ 2003;168(5):553-7.
Author Yusuf, Salim
Dagenais, Gilles
AuthorAffiliation Professor of Medicine, McMaster University, Hamilton, Ont.; †Professor Emeritus, Laval University, Sainte-Foy, Que
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– reference: 12615747 - CMAJ. 2003 Mar 4;168(5):553-7
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– reference: 12615751 - CMAJ. 2003 Mar 4;168(5):568-9
– reference: 12639157 - Ann Pharmacother. 2003 Mar;37(3):327-31
– reference: 7654275 - JAMA. 1995 May 10;273(18):1450-6
– reference: 9788454 - Lancet. 1998 Oct 17;352(9136):1252-6
– reference: 12600907 - Circulation. 2003 Feb 25;107(7):960-5
– reference: 10639539 - N Engl J Med. 2000 Jan 20;342(3):145-53
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A headline appearing in the highlights section of the March 4, 2003, issue of CMAJ was "The hype around HOPE," in reference to an article by Karen Tu and...
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SubjectTerms Angiotensin-Converting Enzyme Inhibitors - economics
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Canada
Cardiovascular disease
Cardiovascular Diseases - prevention & control
Clinical Trials as Topic
Cost-Benefit Analysis
Drugs
Humans
Letters
Physiological aspects
Ramipril - economics
Ramipril - therapeutic use
Treatment
Title More than just hype
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