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Adverse Reactions: The Fenoterol Story

Matt Boyd



When TGN1412 caused immediate pain and grotesque facial swelling and resulted in the admission of six men who participated in a London drug trial last year to intensive care, the world immediately took notice. When a different drug caused the fatalities of hundreds of asthma patients in a decade-long epidemic here in New Zealand in the 1980s, it nearly passed by unnoticed. How could this be so?

Adverse Reactions is the story of a team of Wellington investigators who followed a hunch that the inhaled asthma reliever Fenoterol was deadly due to serious side-effects in frequent users. This hunch turned out to be correct, but difficult to prove, as the number of deaths from asthma was relatively low compared to the prevalence of the disease. Further complicating the issue was the fact that the cause of death in severe asthmatics was usually recorded as ‘due to asthma’.
Neil Pearce and his co-researchers found themselves in a battle against the corporate might of drug company Boehringer Ingelheim, who sought to refute the Wellington group’s findings. They also encountered substantial resistance to their hypothesis from the medical community and New Zealand’s own Asthma Task Force, both of whom refused to accept that a therapeutic measure, which made asthmatics ‘feel better’, could in fact be deadly.
Adverse Reactions is, in a sense, a detective story. The villain is a potent and lethal asthma drug posing as a fine, upstanding member of the therapeutic community. Any opposing evidence is collected through careful epidemiologic techniques. This book clearly illustrates the power of population thinking and statistical analysis in identifying trends invisible to the individual. Furthermore, it demonstrates the extraordinary lengths that those with vested interests will go to in order to discredit rival views. The research of Pearce’s group was certainly not flawless.
However, the first reports of a link between smoking and lung cancer were also flawed. What is most astonishing is the delayed response of the Department of Health in acting upon this information. Adverse Reactions tells how even in the face of so-called ‘safe’ alternative drugs, the use of Fenoterol was continued until there was definitive proof of its deleterious effects. This saga of drug company versus researcher, adjudicated by various drug regulatory bodies, defies belief. This book is essential reading for its clear explanation of powerful epidemiological methods and the absurd dogmatism that it exposes in many groups that were sympathetic to Fenoterol.
The purpose of this book is not to attack drug remedies or modern medicine, both of which effect much good in our community, but rather to demonstrate the single-mindedness of so many of us who glean our information from prestigious sources and fail to consider alternative evidence. Pearce’s group deserves credit for their integrity and eventual vindication.