ATLANTA, April 2 /PRNewswire/ -- The following was released today by
Richard L. Bowen, MD:
At the American College of Cardiology '98 Scientific Session, in a
presentation by Heidi M. Connolly, MD entitled ``FEN-PHEN VALVULOPATHY'' the
Mayo cardiologist stated, ``Initially we thought it may have been the
combination of medications (fenfluramine and phentermine) that caused the
valve problems but it appears to be the fenfluramine medication alone.''
Unfortunately, the authors in the original August 28, 1997 article in the New
England Journal of Medicine (NEJM) went out of their way to implicate
phentermine as a possible culprit. It stated, ``Pulmonary hypertension has been
reported in association with treatment with fenfluramine or phentermine
alone,'' and ``Phentermine interferes with the pulmonary clearance of serotonin,
which may explain its association with primary pulmonary hypertension....We
postulate the combination of fenfluramine and phertermine may potentiate the
effect or concentration of circulating serotonin and result in valvular
injury.'' All of which are based on an incorrect reading of the medical
literature cited as references in the article.
This is not to say that phentermine plays no role in valvular
abnormalities. However, there is no evidence that phentermine when given alone
causes pulmonary hypertension or valvular heart disease.
What is most unfortunate is that due to the initial statements to the
press (prior to NEJM publishing) many patients discontinued phentermine -- as
well as fenfluramine. Most patients then regained the weight they had lost,
again placing them at risk for the many health problems caused by excess fat.
While an extremely important article, the NEJM in rushing to publicize it
failed to provide adequate peer review. (Apparently no obesity specialist
reviewed it because errors as simple as incorrect dosage of the medications
were missed.) It remains to be seen in light of the lead authors' recent
statements whether the NEJM will address this issue.
Thursday April 2, 5:15 pm Eastern Time
Mayo's Cardiologist Connolly Reverses Her Original Position On Heart Valve Damage Caused By Fen-Phen
Company Press Release
SOURCE:
Richard L. Bowen, MD