NEJM spiked conflicts op/ed, says WSJ

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The New England Journal of Medicine pulled an article slamming the National Kidney Foundation (NKF) for its reliance on drug company donations, according to The Wall Street Journal.

The article in question, an opinion piece by NEJM correspondent Dr. Robert Steinbrook, was originally slated to follow NEJM's publication of studies warning that the treatment of anemia in kidney patients with erythropoietin (EPO), a regimen recommended by the NKF, could increase the risk of heart failure, the WSJ said. Steinbrook linked the NKF's EPO advice to its heavy subsidization by the makers of those drugs. Amgen, the maker of Epogen and Aranesp, contributed $4.1 million to the foundation in 2005, while Procrit maker Ortho Biotech chipped in $3.6 million. Steinbrook also noted that two-thirds of the 18 authors of the NKF guidelines disclosed financial relationships with the companies. The foundation credits Amgen as the “founding and principal sponsor” of those guidelines.

A softer editorial piece co-written by Julie Ingelfinger, former president of the NKF's Massachusetts chapter (an association that went undisclosed in the NEJM), ran with the research papers, and Steinbrook re-submitted his piece to The Lancet, where it appeared on the Web on Nov. 17.

NEJM, which has taken flak in the past for its handling of Vioxx data and for loosening rules on conflicts of interest for writers, declined comment on Steinbrook's piece to the Journal, which cited anonymous sources as saying the NEJM editors felt the editorial to be lacking balance and unfair to the NKF guideline writers. NEJM maintains that it cannot talk about pieces it hasn't run, and communications director Sandra Jacobs said the editorial co-authored by Ingelfinger was that originally slated to run with the research. Jacobs also said Ingelfinger's affiliation with the Massachusetts branch of the NKF was immaterial to her editorial since that work was voluntary and had nothing to do with NKF guidelines.

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