Violins Have More Than One String

By: John Scott

Science is one of those endlessly fascinating games that people play with ideas. The method could not be easier to state. You propose a hypothesis and design an experiment to collect evidence to test whether your hypothesis is true (I always pay particular attention when anyone starts talking about truth - if ever there was a flexible friend, truth would be it). So, now your results are in. You claim definitive evidence that "proves" what you speculated was either true or not true. Now it is up to the rest of the world to see whether it can replicate your findings. The more independent people who can reproduce the same results, the more likely it is that your hypothesis is true or not true.

As an irrelevant aside given that I am writing about acomplia, did you see that they are cooling down the Large Hadron Collider (LHC), near Geneva, to look more closely for Higgs boson - the controvesially-named "God" particle. And, hoping that you will forgive me for a flippant moment, weight loss is also increasingly a "holy grail" given the epidemic proportions of the spread of obesity in the human population. So, this April has seen the results of the Stradivarius study published in the Journal of the American Medical Association, and featured in a presentation and discussion at the Annual Scientific Meeting of the American College of Cardiology held at Chicago.

The Strategy to Reduce Atherosclerosis Development Involving Administration of Rimonabant - The Intravascular Ultrasound Study (that is Stradivarius for short) has been looking for evidence that acomplia (generic name riminobant) will slow down the progression of heart disease among overweight individuals whose arteries are hardening. In other words, the trial was trying to define a specific role for acomplia in the treatment of cardiovascular disease. Now a simple headline statement of the results - much to the disappointment of the College of Cardiology, there was no evidence that acomplia had any effect in slowing down the progression of atherosclerosis. You cannot imagine an audience more likely to be disappointed and therefore downbeat about acomplia. But, like those canny Scottish lawyers, I have a third wheel to my justice system. You are guilty, not guilty or the case is "not proven". So the specific hypothesis of the Stradivarius trial is not proven. We still do not know to what extent acomplia may or may not have a part to play in the treatment of cardiovascular disease. But the other parts of acomplia continued to play in Stradivarius according to specification.

Stradivarius had 839 participants with an average BMI 35, whose average waist measurements were 46 inches. After eighteen months, those taking acomplia had lost an average 9.5 pounds and had trimmed their waist measurements by an average of 1.8 inches. Those taking acomplia showed improvement in other factors affecting the risk of cardiovascular disease: high-density cholesterol had risen by 22.4%, triglycerides had reduced by 20% and C-reactive protein diminished by 50%. There was also one very important component under the spotlight. The researchers report with statistical certainty that there were no psychological side effects to taking acomplia - a factor that caused the Food and Drug Administration to treat acomplia with suspicion and will be one of the key considerations when Sanofi-Aventis resubmit acomplia to the FDA later this year.

So, on balance, the results of the Stradivarius study are encouraging. They show a continuing pattern of maintained over time and a reduction in waist measurements among the participants. The study also does not rule out a future role for in the treatment of heart disease.

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