Replies to post #171919 on Amarin Corp Plc (AMRN)

[iwfal]

"Substantial fraction"? How do you know that? Herpes found 4-5 docs who claimed the placebo harmed patients or questioned whether the results were valid - I seriously doubt they are in the majority.

He talked to 6 cardiologists, and 5 expressed reservations:

But what seriously bothered five of the six cardiologists I spoke to was that the mineral oil had not behaved as a placebo at all.

Not only that, but if you had asked me ahead of time who the most influential cardiologists in the US were I would have named Nissen, Weiss and Kathiresan as in the top 10 and all 3 were in his list of 6. So I think he picked a pretty good group of KOLs. Also note that there is a pretty good argument, whether you agree with it of not (he's controversial), that Nissen is the most influential cardiologist in the US.


Is that even physically possible? I'm no expert on blood clotting, but on the surface it seems to me such a drug could not be created. Well, wait a second - we sorta already have one of those, don't we? V lowered risk of stroke by 30% and patients did not have increased/worrisome bleeding problems. I realize semantically low risk of stroke is not equivalent to "lower stroke clotting", but the end game is preventing strokes, so isn't that what really matters?

Precisely my point - paradigm shifts are hard. And, until the big RCTs are complete, it still may not pan out. But there is actually a good RCT (albeit small and in a different indication) and good epidemiological data based upon particular mutations present in the clotting cascade. (As for why it works, it turns out that the cascade is actually substantially different depending upon location in the vascular system - so it is probably possible that if you disable big clots in one part of the system you don't disable small clots in the same part of the system or any clots at all in other parts of the system.)