Integral - This Shows What Happens When Data Goes Crazy

Enjoy this U.K. Protest Anthem against the standardization of our human database.

We are all Mammals, so lets do it - The Bloodhound Gang

This is a great Bloodhound Gang Song, called "The Bad Touch." I think the lyrics are very intelligent.

You and me baby we ain't nothing but mammals, so lets do it like they do on the Discovery Channel.

Music IS the Victim of this Administration TOO - Scissor Sisters

I love this Live Berlin performance. Enjoy!

RUN - Snow Patrol - Final Fantasy

This song was given to me on a CD by a friend that was giving me some of her favorite music. After I listened to this song, it reminded me of DML so much, that I feel it could represent a movement of people. Let me know what you think.

"Light UP as if you have a choice. Even if you can not hear my voice, I'll will be right beside you, Dear."

Sanofi- Adventis SUED for Gender Bias

U.S. sales workers sue Sanofi for gender bias

Reuters Health - Aug. 30, 2007
By Martha Graybow

NEW YORK (Reuters) - Four women sales workers in the United States have sued drugmakerSanofi-Aventis for $300 million, contending they were denied promotions and paid less than their male counterparts.

An earlier version of the gender discrimination lawsuit was filed in U.S. District Court in Manhattan in March by one woman. A revised complaint was filed on Wednesday that includes new claims by three more plaintiffs.

The women are current or former employees of the French pharmaceutical company's U.S. unit, which is based in Bridgewater, New Jersey. Sanofi, the world's third-largest drug maker, markets medicines, including sleeping pill Ambien and blood thinner Plavix.

The suit, which seeks class-action status, names the parent company and the U.S. unit as defendants. A lawyer for the women said the potential class of plaintiffs could total 6,000 to 7,000 current and former female sales employees.

"The essential allegations are that women are not paid the same amount as men and that women are not promoted at the same rate as men," said the women's attorney, David Sanford.

A spokesman for Sanofi's U.S. unit, Marc Greene, said that the company is "confident that the suit lacks merit and that all of our employees are treated fairly and in compliance with all applicable federal and state laws."

Sanford's firm, Sanford Wittels & Heisler, also represents female plaintiffs in a discrimination case against a U.S. unit of drug company Novartis AG. A federal judge in Manhattan earlier this month ruled the lawsuit, which seeks $200 million in damages, can proceed as a class-action.

According to the Sanofi complaint, the women plaintiffs lost out on promotions for which they were well qualified, while men on their teams were quickly promoted. The women also contend they were subjected to sexually hostile work environments.

The complaint contends that one woman, the only female on a team of eight sales representatives, was the target of misogynistic slurs, including lewd comments about her breasts. The woman's manager never reprimanded any of the men on her team about the remarks, the lawsuit says.

Another woman, according to allegations in the complaint, said that during a sales meeting, her manager took the men on their sales team to a strip club. On another trip, the woman contends, her manager announced a male team member wanted to see one of his women colleagues in a bikini sometime during the trip.

These Are MY Friends - Criminal Police Behavior

Neil, the gray-haired man being violently assaulted by the police in Ontario is my friend. So is the man that he was hugging. There was NO NEED for this type of action against peacefully gathered citizens. Canada is turning into a police state, trying to copy its big brother to the South. Poor Canadians.

I don't know who the articulate, calm and cool, heroic woman in the film is, but I will find out soon and let you all know about her. I don't think I could have behaved as well as they did. I love the guy they were trying to arrest. I spent an evening chatting with him, and he is the owner of a local head shop and he is a cannabis activist. He is also very gentle, intelligent and giving. So unlike the reaction and personalities of the arresting officers. It is so surprising that it took 3 officers to take down an old guy. What a shame! This is only one of the new police offensive (or old and long running one) that now tries to discourage the people from coming to rallies supporting legalization of Cannabis. If you look further, you will see videos of FAKE arrests of COPS dressing like activists, and then having their fellow cops take them DOWN, to make the activists look, violent?
Wow, which marketing expert thought that one up?

Can't forget this one.
Famous rodney king beating
http://youtube.com/watch?v=aH-nal6PkQo

Police beat down an old man.
http://www.youtube.com/watch?v=k6BsZUuZmr4

LAPD beating (hi-res)
http://www.youtube.com/watch?v=o9hS0ZhpFPA

Man Gets Wacked Repeatedly
http://www.youtube.com/watch?v=k2F8B2qSzhs&NR

MET Police Beat up man
http://www.youtube.com/watch?v=y_PmSDA1HNc

If you are outraged, please send email to Neil and his crew, I am sure he would LOVE to hear from any of you. Neil is on a Freedom Tour across Canada, and he fights for YOUR right to personal freedoms. Please see www.freedomtour.ca for more information about the assault or the tour.

FDA Approves Risperdal for Two Psychiatric Conditions in Children and Adolescents

Evidence to support this approval was collected through studies the FDA requested as part of its pediatric drug development initiatives.

The efficacy of Risperdal in the treatment of schizophrenia in adolescents was demonstrated in two short-term (6 to 8 weeks), double-blind, controlled trials. All patients were experiencing an acute episode of schizophrenia at the time of enrollment. Treated patients generally had fewer symptoms, including a decrease in hallucinations, delusional thinking, and other symptoms of their illness.

The efficacy of Risperdal in the treatment of manic or mixed episodes in children or adolescents with bipolar I disorder was demonstrated in a three-week, randomized, double-blind, placebo-controlled, multicenter trial in patients who were experiencing a manic or mixed episode. Treated patients generally had fewer symptoms, including a decrease in their elevated mood and hyperactivity, and other symptoms of their illness.

Drowsiness, fatigue, increase in appetite, anxiety, nausea, dizziness, dry mouth, tremor, and rash were among the most common side effects reported.

Schizophrenia is a serious and disabling psychiatric disorder. Symptoms may include hallucinations, delusions, and disorganized thinking. Bipolar disorder, also known as manic-depressive illness, is a serious psychiatric disorder that causes wide shifts in a person's mood, energy, and ability to function.

Risperdal is manufactured by Janssen, L.P. of Titusville, N.J.

For more information:

FDA Office of Pediatric Therapeutics
www.fda.gov/oc/opt/default.htm

National Institute of Mental Health—Schizophrenia
www.nimh.nih.gov/healthinformation/schizophreniamenu.cfm

National Institute of Mental Health—Bipolar Disorder
www.nimh.nih.gov/healthinformation/bipolarmenu.cfm

Is this a good thing, or another attempt to put our youth under the influence of synthetic molecules? It seems to me, that any child that is different will likely now be prescribed Risperidone.

This is not a good thing. IF and ONLY IF it is supervised with FDA oversight (which they can do by randomly interviewing children who have filled DSHS funded prescriptions) could this be a good thing, to treat children who suffer from schizophrenic symptoms. There is some evidence to show that the SOONER a child is treated for schizophrenic symptoms, the better the recovery is down the line in adulthood.

I hope Pharma Giles, Dr. Peter Rost, and Pharma Gossip are all doing well. I miss you guys so much. Thank you so much for all the support you have given me. I hope to see you all soon ON A NEW BLOG I WILL START SOON - ACADEMIC GILES/GOSSIP. Remember Gentlemen, imitation is the most sincere form of flattery. Sometimes humor makes the best of horrible life circumstances... Stay tuned.

House panel approves legal shield for bloggers

This is very good news, I hope. I miss you all, and I hope I will be able to return to blogging in the near future. I wish to shout out Dr. Peter Rost, in his new position at BrandRx, as a columnist. Wow, are they smart to hire him, as no ONE blog can contain this man :)

I am well, however, I am very busy. I am also moving around often, and that disrupts my internet access for many days. I am still very interested in everything that is happening and am following it carefully.

When I finish a mirror site that I am working on, I will be back....

Love, Peace, and more protections for journalists of every type,

BK

The Information Highway - Porn on the Web: The Facts

This video contains adult subject matter about the amount of porn on the web. Since my previous posts border on the fine line of porn, I decided to show you, that I am clearly in the majority. Don't be hypocritical, Porn is the most accessed information on the information highway :). I am bothered by Cuba, who bans Porn. I expect banning from Iran, but NOT Cuba. Oh well, they put AIDS victims in boats and/or prison, so I guess the culture is definitely NOT sex positive.

Via: VideoSift

If You Think This Is FICTION. - Think Again!

Kudos to Pharma Giles, the best humorous, yet very relevant PHARMA blog.

For Your Viewing Pleasure

I hope you enjoy these photos I shot, and please take them with the love they generate. The Kanji on the lovely woman's arm means LONG LIFE. Awesome.

"Do You Take it in the ASS?" - ODE to Many MDs

Contains Adult Language

Bush - You Drive Me Crazy!! Cheney Too!

Please forgive my absence. I am preparing an article and have been very busy with my activism. I hope to return to blogging when I return to work *sigh*. I am SO proud of Dr. Peter Rost and what he has accomplished.

FDA Advisory Panel Says Controversial Cannabinnoid Blocker Not Safe For Human Consumption

Thank you to NORML for this. I apologize for yet ANOTHER take on this same story. This one however, is from a cannabinoid receptor antagonist perspective. When I first heard the academic medical talk on this nasty harmful synthetic molecule, it made me want to go running from the auditorium. I stayed to listen to the cute, young and earnest researcher present her data from a study using this antagonist for college students who wanted to "quit pot."

I asked her if she didn't think that smoking pot was a normal social part of the college experience, much like drinking at frat parties? She said," well yes."

I asked her how does she determine if an individual needs to consider this type of extreme treatment? There was obviously no thought given to this issue other than "meeting DSM-4R criteria for Marijuana Abuse or Dependence."

Give me a break and a toke... my golly gee whiz.

Rockville, MD: An independent Food and Drug Administration (FDA) advisory committee determined on Wednesday that the controversial cannabinoid receptor antagonist Rimonabant (also known as Acomplia) is unsafe for human consumption in the United States. The drug's manufacturer, Sanofi-Aventis Pharmaceuticals, is seeking FDA approval to market the drug in the US as a dietary aid.

Members of the FDA's Endocrinologic and Metabolic Drug advisory panel resolved 14-0 that the drug did not possess a "favorable risk-benefit profile" to warrant US regulatory approval. Panelists reported that patients prescribed Rimonabant experienced increased incidences of depression, nausea, vomiting, and suicidal tendencies. Adverse neurological symptoms, including multiple sclerosis, have also been documented in subjects who have taken Rimonabant.

European regulators previously approved the prescription use of Rimonabant, marketed under the trade name Acomplia, in 2006 but are now expected to review their decision. Rimonabant is the first cannabinoid antagonist ever to be approved for human consumption. More than 100,000 European patients have been prescribed Acomplia since its approval last year.

The FDA is expected to make a final ruling regarding whether to approve or reject the drug in July. The agency typically abides by the recommendations of its advisory panels, but it is not legally required to do so.

Rimonabant blocks the natural binding of endogenous cannabinoids (as well as exogenous cannabinoids such as THC) to the neuronal CB1 receptors, causing users to lose their appetites. However, because the endocannabinoid receptor system is intricately involved in the regulation of a broad range of primary biological functions – including appetite, body temperature, mood regulation, blood pressure, bone density, reproduction, learning capacity, and motor coordination – some experts are concerned that the long-term use of Rimonabant or similar drugs may contribute to a host of significant adverse health effects.

In preclinical trials, newborn mice injected with Rimonabant refuse feeding and often die days after birth. Mice genetically bred to lack the CB1 receptor also suffer from numerous health defects such as cognitive decline, hypoalgesia, decreased locomotor activity, and increased mortality compared to healthy controls.

At least one published case study reports that daily use of the drug may have triggered neurological symptoms of multiple sclerosis in a volunteer with no known history of the disease. Mental health side effects, such as depression, are also commonly reported among volunteers administered Rimonabant. FDA panelists reported that using Rimonabant nearly doubled the users risk of attempting suicide.

The FDA has previously rejected requests by Sanofi-Aventis to approve the drug as a smoking cessation agent.

For more information, please contact Paul Armentano, NORML Senior Policy Analyst, at: paul@norml.org.

Kitty Sees that the FDA is Reading Up on ITS Decision - Gotta LUV IT!

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Date	Time	WebPage
14th June 2007	12:37:54	blogsearch.google.com/blogsearch?hl=en&client=news&q=zimulti&ie=UTF8 The Black Kitty - All Things Health Care Related: Acomplia - New Weight Loss Pill is Dead in the Water
14th June 2007	12:37:54	blogsearch.google.com/blogsearch?hl=en&client=news&q=zimulti&ie=UTF8 The Black Kitty - All Things Health Care Related: Acomplia - New Weight Loss Pill is Dead in the Water
14th June 2007	12:38:35	gcic.blogspot.com/2007/06/acomplia-new-weight-loss-pill-is-dead.html The Black Kitty - All Things Health Care Related: Unanimous "No" to Rimonabant: Safety Not Demonstrated, FDA Advisory Panel Says
14th June 2007	12:38:35	gcic.blogspot.com/2007/06/acomplia-new-weight-loss-pill-is-dead.html The Black Kitty - All Things Health Care Related: Unanimous "No" to Rimonabant: Safety Not Demonstrated, FDA Advisory Panel Says
14th June 2007	12:41:08	blogsearch.google.com/blogsearch?hl=en&client=news&q=zimulti&ie=UTF8 The Black Kitty - All Things Health Care Related: Acomplia - New Weight Loss Pill is Dead in the Water
14th June 2007	12:41:08	blogsearch.google.com/blogsearch?hl=en&client=news&q=zimulti&ie=UTF8 The Black Kitty - All Things Health Care Related: Acomplia - New Weight Loss Pill is Dead in the Water

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Glaxo is Watching... Thank you :)

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14th June 2007 18:13:42 peterrost.blogspot.com/2007/06/why-did-pfizer-hire-detectives-to-spy.html
The Black Kitty - All Things Health Care Related: Dr. Peter Rost Gives it to Pfizer in a Long Dark Way
14th June 2007 18:13:42 peterrost.blogspot.com/2007/06/why-did-pfizer-hire-detectives-to-spy.html
The Black Kitty - All Things Health Care Related: Dr. Peter Rost Gives it to Pfizer in a Long Dark Way
14th June 2007 18:14:59 peterrost.blogspot.com/2007/06/why-did-pfizer-hire-detectives-to-spy.html
The Black Kitty - All Things Health Care Related: Dr. Peter Rost Gives it to Pfizer in a Long Dark Way
14th June 2007 18:14:59 peterrost.blogspot.com/2007/06/why-did-pfizer-hire-detectives-to-spy.html
The Black Kitty - All Things Health Care Related: Dr. Peter Rost Gives it to Pfizer in a Long Dark Way

"Mother Goose" - "I Set Her Loose and SHE was Screaming!"

Good Bye Mother, YOU ARE SET FREE. I would scream too. This Kitty wished it was different, but since you are the BIG CAT, you NEED to be free of Black Scrappy Kitty :) Then maybe we can meet up on the THICK line of BIG LOVE rather than the thin line between Kitty Love and Kitty Hate. Its all the same, just a bundle of Kitty level emotions. That is what being in a parent-child relationship is about, basal animal feelings that defy rationality. Ask any parent of a teenager... they'll tell ya.

Love, Peace, and Positive Loving Mother LUV

Bungle in the Jungle - Good-Bye So CAL

Southern California can equal Florida for this Jethro Tull song, that allows embedding. I am very glad to leave. Although this place has great weather and nice palm trees, it lacks soul. It is police like in the oppression of free thought and speech. Living next to the largest West Coast Marine Base has its disadvantages. Seeing the poverty that is caused by the Bush Reign and wars is very sad to this Kitty. I visited with a wife of a soldier. This LOVELY lady has a new 3 month old and two kids. They all want their Daddy to come home FROM HIS THIRD TOUR IN IRAQ. When I met her a couple of years ago, she was very pro war. NOW, SHE IS ANTI-WAR. It is ironic that these very kind and sweet wives don't do ANYTHING to try to stop the war. Nothing. I guess given how repressed alternative thinking is in So. Orange.. its not surprising at all. Love, PEACE AND PEACE

Wind- Up by Jethro Tull

When I was an adolescent, I used to go to all the Jethro Tull concerts I could. My friend DK was really into him, and I was sorta into him. Well, I was playing the Aqua Lung album the other day and heard this song again. I just loved it. I played it like 20 times in a row in order to clearly hear the words. I think they are meaningful in light of my current belief system.

One of the most positive memories I have of my brother is when he was playing his drum kit to Aqua Lung.. the song. Those were the days... I guess. Enjoy.

Unanimous "No" to Rimonabant: Safety Not Demonstrated, FDA Advisory Panel Says

I apologize for not letting go of this story. But since you all know I am a pudgy Kitty, it is very relevant to my life, and the life of my pals. I think the continual search for the billion dollar anti-obesity PILL is a tragic story that in the end will just serve as a type of genocide against fat people. Who cares about fat people anyway? They are just lazy and don't care about themselves. They incur huge medical costs and they develop chronic conditions. In fact, obese individuals, and WOMEN in particular are discounted and marginalized by society. This is a fact that needs no support. If you are a fat woman, it doesn't matter who you are as a person, or what you have done, you are a fat chick.. period. You will reminded of it, by everyone, often.

I request that all of you normal weight people give us fat folks the benefit of doubt, and take us as we are. Please stop trying to find more and more extreme ways to kill us off... bariatric surgery, mouth wiring, starvation diets, harmful synthetics and social ostracism are just a few of the barbaric methods that society have deemed "acceptable" in the domain of treatment for obesity.

Speaking for my self only, ALL THE SYNTHETIC medications to help with weight loss, have been VERY DETRIMENTAL to humans. If you have a different take, pleases comment, I welcome alternative view points. It is my contention that weight loss is a very personal journey and it revolves totally around calories in and calories out and understanding your body and the effects of the environment on your health and metabolism.

Please, don't take any weight loss synthetic medications. Try walking around a bit, and find things to do that are not passive like watching things and reading.

Peace, Love and Liking your Body

Shelley Wood

from Heartwire — a professional news service of WebMD

June 13, 2007 (updated June 14, 2007)Silver Spring, MD - In a blow to the drug maker and millions of overweight and obese Americans hoping for a new weight-loss medication, the FDA's Endocrinologic and Metabolic Drugs Advisory Committee unanimously told Sanofi-Aventis to gather more detailed safety information about rimonabant over the long term, in larger patient numbers. All 14 members of the advisory committee agreed that rimonabant did not demonstrate the risk/benefit profile that would enable it to be approved for the indication sought: weight management in individuals with a body-mass index (BMI) of >30 kg/m² or in individuals with a BMI of >27 kg/m² when accompanied by at least one comorbid condition. Their concerns centered on a "clear" signal of increased risk of neurological and psychiatric side effects—seizures, depression, anxiety, insomnia, aggressiveness, and suicidal thoughts among patients randomized to rimonabant.

Indeed, new analyses of the randomized controlled trials of rimonabant suggest that "suicidality"—ranging from suicidal thoughts to successful suicides—was 30% higher among subjects taking rimonabant.

"We don't have enough patients who are on this for a long enough period of time to know what's going to happen down the road, and we have enough concerns," panel member Dr Paul D Woolf (Crozer-Chester Medical Center, Upland, PA) summarized. "If the drug were going to cause a 30% weight loss we'd all be jumping up and down and throwing our hands in the air and saying this is marvelous, and we wouldn't be overly worried about the safety concerns. But . . . this drug seems to have the same efficacy as the other two approved [weight-loss] drugs."

No way of managing unknown risks

Experts presenting data on behalf of the company recapped data from the RIO series of trials, previously reported by heartwire, showing that roughly one quarter of obese subjects randomized to rimonabant lost 10% of their body weight after one year, while half of subjects lost about 5% of their original body weight. These losses were significantly greater than those among placebo-treated patients. They also acknowledged some of the side effects of the drug but emphasized that the neurological and psychiatric effects were seen predominantly in people with a history of depressive or neurological disorders. This risk, they argued, could be managed by making these conditions contraindications to getting the drug and by the creation of a novel "risk management plan" for physicians. They also stated their intention to refrain from marketing the drug directly to consumers for the first year, so that physicians could have a chance to better understand the drug before being pestered about it by patients who might not be ideal candidates.

But panelists and speakers punched holes in the sponsor's testimony and plans. During the open public-hearing session, Lynn McAfee, director of the Medical Advocacy Project of the Council on Size and Weight Discrimination, suggested that the sponsor had to be more realistic about the environment a new weight-loss drug would be entering. "People are desperate," she said. "People will take on an enormous amount of risk; it's amazing what people will do, and we have a system in which the unscrupulous can prey on us and cause us harm. . . . I will tell you right now that if this gets out in the public, people will figure out a way to get the drug; it's not laser brain surgery."

Members of the panel, while praising the sponsor's attempts to come up with novel ways of managing use of the drug, suggested the degree of benefit was insufficient given the unknown risks.

"You're going to tell a 220-lb woman that she has a one in four chance that she'll get down to 200 lbs if she sticks with the program? Well, that's not going to make anyone very happy," Dr Jules Hirsch (Rockefeller University, New York) pointed out. "On the other side, what are the dangers? At least everyone will agree that we have to learn a little more and watch this whole affair carefully before we lunge into massive use of the drug."

Long-term data needed

Others pointed out that the popularity of the drug would vastly amplify the signal of adverse events that were seen in the study. "I have made some rough calculations based upon the psychiatric and neurological adverse effects, recognizing that some might be kind of trivial," Dr Robert Kreisberg (University of South Alabama, Birmingham) stated. "The absolute increase in risk is such that the number you'd need to treat to harm is about six and the number you'd have to treat for a benefit of 5% weight loss is about four and for a 10% weight loss is about six. So it looks to me like the number needed to harm and number needed to treat are pretty much balanced."

The panel was universally discomfited by the lack of long-term data in large numbers of patients. In all, only 441 patients stayed on the dose of 20-mg rimonabant over two years; the dropout rate during the first year of the RIO studies ranged from 32% to 49%. The trials were designed to carry over last reported events to the end of the trial rather than follow the large number of patients who discontinued their trial drug, many for adverse events, a design feature that did not sit well with panel members. In fact, patients who required treatment for depression were automatically taken out of the trial yet were not followed to the trial's conclusion. "I think the real implication here is that you've lost data on adverse effects and you've lost serious data on depression and anxiety," Dr Domenic A Ciraulo (Boston Medical Center, MA) suggested.

Several committee members acknowledged the clear need for a new weight-loss medication and suggested that certain subgroups might ultimately benefit from a selective CB1 endocannabinoid receptor antagonist such as rimonabant, but that the sponsor may not be chasing the right group.

Dr Philip S Wang (National Institute of Mental Health, Bethesda, MD) pointed out that the apparent doubling of neurological and psychiatric side effects with rimonabant also occurred in people with no history of these types of problems. Better candidates might be those with "extreme obesity," with BMIs over 40, he suggested.

"There's some preferential efficacy in this group, and according to my back-of-the-envelope calculation, it looks like you actually have lower risks of these psychiatric events in that group. . . . But this is all going to take more data."

Starting from scratch?

Indeed, more data was the unanimous recommendation of panel members.

Dr Katherine M Flegal (Centers for Disease Control and Prevention, Atlanta, GA) called the sponsor's evaluation of adverse effects "a post hoc collection of adverse events and symptoms that really have not been adequately investigated enough in detail and that weren't identified in advance."

Dr Sid Gilman (University of Michigan, Ann Arbor), likewise, questioned why the sponsor had not "drilled down" into reported side effects like "dizziness" or "tremors" and performed the sorts of tests and imaging studies that would have better characterized these events.

"In this case," said acting chair Dr Clifford Rosen (St Joseph Hospital, Bangor, ME), "it's the adverse events and not the serious adverse events that tell the story, and we don't have enough information. . . . I would go back and ask the question, Why weren't these more detailed at the beginning of these big trials, when we knew that this is a central nervous system acting agent that's going to have these kind of effects?"

Even the ongoing CRESCENDO trial may not provide the answers the FDA would need, several members suggested, since it was not appropriately designed to clarify the types of adverse events occurring in people taking the drug.

"I personally don't think there is much you can do with the trials that are already under way," Kreisberg said. "They are what they are, and they probably all suffer from this lack of specificity about definitions. So I think it's going to be hard to mine that information" in the existing data set, he concluded.

The FDA had issued an "approvable letter" to Sanofi-Aventis back in February of 2006, but the panel's opinions Wednesday suggest that an antiobesity indication for rimonabant won't be coming any time soon.

The complete contents of Heartwire, a professional news service of WebMD, can be found at www.theheart.org, a Web site for cardiovascular healthcare professionals.

Shelley Wood is a journalist for Medscape. She joined theheart.org, part of the WebMD Professional Network, in 2000 and specializes in interventional cardiology. She studied literature at McGill University and the University of Cape Town and received her graduate degree in journalism from the University of British Columbia, specializing in health reporting. She can be reached at SMWood@webmd.net.

Heartwire 2007. © 2007 Medscape