Saturday, February 11, 2006

Merck - Vioxx: Topol speaks

The public face of the Cleveland Clinic, its outspoken cardiology chairman, Dr. Eric J. Topol, is leaving for academia after a divisive year long dispute with the clinic's chief executive, Dr. Delos M. Cosgrove.

Both Dr. Topol and Case Western Reserve University School of Medicine in Cleveland, his new employer, announced the move yesterday. Dr. Topol is scheduled to become a professor of genetics at the Case school of medicine, which is affiliated with the Cleveland Clinic. Dr. Topol said the job was a temporary appointment that would allow him to focus on his primary area of research, the genetics of heart disease.

"I'll be able to concentrate on the research I'm passionate about," Dr. Topol said yesterday, but he added that he would eventually return to clinical practice as well.

Dr. Topol is among the country's best-known physicians, a reputation that developed partly as a result of his criticism of drug safety, particularly concerning the Merck painkiller Vioxx. He was among the first doctors to raise questions about the cardiovascular side effects of drugs in the so-called cox-2 class of painkillers.

During his 15-year stewardship, the cardiology department at the Cleveland Clinic rose to become regarded as among the world's best. Before that, the clinic had been known for the caliber of its heart surgery department, but not so much for cardiovascular medicine. He also founded the clinic's medical school in collaboration with Case.

The exact terms of Dr. Topol's departure were unclear and remained a matter of negotiation yesterday. Dr. Topol said he had hired a team of lawyers to negotiate his exit. They include W. Mark Lanier, who is handling hundreds of cases against Merck and won a $253.4 million verdict last August against the drug maker.

During an interview, Dr. Topol said he would remain program director of a $17 million National Institutes of Health study of the genes and proteins that cause heart attacks. Much of the work on the study is being done at the clinic.

"I'll be working in tight collaboration with my colleagues at the clinic," Dr. Topol, 51, said.
Dr. Topol and Dr. Cosgrove, a surgeon, have been regarded as rivals. Both were among contenders to succeed the clinic's former chief executive, Dr. Floyd D. Loop, when he retired in 2004.

Dr. Topol's star at the clinic appeared to wane after he lost out to Dr. Cosgrove. But another reason appeared to be the disclosure that Dr. Topol had served on the advisory committee of a hedge fund that shorted Merck, or bet its stock would fall, just before the company decided to withdraw Vioxx from the market. Dr. Topol said he did not advise on that decision, but announced he would sever all ties to any industry.

Despite that, the clinic ordered an investigation into all of Dr. Topol's previous industry ties.
Later, as a member of the organization's committee on conflicts of interest, Dr. Topol was among doctors who began asking questions about the financial arrangements of other doctors, including Dr. Cosgrove, as well as the use of clinic patients in tests of medical devices made by companies in which the clinic had financial interests.

In December, the clinic removed Dr. Topol from his job as provost of the medical college that he had founded, a move that also meant he was no longer on the conflict-of-interest committee. At the time, Dr. Topol said his unabashed willingness to take on Merck was at the heart of his removal from that job, an accusation Merck denied. Yesterday he accused Merck of a "persistent pattern" of trying to discredit him.

Source: NYT. Hat tip: Mike Lascelles at Pharma Watch

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