From the American Heart Association’s Scientific Sessions in New Orleans
The major reports from blockbuster trials at big medical meetings have lost a lot of their drama.
Traditionally, these big stories draw thousands of attendees in cavernous convention-center halls, with six or nine or more large screens hovering above to bring the face of the presenter and the slides to every corner of the sprawling space. You can tell when the big, anticipated report is over even with your eyes closed and your ears clogged because several thousand pairs of feet create a zephyr aimed at the exits.
At this year’s Scientific Sessions (my.americanheart.org/portal/scientificsessions/ss/plenarysessions2008), the big story was clearly the aptly named JUPITER trial (gotta admire the hubris of whoever came up with that moniker), a study with nearly 18,000 people with LDL cholesterol levels and a low-risk clinical profile that wouldn’t qualify them for statin treatment by current standards. Their one flaw was a relatively high level of a plasma component, C-reactive protein (a level of at least 2.0 mg/dL, denoting a higher than normal level of systemic inflammation). These folks were randomized to receive either 20 mg/day rosuvastatin (Crestor) or placebo. The trial was stopped early, after an average treatment duration of just under 2 years, because the people on this potent statin had an impressive 44% relative reduction in the study’s primary end point, the combined rate of several bad cardiovascular outcomes including death, heart attack, or stroke. The relative risk for death due to any cause fell by 20%. (content.nejm.org/cgi/content/full/NEJMoa0807646).
The results were reported by study leader Dr. Paul M. Ridker at the meeting that started yesterday afternoon at about 3:45 PM CT. But yesterday morning, at about 8:30, Dr. Ridker gave a summary of his report at a press conference, with an announcement from the AHA that the material was off embargo and available for reporting to the world as soon as the press conference ended, which was about 9:30. A copy of the full results in the NEJM paper (see link just above) had been available to the press since last Thursday (Nov. 6) and carried an official embargo from the journal of 9 AM ET, which meant that news reports could actually start to crash the world’s e-waves at 8 AM in New Orleans, even before the news conference got underway.
Despite dissemination of the punchline many hours before the formal report, I’m sure the meeting hall was still packed with attendees seeking a first-hand presentation of the data from Dr. Ridker’s mouth. But if they couldn’t be there, I’m sure their disappointment was softened by having many other ways to find out what was going to be said. A colleague of mine was covering this story, and I decided that the newsiest alternative lay in another, much more sparsely attended room. Just before the session began, I overheard a conversation in which one attendee lamented having missed the JUPITER report. Attendee two shot back that it was no biggie, as he had heard all about it on CNN earlier in the afternoon.
A fellow reporter yesterday noted to me how much easier covering the big stories has become over the last 5-10 years. Used to be we reporters had to tape record and note take furiously in the press conferences and then in the meeting halls because that was the only way to get the data. Nowadays, the high-profile researchers, the high-profile journals, and the high-profile meetings have crafted a détente—prompted and abetted by the Internet—that has eliminated the old tensions over which comes first, the meeting report or the journal article. Instead, there’s a carefully choreographed and timed release of the full data in the form of the embargoed paper, followed by the sound bites at the press conference, followed by the news stories, with the meeting report itself bringing up the rear, by which time the big story has lost quite a bit of its cutting edge.