Comment by estearum
14 hours ago
Yeah I work in clinical trials so I'm very comfortable with all the caveats the need to be applied to correlative studies like these.
Which also answers your other question of why doctors don't recommend it: we don't actually know that it does this.
As for the rest of the ramble, you (or I) definitely don't know hardly anything that hasn't been established in clinical trials. Certainly can't just vibes-based assess a label and its completeness. It's really, really hard to know things.
The precise wording as far as safety is: "we have no substantive or high-quality evidence that the drug is unsafe."
Because we couldn't possibly modify
"we have no substantive or high-quality evidence that the drug is unsafe." - (damn all the research showing it is)
--to
"we have no substantive or high-quality evidence that the drug is safe." - (damn all the research suggesting it isn't)
Well, that's as good a green light for an ad campaign as one could ask for. "we don't actually know that it does this." ain't never stopped a motivated pharmaceutical rep before. You have my official endorsement for feeding advil and acetaminophen to all. And protection from dementia is just what America needs. !Win / !Win
Maybe restless leg and depression too! And don't tell me fetuses don't get depressed there in that dark womb. We know damn well they get restless.
Drugs are approved for the specific uses based on extremely high-quality evidence. That evidence balances the benefits against the detectable downsides/costs/side-effects. Those downsides are also on the label.
That's almost entirely generated by the highest quality evidence generation system we could possibly have, which is RCTs. And no, pharma reps actually aren't allowed to encourage (or even talk about) off-label uses of drugs.
I get the sense that you don't know much about this space.
>highest quality evidence generation system we could possibly have, which is RCTs.
The "best we have" does not mean it is good enough for the task at hand. Just saying.
Basically what I am saying is that qualifying something by saying "best we have", does not justify its using on its own..