The Real Implication of the Niaspan Study (or why I’m going to boost my biosciences investments)

Yesterday we had bad news about Niaspan:

The NIH has stopped a study with Abbott Laboratories’ cholesterol fighter Niaspan 18 months early after results showed the drug failed to prevent heart attacks and even may have boosted stroke risk. And as Bloomberg notes, the results could heighten the debate over whether raising good cholesterol actually helps patients….

….In a study follow-up, participants who took Niaspan and simvastatin had increased HDL cholesterol and lowered triglyceride levels compared to participants who took a statin alone. But the combination treatment failed to reduce heart attacks, strokes, hospitalizations for acute coronary syndromen or revascularization procedures to improve blood flow in the arteries of the heart and brain.

Certainly Abbott stock will fall in the short run. But in the big picture, this is an important step forward in the long and excruciating process of sorting out fact from fiction.  It fits in with the stream of stories like this one, which finds yet another biochemical mechanism that people had not suspected. 
The central dogma in molecular biology states that DNA is copied into RNA, one nucleotide at a time. But it turns out that copy may be a lot less exact than scientists previously thought. ….A new paper, published today in Science,identifies widespread differences between DNA sequences and their corresponding RNA transcripts in human cells, and demonstrates that these differences result in proteins that do not precisely match the genes that encode them. 
When pharma companies embraced genomics, they thought they had a faster path to finding new drugs that would treat well-known and well-understood problems.  Unfortunately, the deeper they got in, the more they discovered was that the problems were actually not well-understood–that conventional medical understanding was simply not correct much of the time.  This fits in with the lesson of evidence-based medicine so far,  which is that we know less than we thought we did. For example,  here’s what a panel of experts recently concluded about diet, lifestyle, and Alzheimer’s:
Although numerous studies have investigated risk factors and potential therapies for Alzheimer’s disease, significant gaps in scientific knowledge exist,” Dr. Martha Daviglus of Northwestern University Feinberg School of Medicine, Chicago, and colleagues wrote in the Archives of Neurology.

“Currently, firm conclusions simply cannot be drawn about the association of any modifiable risk factor with Alzheimer’s disease, and there is insufficient evidence to support the use of any lifestyle interventions or dietary supplements to prevent Alzheimer’s,” the panel wrote.

It turns out we are building a bridge across a wide and deep canyon rather than a narrow ravine.  Researchers are on the canyon floor, putting in the foundations and supports that no one thought we needed.  It’s a long, expensive, depressing, and dangerous process.

But there will come a moment–maybe soon, maybe years from now–when the bridge  will be, not done, but usable.  Traffic across the once-impassable canyon will soar almost overnight, and the Biosciences Century will truly begin.  And I, for one, want to be invested in those companies when that happens.


  1. Good canyon analogy for the biosciences, but I wonder if any of these early companies will even be around by the time the bridge is done. Amazon and other online retailers’ stock was bid up to crazy levels in the ’90s, but most of them don’t exist today, while Amazon ekes out slim retailer margins of 2-3% while competing with a panoply of newer online retailers. I don’t think biosciences will be as competitive or low-profit when it takes off, particularly if they’re still using the flawed patent approach used to secure their IP now, but I think we’ll see as many bioscience firms fail as we saw in tech.

  2. I do not follow this area like you do, Michael, but I only know of a single medical/bio company that has played out according to the dream:

  3. ezra abrams says:

    as a phd in molecular biology, who works at a biotech company, i think this post and the prev one aboutt the lack of benefit from the human genome project are right on
    they way I think about, our knowledge of the human body, at a molecular level, is increasing rapidly, and we know vastly (hugely) more then even 15 years ago, yet we are only a small way to knowing enough: we will know we have enough when technology starts making medicine a lot cheaper, like computers.

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