Talk:Milton Packer

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Bosentan trial

On page 8, the CV says:

Principal Investigator and Chairman, Steering Committee, Effect of Bosentan on Clinical Status in Heart Failure (REACH-1), 1997-2003

Of this trial PMID 11532543 says "bosentan was the first endothelin antagonist that was developed for clinical use. REACH-1 (Randomized Evaluation to Assess the effects of Ro 47-0203 [bosentan] in patients with Chronic Heart failure) was the first larger (pilot) study that was designed to study the efficacy and safety of an endothelin antagonist in patients with CHF, and also to examine whether the higher dose of this drug (500 mg twice daily) was well tolerated [12]."

Ref #12 is Packer M, Swedberg K, McMurray JJV et al., for the REACH-1 Investigators. Multicentre, double-blind, placebo-controlled study of long-term endothelin blockade with bosentan in chronic failure: results of the Reach Trial (abstract). Eur Heart J 1999;20(Abstr suppl):95.

PMID 11532543 goes on to talk about that trial, its termination for safety reasons, and the questions that raised, and bemoans the lack of published data.

Unclear what is wrong with this? So great that the results finally published! Jytdog (talk) 16:31, 6 August 2017 (UTC)

Dear jytdog

Thank you so much for helping with this. This is a new experience for me, so I appreciate any guidance that you can provide. I want to understand what I can do to help.

Regarding bosentan, there is confusion because there were two trials. The first was a small pilot trial, known as REACH-1. It was presented in 1999 and published as a full paper in 2005; it had promising results. A much larger trial with bosentan was then launched; this was called ENABLE. It was not terminated early. However, the results of the ENABLE trial were disappointing; these results were presented in 2002, and these were published as a full paper in 2017. So I think that the next to last paragraph should refer to ENABLE (not REACH1), and it should not say that the trial was terminated early. Both ENABLE and PROFILE trials were published as full papers in 2017.

There is an explanation for the delay of publication of the trials. Both projects were closed immediately by the sponsors after the trials were completed, and we had great challenges getting access to the databases. Only after many years, were we able to get full access and find a sympathetic editor. The full story of the delay is described in a commentary (JACC Heart Fail. 2017 Jun;5(6):408-410).

I hope this is helpful. — Preceding unsigned comment added by Xostugo (talk • contribs) 17:50, 6 August 2017 (UTC)

Quick note about using talk pages - we "thread" comments by indenting. The Wikipedia software recognizes a colon in front of a comment as a sign it should make an indent when it displays the text. So you are replying an original post (as you did above) you put one colon, and it indents once. I am replying to you, so i put two colons and you will two indents as you read this. When you reply, you will put three colons, etc. When that gets silly we "outdent" by putting {{od}} in front of the comment. Will reply on the substance in the second... The other key thing on talk pages is signing -- you do that by typing exactly four tildas at the end of your comment, and the software turns that into a link to your userpage and the date. That is how we know who said what, and to whom! Complicated and clunky, but that is the software we have to work on. Jytdog (talk) 18:35, 6 August 2017 (UTC)

Thanks for your reply! I hear you on the ENABLE thing, but this is weird the strange world of Wikipedia arises. Everything in WP must be based on what sources actually say. PMID 11532543 doesn't discuss the ENABLE trial -- it discusses REACH1. As a Wikipedia editor, I have no right to talk about the data from ENABLE not being published, as there the source I am using doesn't discuss that (it was ongoing at the time that reference was written). I know that probably seems insane to you but this limitation is one of things that makes Wikipedia possible -- editors here cannot do their own research. We summarize what reliable sources say. I added something earlier today that the two new papers explain why the research wasn't published. Is that OK with you? Jytdog (talk) 18:39, 6 August 2017 (UTC)

I am beginning to understand. At the age of 66, this is a very unfamiliar world to me. (But I think I got the number of colons right!) You can certainly leave the text the way it is. I think I need to think about all of this for a bit. Until a few weeks ago, I never had a Wikipedia page and was surprised when someone created one on me. Most of the summaries of my career achievements have not appeared on the internet, so I am still getting used to the idea. The only one that I know about is when I was designated a "Pioneer in Cardiovascular Medicine" by the European Heart Journal. Here is the reference: https://academic.oup.com/eurheartj/article/37/21/1633/2887778/CardioPulse-Articles. If you were to look it up, you will see that the post has two parts; the first part is a memorium I wrote for a dear friend, and the second part is a description of my career and contributions. (You need to scroll down to the second part to see it.) This career summary (which I did not write!) highlights my major contribution, which was the development of the "neurohormonal hypothesis of heart failure". If there is anything in the "Pioneer" summary that you think is worth moving to the Wikipedia page, please do so. I will leave that up to you. Thank you! Xostugo (talk) 22:50, 6 August 2017 (UTC)

Thanks for the reference. The interview when you took the job at UTSW was super helpful. as well. Wikipedia is not like the rest of the internet. It is it own strange corner, with all these "policies and guidelines". Jytdog (talk) 02:39, 7 August 2017 (UTC)