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El dolor y el fraude que duro 12 años
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El dolor y el fraude que duro 12 años

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Igual que el economista estadounidense Bernard Madoff mantuvo a todo el mundo engañado durante años mientras desarrollaba su entramado financiero; el doctor Scott Reuben se dedicó a escribir artículos falsos sobre el uso de fármacos contra el dolor entre los años 1996 y 2008. Aunque uno de sus 'jefes' descubrió el fraude por casualidad el pasado mes de mayo, es ahora cuando el escándalo sale a la luz.

Reuben, especialista en anestesia y manejo del dolor en el Centro Médico Baystate, en Springfield (EEUU), escribió un total de 21 artículos falsos sobre el uso de los modernos inhibidores de la Cox 2 para aliviar las molestias después de una operación de prótesis de cadera o rodilla. Concretamente, el doctor proponía que la combinación de Vioxx (rofecoxib) o Celebrex (celecoxib) con tratamientos anticonvulsionantes o pregabalina; sería más útil en el control del dolor y permitiría reducir el uso de morfina durante la recuperación.

Además de los 21 trabajos que su universidad ha pedido a las revistas que retiren, se cuestiona también la fiabilidad de otras docenas de trabajos sobre este mismo campo. Precisamente, Reuben se distinguió entre sus colegas por su encendida defensa del uso de estos productos en lugar de los clásicos antiinflamatorios no esteroideos (como la aspirina o el ketorolaco) para tratar el dolor tras una cirugía ortopédica.

Según explica a el doctor José Ramón González Escalada, secretario de la Sociedad Española del Dolor, esta indicación no llegó a implantarse en nuestro país, debido a que la Agencia Europea del Medicamento (EMEA) no llegó a dar el visto bueno a este uso. "Aquí, esos trabajos carecieron de trascendencia porque se descubrió que este tipo de fármacos tenían riesgos cardiovasculares y la FDA los retiró del mercado antes de que en Europa se llegasen a usar después de las cirugías".

Riesgo cardiovascular
Precisamente, debido al carácter polémico de estos medicamentos, el escándalo de Reuben ha sido ampliamente difundido por la prensa estadounidense, que lo considera ya uno de los fraudes académicos de más larga duración en la historia científica reciente. De hecho, a pesar de que Vioxx fue retirado del mercado en el año 2004, Reuben siguió publicando trabajos en los que minimizaba sus posibles riesgos.

El hecho de que el investigador recibiese abundantes becas y financiación del fabricante de uno de estos productos, la farmacéutica Pfizer, tampoco ha sido muy útil en su descargo. La compañía ha lamentado lo ocurrido y asegura que Reuben formaba parte del grupo de expertos independientes con los que suele colaborar habitualmente, y con los que se realizan trabajos para descubrir nuevas utilidades de fármacos ya autorizados. Aunque como recuerda un antiguo editor de la revista 'The New England Journal of Medicine', Jerome Kassirer, "hay una increíble tendencia a que este tipo de trabajos arrojen resultados favorables a las compañías".

De momento, la universidad asegura que el anestesista se encuentra de baja médica hasta el próximo mes de mayo, y a través de su abogado éste ha mostrado su consternación por lo ocurrido y ha asegurado que colaborará plenamente con los comités que revisarán sus datos.

Todo se descubrió el pasado mes de mayo, durante una auditoría rutinaria, cuando uno de los responsables de la Universidad detectó que el científico no había solicitado permiso a los comités éticos del centro para dos de sus trabajos. Tirando del hilo, el escándalo ha revelado también que el médico incluyó la firma de otros colegas en sus estudios sin su conocimiento. El resto de sus colaboradores, y quienes colaboraron con él durante varios años, tampoco dan crédito a lo ocurrido.

Steve Shafer, máximo responsable de la revista 'Anesthesia & Analgesia', la publicación donde vieron la luz la mayoría de estudios falsos, ya ha anunciado que se está planteando retirar cualquier investigación en la que Reuben haya podido jugar un papel clave. "Era uno de los investigadores más prolíficos en el área del manejo del dolor postoperatorio", reconoce Shafer, "su fraude hace retrasar nuestro conocimiento en esta área tremendamente". Aunque sus estudios podrían haber influido en el tratamiento que han recibido millones de pacientes en este tiempo, los expertos consideran que los riesgos y el impacto que esto haya podido tener sobre su salud son pequeños

Ni la revista ni su universidad han sido capaces de momento de dar ninguna explicación coherente sobre porqué se ha tardado más de 12 años en descubrir las falsedades. elmundosalud

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