A couple of days ago I recommended a short information table that compared conventional small molecule drugs to biologics (antibody therapies and other peptides/proteins). It was quick and I recommended it for the average Terra Sig reader.
However, I was quick in writing the post, and should have been more critical of the information I was recommending. Quick and concise means nothing if the information isn’t accurate. To be honest, I haven’t gone back to look at the table since – that is, until my colleague Ian Musgrave (I hope he’s not ashamed that I called him “my colleague”) pointed out the error of my ways:
I’m going to respectfully disagree with you here Abel, there is nothing nice about it and it displays an astounding degree of ignorance.
Chemical drugs are essentially made up of elements from the periodic table.
Essentially! essentially! They are composed of elements of the periodic table, as are biologicals. The article makes it sound as if all small molecule drugs are built from raw atoms, and biologicals come from some ethereal plane, where organisms make things constructed from matter not of this world (is the carbon in insulin not from the periodic table, after all).
Few small molecule drugs would be constructed de-novo from raw elements, more often they are made simpler building blocks that are multi-atom compounds to begin with, or modifications of naturally occurring products. Most of the statins are modifications of bacterial fermentation products (their example, Lipitor, atorvastatin, is made synthetically, with
staring products that include the amino-acid valine, derived from fermentation).
What’s wrong with saying that “pharmaceuticals” are small non-protein molecules, and that biologics are proteins or peptides (they may have to explain that, but it would be better than what they have got currently).
Automatic molecule screening systems are used in both small molecule drugs and biologics.
Because they’re not as targeted as biologic drugs, chemical medicines can come with more side effects.
What!!!! The whole point of modern pharmacology is to develop highly targeted drugs (with recent exceptions of multi-target anti-cancer drugs). HMG-CoA reductase inhibitors (for example) are just as targeted as biologicals and have few side effects (most of those due to its effect on the target). Vioxx, which was withdrawn because of side effects, had those
side effects because it was a highly targeted drug. The biological erythropoeitin has a wide range of side effects, with some really nasty ones.
All in all, although it has a few good points, the severe misrepresentation of the small molecule and biological drugs it produces outweighs the benefits.
The rant endeth here.
Uggh, I can’t disagree with a single one of his points and even expanded upon some in my comments back to him. I won’t even try to make excuses. And that’s why I’ve written this retraction. While I’m embarrassed that I recommended such a misleading information source, I’m equally surprised that the attribution for this table was:
Sources: PhRMA, Tufts Center for the Study of Drug Development, WSJ research
Prof Musgrave often uses this blog as a source for his pharmacology students – perhaps he can use this table as an example of how not to communicate information about small molecule drugs vs. biologics.
I should really be recommending it as a source for misinformation and as an exercise in how not to communicate drug information.