AstraZeneca and Wikipedia: More Edits Uncovered

August 17, 2007 at 11:17 pm 9 comments

[Since I’m getting a lot of hits from the Bad Science Blog, I wonder if I can point out this amusing edit from somewhere within the Pfizer network. Clearly Ben Goldacre has fans in Big Pharma.]

So the AstraZeneca edits to Seroquel page on Wikipedia have become a controversy. Turns out there’s more, covering a large number of antipsychotics. We start, however, with PPI’s.

Proton Pump Inhibitors and AstraZeneca

You’d take a PPI if you had gastric reflux or a similar condition. They stop the stomach producing so much acid. AstraZeneca produce a drug called Nexium (esomeprazole) for this. This replaced Losec (omeprazole). Those names sound similar because they’re pretty much the same drug. Chemicals can be right handed or left handed. Omeprazole is what they call a ‘racemic mixture’ – it’s made up of a mixture of left-handed and right-handed omeprazole molecules. Esomeprazole is the left-handed omeprazole molecule: It’s omeprazole with all the right-handed bits removed.

[Note for chemists: Yes, I know this is a simplification.]

Why produce such a thing? The patent on omeprazole expired, allowing other companies to make it. It’s a lot easier (and cheaper) to develop a new drug for market when you’re pretty much already making it.

The other drug in this story is Prevacid (Lansoprazole), already generic in some markets. All three drugs, omeprazole, esomeprazole and lansoprazole are PPIs. They do the same kind of thing. Since omeprazole went generic, they’re all competitors for the same market.

Anonymous Edits to various PPIs by a computer that seems to be on AstraZeneca’s network

Our story starts on the 15th September 2006. Someone using a computer on AstraZeneca’s network (or making it look as if they’re doing so – which would be difficult and without any immediate purpose) takes it upon themselves to make some edits to the pages of these PPIs.

At 02:18, they edit the Esomeprazole page, adding in plenty of information about how it compares favourably to other PPIs.

Eight minutes later, they edit the Lansoprazole page, mentioning that Nexium – the AstraZeneca drug – is better: “Available data comparing the effect of esomeprazole 40 mg and lansoprazole 30 mg once daily on intragastric pH found that esomeprazole provided significantly more effective acid control than lansoprazole.”

Another three minutes pass and they hit the omeprazole page, adding in that: “Esomeprazole 40 mg once daily has been shown to have statistically significantly higher rates of healing EE compared to omeprazole (Prilosec) 20 mg once daily, at both 4 and 8 weeks. Esomeprazole also provided more rapid healing and heartburn control compared to omeprazole.” Remember, omeprazole is generic and doesn’t make much money now, while esomeprazole is still nicely under patent and does.

Wikipedia being what it is, it doesn’t take its more benign users very long to fix things, so all of the edits that AstraZeneca (or the person pretending to be from AstraZeneca) made get reverted. This can’t have pleased our pharmaceutical editor, because they come back to the Lansoprazole page at 18:46, probably the next working day, and put all their information back in. This gets fixed pretty soon afterwards, too.

Things go quiet for a month, then on the 26th October, our user who seems to be from AstraZeneca is back. The esomeprazole page gets touched up again. But things keep getting reverted – maybe these anonymous edits are arousing suspicion.

chrisgaffneymd, come on down!

We move slightly out of the realms of the factual now, to some slight speculation. We focus on a user of Wikipedia calling themselves ‘chrisgaffneymd’.

You can see a list of chrissgaffneymd’s edits here. His first edit, on 12 September was to the Lansoprazole article. Of more interest are the edits, on the same day, to Esomeprazole, in which he adds very similar information to the anonymous user who seems to be from AstraZeneca. We’ll take a look at some of his other edits in due course.

But take a look at his User:Talk page. On Wikipedia, every registered user has a ‘talk’ page, which anyone can edit. It’s a bit like email and a bit like a forum. On this page we see that chrisgaffneymd was blocked from editing on the 15th September, because of edits to the Omeprazole page:

You have been temporarily blocked from editing: see [3], which appears to have been copied from a medical journal. If you wish to make useful contributions, you may come back after the block expires.– The Anome 00:10, 15 September 2006 (UTC)

The anonymous user who seems to be from AstraZeneca turned up, editing the same page (and others) on the 15th September, adding exactly the same information as chrisgaffneymd. Also note the following comments on the talk page from 28th October 2006:

I have explained this before on the lansoprazole talk page to 156.70.222.27 (I believe this is you, as edits by yourself and this IP are nearly identical – if not, I apologize): referencing articles and papers is one thing, adding their content verbatim is another. You are welcome to add relevant, verifiable content in your own words, rather than simply copying content from prescribing information or package inserts (I will gladly provide evidence of this if you wish). Some of your edits have also removed relevant contributions previously added by other editors, while adding unnecessary or overly technical information. If you look closely at my reversion of your last edit to Lansoprazole, you will notice I kept useful additions, such as CYP isozymes involved in the metabolism of lansoprazole and some drug interactions. I hope you understand my reasons for reverting your edits.

On another note, please sign your posts on talk pages by typing four tildes (~~~~) before saving. This prevents confusion as to who said what. Fvasconcellos 00:29, 28 October 2006 (UTC)

Fvasconcellos,

Ahhh … now I understand. However, many of the edits that I provided under the esomeprazole page were valid and not copied (although some – including dosage/indications were derived from the prescribing information … is this information not within the public domain??).

I think we can conclude, with very little doubt that chrissgaffneymd is the anonymous user who appears to be from AstraZeneca.

Disturbing Edits

13th September: A significant edit to Bipolar Spectrum

13th September: A significant edit to Bipolar Disorder

14th September: Rewrites to the Quetiapine (Seroquel) article).

Highlights of this edit include:

Original:

Two rare but serious side effects from quetiapine are neuroleptic malignant syndrome and tardive dyskinesia. However, quetiapine is believed to be less likely to cause [[extrapyramidal system|extrapyramidal]] side effects and tardive dyskinesia than typical antipsychotics.

Changed:

Two rare but serious side effects of atypical antipsychotics are neuroleptic malignant syndrome and tardive dyskinesia. However, Seroquel is the only atypical antipsychotic with an EPS profile that does not differ from placebo. In addition, NMS has never been reported through the AERS reporting system (FDA)

Original:

Weight gain can be a problem for some patients using quetiapine, by causing the patient’s appetite to persist even after meals. However, this effect may occur to a lesser degree compared to some other atypical antipsychotics such as olanzapine or clozapine. Like other atypical antipsychotics, there is some evidence suggesting a link to the development of diabetes, however this remains unclear and controversial.

Changed:

Weight gain can be a problem for some patients using quetiapine, by causing the patient’s appetite to persist even after meals. However, in pivotal clinical trials this effect was (on average) = 1.9kg. Additionally, this effect may occur to a lesser degree compared to some other atypical antipsychotics such as olanzapine or clozapine. Like other atypical antipsychotics, there is some evidence suggesting a link to the development of diabetes, however this remains unclear and controversial.

Original:

There is no reliable data to date regarding abuse of the drug. However, it seems that quetiapine has the potential for misuse due to its sedative effects. Users may crush the pill and insufflate the substance for rapid onset, or ingest multiple times the recommended dose. As individuals react to medicines differently small doses of quetiapine, 50 mg or less, may still cause severe sedation.

Changed:

Based on current prescribing information for Quetiapine Fumerate, this drug does not have the ability to cause chemical dependancy.

14th September: Adds negative information to Apiprazole.

Apiprazole is better known as Abilify. It’s an atypical antipsychotic and a competitor to AstraZeneca’s Seroquel.

Original:

Adverse events reported in the package insert for aripiprazole include headache, nausea, vomiting, somnolence, insomnia, and akathisia. It appears that aripiprazole has a very low incidence of EPS (extrapyramidal side effects). The risk of tardive dyskinesia with prolonged aripiprazole use is unclear.

Changed:

Adverse events reported in the package insert for aripiprazole include headache, nausea, vomiting, somnolence, insomnia, and akathisia. Of particular note is the high incidence of treatment-emergent EPS (notably, akathisia) that occurs with aripiprazole. Recent studies have been able to correlate a high incidence of akathisia to an increased risk for tardive dyskinesia. However, to date, the risk of tardive dyskinesia with prolonged aripiprazole use is unclear.

14th September: Adds negative information to Risperidone

Risperidone (Risperdal) is another competitor of Seroquel.

Original:

Like all antipsychotics, Risperidone can potentially cause tardive dyskinesia (TD), extrapyramidal symptoms (EPS), and neuroleptic malignant syndrome (NMS), although the risk is generally less than for the older typical antipsychotics.

Changed:

Risperidone can potentially cause tardive dyskinesia (TD) and neuroleptic malignant syndrome (NMS), although the risk is generally less than for the older typical antipsychotics. However, Risperidone has been associated with an increased incidence of EPS (when compared to placebo) and therefore may confer a higher risk for TD than other atypical antipsychotics.

14th September: Adds negative information to the Olanzapine article.

Olanzapine (Zyprexa) is another competitor to Seroquel.

14th September: Adds negative infromation to the Ziprasidone article.

Ziprasidone (Geodon) is yet another competitor of Seroquel.

26th October: Adds some marketing to the Quetiapine article.

Seroquel owes it’s #1 Prescribed Status due to it’s powerful tolerability (lack of Metabolic effects as seen with other atypical drugs, placebo-level occurence of EPS (including askithisia)**, decent weight profile, and no changes in serum prolactin or blood glucose.

** = Seroquel is the only agent which can make this claim.

28th October: A further three edits to the Quetiapine article.

And then chrisgaffneymd disappeared…

All this is rather concerning. Not only do we have AstraZeneca (or someone doing a good job of pretending to be them) editing articles on their own drugs, we also have them editing the articles for competitors to these drugs. Had this user not been banned at one point, forcing him to edit anonymously and hence fall prey to wikiscanner, it’s entirely possible his connections to the pharmaceutical industry would have gone unnoticed. How many other users like this are there, editing in their corporation’s interest?

The edits to the articles on bipolar disorder and bipolar spectrum are also concerning; they don’t promote specific drugs, but do promote a specific interpretation of the evidence. There are obvious reasons why it’s a bad idea for pharmaceutical companies to edit publicly-owned information about the disorders and diseases for which they produce drugs.

AstraZeneca have already stated that they’ll be investigating the original Seroquel edits that have been found. Unfortunately for them, it seems the problem is much larger than they originally thought.

[Note for journalists and other media types: If you happen to pick up on this story, a link would be appreciated. Thanks.]

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Still Life with Ex-Colleague Outside Supermarket Post that probably should have been deleted

9 Comments Add your own

  • 1. Wikipedia, AstraZeneca and Seroquel « Experimental Chimp  |  August 17, 2007 at 11:26 pm

    […] August 15, 2007 [The second part of this story is at: Astrazeneca and Wikipedia: More Edits Uncovered] […]

  • 2. katielou82  |  August 18, 2007 at 12:17 am

    thank you! thank you ! thank you! for writing this post. This is very important stuff for people to know. But something I had already figured was going on. Big Pharma is soooo sneaky. a bunch of snakes.

    Oh and Seroquel can be abused i have seen people do it, i have friends who have begged me for pills when they found out I am taking it. And i have struggled with it myself….. and well, the prison system has had some problems with it and that is well documented.

  • 3. patientanonymous  |  August 18, 2007 at 1:48 am

    Wow…well done my friend. You’re a little super sleuth!

    Hope you’re doing okay. Sorry for my absence of late.

  • 4. anonymous mom  |  August 19, 2007 at 10:42 pm

    thanks again chimp – keepin’ an eye out for us. coincidence, or did they find it the same time you did?

  • 5. experimental chimp  |  August 20, 2007 at 4:43 pm

    katielou: Glad you found my post informative.

    PA: Thanks. Things continue pretty much as normal for me. I’m generally OK.

    anonymous mom: The Times got it from a list of edits that Wired is maintaining. The person who posted it to the Wired list may have found it here, or may have discovered it at the same time. I think the latter possibility’s more likely.

  • 6. drunkenoaf  |  August 21, 2007 at 9:40 pm

    Oh well. Perhaps the people making these edits will now use a few dial-up accounts to give them a spread of IP addresses from which they can do so from.

  • 7. TodayYesterdayAndTomorrow (TYT)  |  September 2, 2007 at 9:38 pm

    Excellent sleuthing job!

    I’ve been using the wikiscanner recently, and caught an odd edit by Monsanto’s IP too.

    Although they have a vested interest in milk, they edited a particular page to ADD milk as a product to avoid. I put up the find on the bottom of the post
    Wikipedia Is Now The Gotcha Machine Would luv to know who made that edit!

  • 8. Dan  |  April 8, 2009 at 9:06 am

    Looks like you’re big in France;)

    http://www.rue89.com/2009/04/07/l-industrie-pharmaceutique-manipule-wikipedia?page=0

  • 9. Mikkel Borch-Jacobsen  |  April 9, 2009 at 4:22 pm

    The complete article in which your information is taken up is to be found in ‘BOOKS’ magazine: http://www.booksmag.fr. There is a link there to your site which was deleted in the shortened version found on http://www.rue89.com.

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Hi, I'm James. I'm a 26 year old guy from England with bipolar disorder (currently well controlled). I also have a circadian rhythm sleep disorder (not so well controlled). This blog has charted my journey from mental illness, through diagnosis and, recently, into recovery. It's not always easy, but then, what is?

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