Sir

I read the News article on the large multicentre trial of lexipafant (Zacutex) in severe pancreatitis and the response of the chief executive of British Biotechnology (Nature 393, 291; 1998, Nature 393, 299; 1998 & Nature 393, 509; 1998). I used lexipafant to block platelet-activating factor in different models of shock and sepsis during 1993-95 at Linköping University, Sweden. It was hard to defend my PhD thesis because of the lack of published data on the basic pharmacology of lexipafant at that time. I am disappointed that this remains the case despite progress in clinical trials.

Commercial considerations resulting from the potential for profit from a new treatment in areas where there is a high rate of death, like severe pancreatitis, are no excuse for keep this basic pharmacological data hidden.

I searched three major medical databases and found that 37 peer-reviewed scientific papers related to lexipafant have been published. Fourteen were review articles and five were original experimental papers on acute pancreatitis, which did not collectively show clear evidence for improved survival (via an anti-inflammatory effect) for those taking this drug. Yet only two of the review articles were conservative about the future of lexipafant whereas most, including mine, were hopeful.

Scientific literacy in the investment community is of no use without an appreciation of the difference between hope and facts — I will not be surprised if the large multicentre trial of lexipafant in the United States fails, but I hope it will not.

I wonder how much it will cost to acknowledge that the inflammatory process cannot be hit by a single golden bullet. The line between hope and hype is a thin one, and in this case it is only when the results of large-scale trials are available that it will be clear where it should be drawn.