Evidence “beyond reasonable doubt” may never be achievable for low-volume drugs
The recent publication of a randomised controlled trial (RCT) of inhaled cyclosporin in the New England Journal of Medicine represents another milestone in the evolution of lung transplantation (LTx) as a standard therapy in the management of severe lung and pulmonary vascular diseases.1,2 RCTs have been few and far between in lung transplantation, and this is the first in such a high-profile general journal. However, the big question is: how will we integrate the study results into the clinical practice in Australia?
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Greg Snell serves on the Transplant Advisory Board of Roche Pharmaceuticals. Both Greg Snell and Tom Kotsimbos have received speakers’ fees for delivering talks at Roche and Novartis Pharmaceutical meetings over the past 2 years, and travel assistance from Novartis Pharmaceuticals to attend the 2006 meeting of the International Society for Heart and Lung Transplantation.