A leading senior Australian gastroenterologist has hit back at suggestions she and her fellow researchers had been unethical in the course of a project that looked at the benefits to patients of compassionate access to anti-TNFs for ulcerative colitis.

She says it is time researchers and clinicians stopped tiptoeing around the issue of the pharma industry and its important role in clinical research.

“A lot of people are afraid to talk about it for fear of being labelled as in the back pocket of pharma,” Professor Jane Andrews told the limbic.

The head of IBD Service and Education at the Royal Adelaide Hospital’s department of gastroenterology and hepatology was involved with the original study published in the Internal Medicine Journal last year.

In a letter published in a subsequent issue of the same journal, an author who was unidentified and known only as ‘J Niall’ from Melbourne, raised questions relating to the study’s conflict of interest (COI) statements.

Dr Andrews and her fellow authors have now had their response to the letter published in the Internal Medicine Journal, and she did not hold back.

“COI are an important issue as they are impossible to avoid completely and so reducing discussion of COI to a letter in which inaccurate statements are made and deceitful conduct implied is not helpful,” she and her fellow authors wrote.

Their extended letter addressed the issues raised by the Niall, strongly objecting to implications they had acted unethically, and subjected him to a taste of his own medicine.

“Furthermore, we find it ironic that Niall does not make any COI statement,” they wrote. “Are we to understand he has never had any dealings with any industry involved in delivering medical services? This in itself may be an undeclared COI, as it is possible that this lack of recognition or engagement is resented.”

While not suggesting this was in any way true, Professor Andrews told the limbic it served to highlight the fact that there was no simple approach to the complexities of COI issues.

“It is a complex area and a simplistic approach really does our patients a disservice,” she said.

“There are conflicts everywhere, every day in everything we do, but they’re not all declared,” she said. “Why do we get hysterical about conflicts of interest and Big Pharma?”

Professor Andrews and her fellow researchers reiterated this in the conclusion to their letter.

“Personally we feel that much more could be achieved by concentrating on evaluating outcome of care actually achieved than sniping from the sidelines when people who are prepared to engage in consultation and declare their funding sources dare to audit their clinical results,” they wrote.

“Our patients knew from whence extra drug doses came, and all were very grateful for and comfortable with the arrangement.”