This article originally appeared in BMJ USA

In this issue the journalist Jeanne Lenzer draws attention to the uneasy alliance between industry, science, and policy (BMJ USA p 283). She explores the relationship between Genentech, the manufacturer of alteplase (tPA), and the decision of the American Heart Association (AHA) to give that drug a class I recommendation as thrombolytic therapy for stroke. She accuses the AHA and Genentech of overstating the trial evidence for tPA, creating the “stroke attack” ad campaign to promote the drug, denying the existence of a guideline panel member because he disagreed with its recommendation, barring access to trial data, and delaying release of information from another trial.

Whether these assertions are true is not the focus of this editorial. Saver and colleagues (BMJ USA p 291) suggest that her characterization of the evidence may not be entirely accurate. Since the publication of the National Institutes of Neurologic Disease and Stroke trial, numerous other studies support the efficacy of this therapy.1 2 Moreover, the AHA recommendations are consistent with those from the National Stroke Association, American Academy of Neurology, Brain Attack Coalition, and Stroke Belt Consortium.3 …