Monday, October 30, 2006

Who Coined the Term "The Gold Standard" for Levodopa?

If you have read any of my recent posts, you will know that I don’t think too highly of the drug most commonly prescribed for Parkinson’s, levodopa/carbidopa (often referred to as l-dopa). Because of its obvious deficits, I have marveled at its having acquired the moniker “the gold standard,” and have long since concluded that it must have been a stroke of genius on the part of some marketing person, probably at a time when the drug’s public image needed a boost. This weekend, I decided to try and figure out who first used the term, and when. The following is what I found.

The term "the gold standard" with reference to levodopa makes its first appearance in PubMed in 1996, in a study by a fellow named Mark D Lindner, sponsored by company called Cytotherapeutics:

" Although the therapeutic gold standard, L-DOPA:carbidopa (Sinemet), effectively attenuates parkinsonian symptoms..."(1)

And then, again, in 1997, the second time “the gold standard” appears on PubMed, Mark D. Lindner is one of the authors:“

Guidelines for clinical transplantation studies for Parkinson's disease emphasize that transplants should be considered as an adjunct to systemic L-DOPA, yet few preclinical studies have specifically assessed the potential of transplants as an adjunct to the clinical gold standard treatment.” (2)

Interestingly, In 1992, there was a Mark D. Lindner at Bristol-Myers Squibb Pharmaceutical Research Institute (3), and he was still there in 2003 (4).

The most interesting part is, however, that in 1997, a Mark D. Lindner published a paper entitled “Reliability, Distribution, and Validity of Age-Related Cognitive Deficits in the Morris Water Maze,” in which he says both:

“The data presented in this study were collected by the author as a Post-doctoral Research Fellow at Bristol-Myers Squibb Pharmaceutical Research Institute.” (5)


“Address correspondence and reprint requests to Mark D. Lindner, CytoTherapeutics, 701 George Washington Highway, Lincoln, RI 02865. E-mail: MLINDNER@CYTO.COM.” (5)

There is no mention of an affiliation with Bristol-Myers Squibb in either of the two papers that use the term "the gold standard."

Bristol-Myers Squibb makes Sinemet (the original levodopa/carbidopa). Sinemet lost patent protection somewhere in the early to mid 90s.


(1) Lindner, Mark D., et al. Validation of a Rodent Model of Parkinson's Disease: Evidence of a Therapeutic Window for Oral Sinemet. Brain Research Bulletin, Vol. 39, No. 6, pp. 367-372, 1996 (CytoTherapeutics, Inc., Provicence, RI 02906, USA. MLINDNER@CTYO.COM)

(2) Lindner, Mark D., et al., Somatic delivery of catecholamines in the striatum attenuate parkinsonian symptoms and widen the therapeutic window of oral sinemet in rats. Experimental Neurology, May;145(1):130-40. 1997 (Cyto Therapeutics Inc., Providence, Rhode Island 02906, USA.

(3) Lindner MD, Gribkoff VK. Effects of oral BMY 21502 on Morris water task performance in 16-18 month old F-344 rats. Psychopharmacology (Berl). 107(4):485-8, 1992. (Department of Neuropharmacology, Bristol-Myers Squibb Pharmaceutical Research Institute, Wallingford, CT 06492)

(4) Lindner MD, Gribkoff VK, Donlan NA, Jones TA. Long-lasting functional disabilities in middle-aged rats with small cerebral infarcts. J Neurosci. Nov 26;23(34):10913-22, 2003. (Neuroscience Drug Discovery, Bristol-Myers Squibb Pharmaceutical Research Institute, Wallingford, Connecticut 06492, USA.

(5) Lindner, Mark D. Reliability, Distribution, and Validity of Age-Related Cognitive Deficits in the Morris Water Maze. Neurobiology of Learning and Memory, 68, 203–220 1997. (Department of CNS Biology, Bristol-Myers Squibb Pharmaceutical Research Institute)

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