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"What the government has here is a cooked deal with a huge pharmaceutical company," fumes Mary Beth Sweetland, director of research, investigation, and rescue for PETA. "The taxpayers are paying for a clinical trial that can only benefit one company."
According to doctors familiar with various estrogen-replacement therapies, Premarin costs about the same as the other drugs. The primary difference lies in the types of estrogen a drug provides. Plant-derived or synthetic forms of estrogen more closely mimic the hormone produced by the human body. But that, doctors emphasize, does not mean such forms present any advantage. Prescribing one form of estrogen over another "comes down to side effects," says Dr. Arthur Shapiro, a reproductive endocrinologist at the University of Miami. "It's a matter of suiting the patient."
Sweetland contends that the problem with using Premarin for the long-term study is that researchers will have no way of knowing whether their results are due to properties unique to horse estrogen. "At the end of fifteen years, we'll still be left wondering if other estrogen-replacement technologies have the same capabilities," she insists.
Through a publicity blitz, PETA is attempting to persuade women to drop out of the WHI study unless the government switches to other estrogen-replacement drugs. The group spreads its message by leafletting at local horse shows and conducting symbolic yam dumps in front of clinic sites. (Yams are a source of plant-derived estrogen.) The University of Miami was treated to a free load of tubers in May.
Sweetland says thousands of women have responded to PETA's campaign. "We have received a lot of calls from Florida and Arizona and California, from women who had no idea that they were taking a pill made out of mares' urine and they had no idea of the suffering involved in that process," the PETA activist reports.
University of Miami employees working on the study referred all questions about PETA's campaign to the National Institutes of Health, where Dr. Jacques Rossouw is the lead project officer on the Women's Health Initiative study. Rossouw says he doubts the allegations of abuse, and explains that the NIH chose Premarin for the project because of the drug's widespread use. "Our feeling is that we owe it to the women of this country to test the drug that is most commonly prescribed, rather than another drug," he emphasizes.
"We have seen no indication that PETA has had any effect whatsoever on the study," adds Rossouw. "I don't think they have a lot of support for their campaign.