Medical journals and physicians ignore conflicts of interest after a few years

SUMMARY: Dr. J. Curtis Nickel’s past involvement in the launch of Merck’s Proscar and GSK’s Avodart were not disclosed in 2016 and 2017 articles about risks of these drugs. In a 2024 commentary about post-finasteride syndrome, Dr. Michael Perelman’s link to Merck’s defense in Propecia litigation was not adequately disclosed, and his role as a Medical Advisor to Roman, a telehealth company which prescribes finasteride for hair loss, was not disclosed. All three concerns have been reported to the respective journal publishers (BMJ, Wiley and Springer Nature) in April–May 2024.

Physician-researchers known as key opinion leaders have a crucial role in launching a drug into the marketplace. They give the product their stamp of approval, and in return receive benefits including research funds, publication credits, and speaking and consulting opportunities.

While Propecia litigation was underway in the 2010s, a number of opinion leaders who had helped Merck launch Proscar and Propecia wrote articles defending the drug’s safety. Their former roles with Merck were not disclosed in these articles. Some journals only require conflicts of interest to be disclosed if they occurred within the last three to five years. This means influential physicians who had promoted a drug can later defend its products in the literature without revealing their former ties.

Finasteride Watch has identified some cases where a significant past role with Merck or GlaxoSmithKline (the maker of dutasteride) was undisclosed or inadequately disclosed in an article.

In articles which appeared in 20161 and 2017,2 Dr. J. Curtis Nickel’s past roles with Merck and GSK on the rollout of Proscar and Avodart, respectively, were not disclosed. The concern about the article in Pharmacotherapy was reported to Wiley’s Research Integrity team on April 9, 2024. The concern was reported to BMJ’s publication ethics and content integrity editor on May 28, 2024.

In a 2024 commentary about post-finasteride syndrome,3 Dr. Michael A. Perelman described his involvement in Merck’s defense in Propecia product liability litigation (emphasis added):

More importantly as a consultant to the law firm that represented Merck & Co, Inc. (Propecia’s™️ USA manufacturer), in decade long lawsuits regarding 5α-reductase inhibitors (5αri), I was able to review individual plaintiff’s medical records as well as summary data from over a thousand cases.

In addition, Dr. Perelman is currently a Medical Advisor to Roman, a telehealth company that prescribes finasteride for hair loss. Yet the Competing Interests section states: “The author declares no competing interests.” The journal, the International Journal of Impotence Research, is published by Springer Nature. These concerns were reported to its Research Integrity Group on April 22, 2024.

Any updates from the publishers will be posted here.


  1. Hagberg KW, Divan HA, Persson R, Nickel JC 💊 [COIs], Jick SS. Risk of erectile dysfunction associated with use of 5-α reductase inhibitors for benign prostatic hyperplasia or alopecia: population based studies using the Clinical Practice Research Datalink. BMJ. 2016. doi:10.1136/bmj.i4823 ↩︎
  2. Hagberg KW, Divan HA, Nickel JC 💊 [COIs], Jick SS. Risk of incident antidepressant-treated depression associated with use of 5α-reductase inhibitors compared with use of α-blockers in men with benign prostatic hyperplasia: a population-based study using the Clinical Practice Research Datalink. Pharmacotherapy. 2017. doi:10.1002/phar.1925 ↩︎
  3. Perelman MA. Comment on “The post-finasteride syndrome: possible etiological mechanisms and symptoms”. Int J Impot Res. 2024. doi:10.1038/s41443-024-00886-7 ↩︎