Edward Tobinick

Edward Lewis Tobinick is an American physician who is known for the study and promotion of etanercept as a potential off-label treatment for neurological disorders. Tobinick trained in internal medicine and dermatology. Prior to his work with etanercept, Tobinick practiced dermatology and developed a laser hair removal technique. Tobinick offered etanercept therapy for back problems (in a treatment known as DiskCure) before promoting its use for other neurological conditions, including Alzheimer's disease, stroke and Parkinson's disease. An article in Science Based Medicine was written critical of his use of perispinal etanercept injections for these conditions. Author Steven Novella was subsequently sued by Tobinick in 2015 for that article. On September 30, 2015 the court found no merit in Tobinick's claim that Novella and SBM were profiting from criticism of perispinal etanercept and found in Novella's favor.

Early career

Tobinick is an internist and dermatologist.^[1][2] He previously ran a hair removal practice known as the Institute of Laser Medicine,^[2][3] practiced dermatology in Beverly Hills and was the medical director of a skin cancer clinic.^[4] While at the Institute of Laser Medicine, Tobinick developed a hair removal technique known as photolysis.^[5]

Work with etanercept

Tobinick operates the Institute of Neurological Recovery. The neurological disorders he has claimed to treat with etanercept include: Alzheimer’s, stroke, traumatic brain injury, Parkinson’s disease, carpal tunnel syndrome, brain tumor, spinal cord injury, and back pain.^[6] These practices are controversial.^[2] He referred to the treatment as DiskCure when he was focusing on its use for back pain. In 2002, he said that he did not create publicity for DiskCure because he already had patients from around the United States and did not want to end up with more patients than the clinic had the capacity to treat.^[7]

Explaining the treatment's effects on the brain, Tobinick says that after the medication is injected at the back of the neck and the patient is tilted backwards for a few minutes, the drug is able to reach the brain via the cerebrospinal venous system.^[8] He says that the drug works in Alzheimer's disease because of its action on a protein known as tumor necrosis factor alpha.^[9] The manufacturer of the medication, Amgen, specifically does not support its use in Alzheimer's disease.^[10]

The same year, the Medical Board of California placed Tobinick on probation for promoting the unapproved use of etanercept for back or neck pain before any scientific studies had been published on the subject. He completed the requirements they imposed on him in 2008 and is no longer on probation.^[6][11]

According to a 2012 article in the Sydney Morning Herald, there is one physician in Australia who was trained in Tobinick's technique, but that physician would not allow the publication to disclose his identity.^[12]

A 2013 article in the Los Angeles Times said that Alan Waxman, the chief of nuclear medicine at Cedars-Sinai Medical Center, had been willing to collaborate with Tobinick on a study that evaluated brain scans following etanercept injections for Alzheimer's disease. The article said that the widower of a woman Tobinick had treated for five years before her 2011 death had been willing to pay the $60,000 required to fund the study. Tobinick refused to participate in the study. He cited scientific inadequacies of the proposed study and said that he wanted to study the drug in stroke patients instead.^[13]

An article in Science Based Medicine is critical of his use of perispinal etanercept injections for these conditions.^[6] It raises concerns over his patenting of a procedure which is viewed negatively in many areas of the world.^[6] It concludes that his research does not "establish the effectiveness" of this treatment.^[6] In 2014, Tobinick (along with two of his companies) sued Steven Novella, the Society for Science Based Medicine, SGU Productions and Yale University, Novella's employer, alleging that the blog post constituted an advertisement and that "in violation of the Lanham Act, Novella has and continues to publish a false advertisement disparaging Plaintiffs entitled 'Enbrel for Stroke and Alzheimer's', ('the 'Advertisement') and implying that the INR plaintiffs' use of entanercept is ineffective and useless;" and "The Advertisement is extremely inflammatory and defamatory in nature as it contains multiple false and misleading statements of fact regarding Plaintiffs.".^[1] Yale University, SFSBM and SGU Productions were removed form the case through summary judgements, leaving only Novella as defendant. The suit in respect of one of the plaintiffs, Tobinick's California corporation, was then struck down under California's anti-SLAPP statute.^[14]

Finally on September 30, 2015, United States District Judge Robin Rosenberg ordered the case closed and found in summary judgement for Novella. Tobinick was unable to show that Novella had profited from his blog post or that it was in anyway an advertisement. "... It is hereby ORDERED and ADJUDGED that defendant Dr. Steven Novella ... is GRANTED. All pending motions are DENIED AS MOOT, all deadlines are TERMINATED, and the Clerk of Court is directed to CLOSE THE CASE.^[15][16]

References