Louis C. Lasagna dies

Email: Milly Dawson - millydawson@alum.wellesley.edu
News from The Scientist 2003, 4(1):20030908-02

Published 8 September 2003

Louis C. Lasagna, MD, best known for having pioneered well controlled research on the placebo effect, died of lymphoma on August 6 at the Newton-Wellesley Hospital in Newton, Mass. Dr. Lasagna was dean emeritus of the Sackler School of Graduate Biomedical Sciences at Tufts University.

"The [placebo] phenomenon was known but [Lasagna's research] was a turning point for how drugs should be evaluated. He was a leading figure in establishing the efficacy of drugs," said David Stollar, acting dean of the Sackler School. "One could be seriously misled in evaluating the effectiveness of a drug without recognizing that some of the effectiveness was not reflecting the action of the drug."

Richard I. Shader, professor of pharmacology and experimental therapeutics at the Sackler School, explained that before Lasagna's studies, "people were just capitalizing on the placebo effect without trying to quantify it. Lou worked with a man named Beecher at Mass General Hospital, and they approached the placebo effect scientifically, trying to keep the psychological and the actual effects straight and to figure out why some groups of people were more responsive to placebo than others."

In 1954, Lasagna published his classic paper, "A study of the placebo response," in the American Journal of Medicine. There was little literature at that time on placebos, and he cited only a few references dating to the 1940s and 1950s.

Robert Temple, associate director of medical policy of the Center for Drug Evaluation and Research at the Food and Drug Administration (FDA), views Dr. Lasagna as a leader among those clinical pharmacologists who, during the late 1950s and early 1960s, "started to point out that our data to support the efficacy of drugs was utter [rubbish]."

The food, drug, and cosmetic act of 1938 that originally shaped the FDA was "devoted entirely to safety," said Temple. "Lasagna [who addressed Congress in 1962, helped to bring about] an amendment to that act which, for the first time, said that a drug had to be effective. In fact, if a drug doesn't work, it can't be safe, since nothing is absolutely safe. The importance of [the effectiveness requirement] isn't appreciated enough. This was well in advance of what the rest of the world was doing. It meant you've got to do [these studies] right, and it changed everything."

Ira Shoulson, who holds an endowed chair in experimental therapeutics at Rutgers University named for Dr. Lasagna, described him as "a translator between the academic community and Congress."

The 1962 amendment also required the FDA to "go back and look at every drug that it had approved since 1938 and at every claim for every drug," said Temple. Lasagna helped to lead this "heroic, two-decade effort, and something like a third of all the drugs were removed from the market" as a result.

Dr. Lasagna, who was a member of The Scientist's editorial advisory board, was the author of two books and numerous scientific and popular articles. He was "very erudite" and "open to new ways of looking at things," recalled Shader. He wrote about medical education and ethics, euthanasia, drug advertising and fads, among other topics.

In 1964, Dr. Lasagna also wrote an alternative, modernized Hippocratic Oath, which emphasized prevention over cure and a holistic approach to patient care. "I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being," it states. Tufts, among many other medical schools, has adopted his oath.

Louis C. Lasagna was born to Italian immigrant parents in Queens, NY, in 1923 and grew up in New Brunswick, NJ. He earned a bachelor's degree at Rutgers University in 1943 and a medical degree from Columbia in 1947. He served at Harvard as a clinical research fellow and thereafter taught medicine and pharmacology at Johns Hopkins University until 1970. In that year, he became a professor of pharmacology, toxicology, and medicine at the University of Rochester.

At Rochester, he established the Center for the Study of Drug Development. "It was one of a kind at that time," said Dr. Shoulson of the center, which Dr. Lasagna brought to Tufts University when he moved there in 1976. Tufts named Dr. Lasagna dean of its Sackler School in 1984.

Dr. Shader recalled Lou Lasagna as "one of the most warm and generous people in science I have ever known, and a great family person." Son Peter Lasagna recalled that "even though he traveled all over the country and the world, every Christmas he'd put tremendous thought into procuring an utterly amazing little present for each of his seven children and our mother. You'd marvel at how well he knew each of us."

Peter Lasagna also recalled his father's enormous pride in his students. "If any of his students went on to do great work, no matter how long after he'd seen them, he'd write to them or get there in person."

Dr. Lasagna was also "an opera buff," said Peter, "and, in whatever town we lived in, he and my mother always sat on the board of the philharmonic. They were also involved in work for special needs children," in part, he said, because they had a son with Down syndrome. Dr. Lasagna "lived almost exactly as he wanted to live, accomplished many of the things he wanted to accomplish, and left seven different legacies" through his offspring, Peter said.

Dr. Lasagna is survived by his wife Helen, their seven children, and eight grandchildren.



References

1.  [http://www.tufts.edu/sackler/index.html]
  Sackler School of Graduate Biomedical Sciences, Tufts University
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2.  [http://pubs.acs.org/hotartcl/mdd/99/aug/mysterious.html]
  C. Hart, "The mysterious placebo effect," Modern Drug Discovery, 2:30-40, July/August 1999.
Return to citation in text: [1]
 
3.  [http://www.amjmed.org/]
  L. Lasagna et al., "A study of the placebo response," American Journal of Medicine, 16:770-779, 1954.
Return to citation in text: [1]
 
4.  [http://www.pbs.org/wgbh/nova/doctors/oath_modern.html]
  The Hippocratic Oath: Modern Version
Return to citation in text: [1]
 


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