The first trial in the USA, which sees Merck & Co and its withdrawn painkiller Vioxx (rofecoxib) in the dock, has got off to an explosive start [[13/07/05f]], [[01/10/04a]].

A court in Angleton, Texas heard two very different opening arguments, according to Industry reports. Mark Lanier, the lawyer for plaintiff Carol Ernst, who alleges her husband took Vioxx for about eight months to ease pain but which caused him to die of an arrhythmia, accused Merck and chief executive Raymond Gilmartin of being driven by greed, the Financial Times reports.

Speaking of the company’s chief executive, Mr Lanier said “he took that company and made the needle always point toward the dollar sign,” and using eye-catching slides and adopting a highly informal approach, he painted a picture of a company desperate to get Vioxx on the market ahead of Pfizer’s COX-2 inhibitor Celebrex (celecoxib) to the point that it was prepared to ignore data which suggested that drug caused cardiovascular problems.

Arguing that “nothing could stop the Merck marketing machine,” he claimed the company had mislead the US Food and Drug Administration when filing Vioxx and “turned science into science fiction.” This was said with a backdrop of a slide saying simply “Merck-y ethics.”

The drugmakers’ response was much more traditional in style. Lawyer David Kiernan opened by saying that the company had thoroughly tested Vioxx before introducing the drug in 1999 and continued to research the safety and efficacy of the product Vioxx for the next five years before withdrawing it.

However, Mr Ernst died from an arrhythmia and Vioxx has never been shown to cause this problem, Mr Kiernan pointed out, noting that seven of the high-level Merck officers most involved in the case used Vioxx personally. He asked the seven male and five female jurors to consider whether they would knowingly conceal safety issues with the drug given this fact.

The eyes of the world are on this trial as it is the first of thousands of lawsuits Merck faces over Vioxx. However, there are fears among some observers that style could be seen to be taking over from substance and Mr Lanier’s more colourful approach is likely to grab more headlines than Mr Kiernan’s presentation of scientific facts.