A pivotal article in a decades-old feud about a controversial drug to treat patients with a rare blood disorder has been retracted 17 years after it was deemed problematic.The retraction, a statement published online last week, marks the second time this year that a medical journal has taken action against a paper co-authored by Gideon Koren, the now disgraced former head of the Hospital For Sick Children’s Motherisk program. The retraction was prompted by a call from Sick Kids’ interim CEO Dr. David Naylor in late December, according to the journal editor, around the time a Star investigation exposed flaws in medical publishing, including the inability and unwillingness of journals and research institutions to correct the scientific record. Corrections, the Star found, routinely take years to be published, if they happen at all. Retractions are less frequent. A statement on the website of Therapeutic Drug Monitoring (TDM) said the retraction of the article about deferiprone, a drug developed to treat thalassemia, an inherited disorder, was due to “concerns regarding academic and research misconduct.” These included the failure to appropriately identify the manufacturer of the studied drug as a funding source and using collaborator’s data without their consent, resulting in the inappropriate assignment of authorship. The retraction also implied that Koren, who gave up his Ontario medical licence last week, while under investigation by the province’s medical watchdog, had asked for the retraction himself. In early February, Canadian Family Physician, which frequently published columns by Koren, said in a correction that two articles had not been properly peer-reviewed and failed to disclose a conflict of interest.Koren has not responded to the Star’s request for comment. But he recently told the online publication Retraction Watch that in 2002 he was “forced” to ask TDM to retract the article, according to the email exchange obtained by the Star. However, in that same email exchange with Ivan Oransky, co-founder of Retraction Watch, Koren also said: “I DID NOT ask to retract the paper. … I strongly oppose the retraction.” Published in 1999, the study, titled “An investigation into variability in the therapeutic response to deferiprone in patients with thalassemia major,” contributed to a heated dispute between Koren and Dr. Nancy Olivieri, a blood diseases specialist at Sick Kids who voiced concerns about the efficacy of the drug, which Koren did not share.In 2000, the heads of Sick Kids and U of T suspended and fined Koren for “repeatedly lying” and sending anonymous “poison pen letters” to doctors and the media disparaging Olivieri and her supporters. Koren denied writing the letters until DNA evidence provided irrefutable proof. A committee formed by the U of T Faculty of Medicine at the time found that Koren had published the paper without consulting the other researchers, including Olivieri, failed to disclose support for the trial from Canadian generic drug-maker Apotex, and had not discussed the safety concerns about the drug. At the time, Naylor, then dean of medicine, said he had insisted Koren write to the journal to acknowledge his error and ask that the article be deleted from the scientific record. But the article was never withdrawn. Instead, in 2004, TDM published an erratum stating that “the specific industry sponsor, Apotex Inc., of Weston, Ontario, was not mentioned.”In 2017, TDM reviewed all of the roughly 90 articles Koren co-authored, and sent 19 to independent reviewers. In seven, the reviewers recommended action, such as requesting proof of confirmation testing and ethics-board approval from the authors.Dr. Uwe Christians, TDM’s editor, said the journal, “in close collaboration with Sick Kids in Toronto,” was still investigating the other seven papers.Naylor told the Star in an email that he supports the retraction and that Christians and his editorial team “have approached these matters in a thorough and principled fashion.” The 1999 article has had sparse citations in the literature, Naylor said, so its retraction has limited scientific impact. But, Naylor said, the “retraction does highlight that misappropriation of data should be taken seriously as a form of publication misconduct. It’s just unfortunate that this didn’t occur fifteen or sixteen years ago.” The article was cited 26 times, according to Scopus, a scientific database. Jessamine Luck, a spokesperson for Sick Kids, said the hospital has provided TDM with information about Koren’s papers, but that the decision to retract is up to the journal editor.