Golder Su, Loke Yoon K
CRD, University of York, York and School of Medicine, University of East Anglia, Norwich, UK.
Br J Clin Pharmacol. 2008 Dec;66(6):767-73. doi: 10.1111/j.1365-2125.2008.03272.x. Epub 2008 Jul 31.
To investigate whether adverse effects data for the sponsor's product are presented more favourably in pharmaceutical industry-funded studies than in non-industry-funded studies.
We conducted a systematic review of methodological evaluations that had assessed the relationship between industry funding and the reported risk of adverse effects. Searches were undertaken in 10 databases and supplemented with other sources of information such as handsearching, citation searching, checking conference proceedings and discussion with experts. Two reviewers independently screened the records and carried out data extraction for potentially relevant papers. We included studies that compared the results and interpretation of the adverse effects data according to funding source (e.g. adverse effects data in pharmaceutical industry research vs. data from nonprofit organizations, or from one manufacturer vs. another). Methodological evaluations were excluded if categories of funding source were not explicitly specified by the researchers, and if we were uncertain that industry-funded studies were present in the evaluation.
The search strategy yielded 4,069 hits, of which six methodological evaluations met our inclusion criteria. One survey of 370 trials covering a wide range of topics found that trials with industry sponsors had more complete reporting of adverse effects compared with non-industry-funded trials, whereas another survey of 504 inhaled corticosteroid studies showed no apparent difference after confounding factors were adjusted for. In contrast, we found evidence from post hoc subgroup analyses involving two products where the likelihood of harm was of a lower magnitude in manufacturer-funded studies compared with nonmanufacturer-funded studies. There is also evidence from four methodological evaluations that authors with industry funding were more likely than authors without pharmaceutical funding to interpret and conclude that a drug was safe, even among studies that did find a statistically significant increase in adverse effects for the sponsored product.
Our review indicates that industry funding may not be a major threat to bias in the reporting of the raw adverse effects data. However, we are concerned about potential bias in the interpretation and conclusions of industry-funded authors and studies.
调查制药行业资助的研究中,申办方产品的不良反应数据呈现是否比非行业资助的研究更有利。
我们对评估行业资助与所报告的不良反应风险之间关系的方法学评价进行了系统综述。在10个数据库中进行了检索,并辅以其他信息来源,如手工检索、引文检索、查阅会议记录以及与专家讨论。两名评审员独立筛选记录,并对潜在相关论文进行数据提取。我们纳入了根据资助来源比较不良反应数据结果和解读的研究(例如制药行业研究中的不良反应数据与非营利组织的数据,或一个制造商与另一个制造商的数据)。如果研究人员未明确指定资助来源类别,且我们不确定评估中是否存在行业资助的研究,则排除方法学评价。
检索策略共获得4069条记录,其中六项方法学评价符合我们的纳入标准。一项对370项涵盖广泛主题的试验的调查发现,与非行业资助的试验相比,有行业资助的试验对不良反应的报告更完整,而另一项对504项吸入性糖皮质激素研究的调查显示,在调整混杂因素后没有明显差异。相比之下,我们从涉及两种产品的事后亚组分析中发现,与非制造商资助的研究相比,制造商资助的研究中危害可能性较低。还有四项方法学评价的证据表明,有行业资助的作者比没有制药行业资助的作者更有可能解读并得出药物安全的结论,即使在那些确实发现所资助产品的不良反应有统计学显著增加的研究中也是如此。
我们的综述表明,行业资助可能不是原始不良反应数据报告中偏差的主要威胁。然而,我们担心行业资助的作者和研究在解读和结论方面存在潜在偏差。