Evaluating Associations of Financial Conflicts of Interest With RA Drug Trial Outcomes

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Financial conflicts of interest among authors of RA randomized controlled trials are common and temporally increasing.
Financial conflicts of interest among authors of RA randomized controlled trials are common and temporally increasing.

Although many types of financial conflicts of interest reported by authors of randomized controlled drug therapy trials for rheumatoid arthritis (RA) are not associated with positive study outcomes, the receipt of honoraria or consulting fees was independently associated with an increased likelihood of the study reporting a positive outcome, according to a study published in Rheumatology.  

In the current study, researchers examined the types, prevalence, and temporal trends of financial conflicts of interest reported by the authors of randomized controlled trials for RA drugs and their associations with trial outcomes. A total of 146 non-phase 1, original, parallel-group, RA drug therapy randomized controlled trials were included. The trials were published in 3 time periods: 2002 to 2003, 2006 to 2007, and 2010 to 2011. Trial characteristics data were independently obtained by 2 separate investigators. Financial conflicts of interest were classified as follows: employee status, receipt of honoraria or consultation fees, stock ownership, and research grants. Determinations regarding associations between financial conflicts of interest and study outcomes were made using multivariable logistic regression.

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Out of the 146 eligible trials, 32.9% were published in 2002 to 2003, 37.7% in 2006 to 2007, and 29.5% in 2010 to 2011. In addition, 58.4% of the total trials had at least 1 author reporting a financial conflict of interest related to an industry sponsor and 32.8% had authors reporting >1 financial conflict of interest subtype. Efficacy outcomes could be assessed for 85.6% of trials, and 68.8% showed a positive outcome. The presence of any reported financial conflict of interest was not associated with positive study outcome (=.93), and industry funding for studies was not associated with positive study outcome, even after trials with unspecified funding sources were recategorized as industry-funded. After adjusting for the number of patients, random sequence generation description, and study phase, receipt of honoraria or consulting fees was shown to be independently associated with increased likelihood of positive study outcome (odds ratio, 3.27; 95% CI, 1.01-10.44).

The study investigators concluded that although financial conflicts of interest are common among RA drug trials, only the receipt of honoraria or consultancy fees was associated with positive study outcomes. "Adoption of uniform nomenclature for the types of [conflicts of interest] by journals may provide a clearer analysis of their potential influence on research integrity."

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Reference

Khan NA, Nguyen CL, Khawar T, Spencer H, Torralba KD. Association of author's financial conflict of interest with characteristics and outcome of rheumatoid arthritis randomized controlled trials [published online December 10, 2018]. Rheumatology (Oxford). doi: 10.1093/rheumatology/key368

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