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11-04-2010 | Cardiology | Article

‘Strong link’ between authors views on rosiglitazone and financial conflicts of interest

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MedWire News: Results from a systematic review and meta-analysis show that authors’ expressed views on the rosiglitazone controversy are strongly linked to financial conflicts of interest with pharmaceutical companies.

In addition, the researchers found that disclosure rates for financial conflicts of interest were “unexpectedly low.”

Use of the antidiabetic thiazolidinedione drug rosiglitazone has been linked to increased risk for myocardial infarction (MI) and heart failure in various studies, as reported previously by MedWire News.

However, other studies have reported conflicting results, leading Mohammad Murad (Mayo Clinic, Rochester, Minnesota, USA) and colleagues to investigate whether authors’ financial conflicts of interest affected their published position on the cardiovascular risks associated with rosiglitazone use.

The researchers selected 202 articles, including original research, reviews, meta-analyses, guidelines, responses, letters, commentaries, and editorials, for analysis that commented on rosiglitazone and the risk for MI. Of these, 108 (53%) had a conflict of interest statement and 90 (45%) authors reported financial conflicts of interest.

Two reviewers who were blinded regarding the conflict of interest statements classified the articles as reporting a favorable (no increased MI risk with use), neutral, or unfavorable (increased MI risk with use) view on rosiglitazone use.

The researchers found that authors who had a favorable view of rosiglitazone were 3.38 times more likely to have financial conflicts of interest with manufacturers of antidiabetic drugs in general and rosiglitazone in particular than those with an unfavorable view.

Similarly, authors who gave favorable recommendations on the use of rosiglitazone were a significant 3.36 times more likely to have financial conflicts of interest than other authors.

The association remained significant when articles rather than authors were used as the unit of analysis (rate ratio [RR]=4.69), when only opinion articles (RR=6.29) or those focusing on the rosiglitazone controversy (RR=6.50) were analyzed, and when articles published before (RR=3.43) and after (RR=4.95) the US Food and Drug Administration warning about rosiglitazone in 2007 were considered.

“Despite the ubiquity of requirements for reporting conflicts of interest, the presence of conflict of interest statements in the articles we assessed was low,” writes the team in the British Medical Journal.

“Our findings serve as a call to action for an ongoing conversation on how best to foster objectivity in readers and writers of the scientific literature,” the researchers conclude.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Helen Albert

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