#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Differences in Reporting of Analyses in Internal Company Documents Versus Published Trial Reports: Comparisons in Industry-Sponsored Trials in Off-Label Uses of Gabapentin


Background:
Details about the type of analysis (e.g., intent to treat [ITT]) and definitions (i.e., criteria for including participants in the analysis) are necessary for interpreting a clinical trial's findings. Our objective was to compare the description of types of analyses and criteria for including participants in the publication (i.e., what was reported) with descriptions in the corresponding internal company documents (i.e., what was planned and what was done). Trials were for off-label uses of gabapentin sponsored by Pfizer and Parke-Davis, and documents were obtained through litigation.

Methods and Findings:
For each trial, we compared internal company documents (protocols, statistical analysis plans, and research reports, all unpublished), with publications. One author extracted data and another verified, with a third person verifying discordant items and a sample of the rest. Extracted data included the number of participants randomized and analyzed for efficacy, and types of analyses for efficacy and safety and their definitions (i.e., criteria for including participants in each type of analysis). We identified 21 trials, 11 of which were published randomized controlled trials, and that provided the documents needed for planned comparisons. For three trials, there was disagreement on the number of randomized participants between the research report and publication. Seven types of efficacy analyses were described in the protocols, statistical analysis plans, and publications, including ITT and six others. The protocol or publication described ITT using six different definitions, resulting in frequent disagreements between the two documents (i.e., different numbers of participants were included in the analyses).

Conclusions:
Descriptions of analyses conducted did not agree between internal company documents and what was publicly reported. Internal company documents provide extensive documentation of methods planned and used, and trial findings, and should be publicly accessible. Reporting standards for randomized controlled trials should recommend transparent descriptions and definitions of analyses performed and which study participants are excluded.



Please see later in the article for the Editors' Summary


Vyšlo v časopise: Differences in Reporting of Analyses in Internal Company Documents Versus Published Trial Reports: Comparisons in Industry-Sponsored Trials in Off-Label Uses of Gabapentin. PLoS Med 10(1): e32767. doi:10.1371/journal.pmed.1001378
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1001378

Souhrn

Background:
Details about the type of analysis (e.g., intent to treat [ITT]) and definitions (i.e., criteria for including participants in the analysis) are necessary for interpreting a clinical trial's findings. Our objective was to compare the description of types of analyses and criteria for including participants in the publication (i.e., what was reported) with descriptions in the corresponding internal company documents (i.e., what was planned and what was done). Trials were for off-label uses of gabapentin sponsored by Pfizer and Parke-Davis, and documents were obtained through litigation.

Methods and Findings:
For each trial, we compared internal company documents (protocols, statistical analysis plans, and research reports, all unpublished), with publications. One author extracted data and another verified, with a third person verifying discordant items and a sample of the rest. Extracted data included the number of participants randomized and analyzed for efficacy, and types of analyses for efficacy and safety and their definitions (i.e., criteria for including participants in each type of analysis). We identified 21 trials, 11 of which were published randomized controlled trials, and that provided the documents needed for planned comparisons. For three trials, there was disagreement on the number of randomized participants between the research report and publication. Seven types of efficacy analyses were described in the protocols, statistical analysis plans, and publications, including ITT and six others. The protocol or publication described ITT using six different definitions, resulting in frequent disagreements between the two documents (i.e., different numbers of participants were included in the analyses).

Conclusions:
Descriptions of analyses conducted did not agree between internal company documents and what was publicly reported. Internal company documents provide extensive documentation of methods planned and used, and trial findings, and should be publicly accessible. Reporting standards for randomized controlled trials should recommend transparent descriptions and definitions of analyses performed and which study participants are excluded.



Please see later in the article for the Editors' Summary


Zdroje

1. MoherD, JonesA, LepageL (2001) Use of the CONSORT statement and quality of reports of randomized trials: a comparative before-and-after evaluation. JAMA 285: 1992–1995.

2. ICH (1998) International conference on harmonisation; guidance on statistical principles for clinical trials. Fed Regist 63: 49583–49598.

3. SchulzKF, AltmanDG, MoherD (2010) CONSORT 2010 Statement: Updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol 63: 834–840.

4. National Research Council (US). Panel on Handling Missing Data in Clinical Trials, National Research Council (US), Committee on National Statistics., National Academies Press (US (2010) The prevention and treatment of missing data in clinical trials. Washington (D.C.): National Academies Press. xv, 144 p.

5. The PLoS Medicine Editors (2009) An unbiased scientific record should be everyone's agenda. PLoS Med 6: e1000038 doi:10.1371/journal.pmed.1000038.

6. MoherD, SchulzKF, AltmanDG (2001) The CONSORT statement: revised recommendations for improving the quality of reports of parallel group randomized trials. BMC Med Res Methodol 1: 2.

7. AbrahaI, MontedoriA (2010) Modified intention to treat reporting in randomised controlled trials: systematic review. BMJ 340: c2697.

8. ChanAW, HrobjartssonA, JorgensenKJ, GotzschePC, AltmanDG (2008) Discrepancies in sample size calculations and data analyses reported in randomised trials: comparison of publications with protocols. BMJ 337: a2299.

9. HollisS, CampbellF (1999) What is meant by intention to treat analysis? Survey of published randomised controlled trials. BMJ 319: 670–674.

10. KruseRL, AlperBS, ReustC, StevermerJJ, ShannonS, et al. (2002) Intention-to-treat analysis: who is in? Who is out? J Fam Pract 51: 969–971.

11. MontedoriA, BonaciniMI, CasazzaG, LuchettaML, DucaP, et al. (2011) Modified versus standard intention-to-treat reporting: are there differences in methodological quality, sponsorship, and findings in randomized trials? A cross-sectional study. Trials 12: 58.

12. MontoriVM, GuyattGH (2001) Intention-to-treat principle. CMAJ 165: 1339–1341.

13. Ruiz-CanelaM, Martinez-GonzalezMA, de Irala-EstevezJ (2000) Intention to treat analysis is related to methodological quality. BMJ 320: 1007–1008.

14. Saris P (2010) U.S.D.J. Findings of fact and conclusions of law. In re Neurontin marketing and sales practices litigation. Civil action No. 04-cv-10739-PBS, 2010 WL 4325225.

15. VedulaSS, BeroL, SchererRW, DickersinK (2009) Outcome reporting in industry-sponsored trials of gabapentin for off-label use. N Engl J Med 361: 1963–1971.

16. VedulaSS, GoldmanPS, RonaIJ, GreeneTM, DickersinK (2012) Implementation of a publication strategy in the context of reporting biases. A case study based on new documents from Neurontin litigation. Trials 13: 136.

17. GordhTE, StubhaugA, JensenTS, ArnerS, BiberB, et al. (2008) Gabapentin in traumatic nerve injury pain: a randomized, double-blind, placebo-controlled, cross-over, multi-center study. Pain 138: 255–266.

18. BackonjaM, BeydounA, EdwardsKR, SchwartzSL, FonsecaV, et al. (1998) Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: a randomized controlled trial. JAMA 280: 1831–1836.

19. BackonjaM, GlanzmanRL (2003) Gabapentin dosing for neuropathic pain: evidence from randomized, placebo-controlled clinical trials. Clin Ther 25: 81–104.

20. CaraceniA, ZeccaE, BonezziC, ArcuriE, Yaya TurR, et al. (2004) Gabapentin for neuropathic cancer pain: a randomized controlled trial from the Gabapentin Cancer Pain Study Group. J Clin Oncol 22: 2909–2917.

21. Gómez-PérezFJ, Perez-MonteverdeA, NascimentoO, AschnerP, TagleM, et al. (2004) Gabapentin for the treatment of painful diabetic neuropathy: dosing to achieve optimal clinical response. The British Journal of Diabetes & Vascular Disease 4: 173–178.

22. GorsonKC, SchottC, HermanR, RopperAH, RandWM (1999) Gabapentin in the treatment of painful diabetic neuropathy: a placebo controlled, double blind, crossover trial. J Neurol Neurosurg Psychiatry 66: 251–252.

23. MathewNT, RapoportA, SaperJ, MagnusL, KlapperJ, et al. (2001) Efficacy of gabapentin in migraine prophylaxis. Headache 41: 119–128.

24. PandeAC, CrockattJG, JanneyCA, WerthJL, TsarouchaG (2000) Gabapentin in bipolar disorder: a placebo-controlled trial of adjunctive therapy. Gabapentin Bipolar Disorder Study Group. Bipolar Disord 2: 249–255.

25. SerpellMG (2002) Gabapentin in neuropathic pain syndromes: a randomised, double-blind, placebo-controlled trial. Pain 99: 557–566.

26. VietaE, Manuel GoikoleaJ, Martinez-AranA, ComesM, VergerK, et al. (2006) A double-blind, randomized, placebo-controlled, prophylaxis study of adjunctive gabapentin for bipolar disorder. J Clin Psychiatry 67: 473–477.

27. WesselyP, BaumgartnerC, KlinglerD, KrecziJ, MeyersonN, et al. (1987) Preliminary results of a double-blind study with the new migraine prophylactic drug gabapentin. Cephalalgia 7: 477–478.

28. DallocchioC, BuffaC, MazzarelloP, ChiroliS (2000) Gabapentin vs. amitriptyline in painful diabetic neuropathy: an open-label pilot study. J Pain Symptom Manage 20: 280–285.

29. WangPW, SantosaC, SchumacherM, WinsbergME, StrongC, et al. (2002) Gabapentin augmentation therapy in bipolar depression. Bipolar Disord 4: 296–301.

30. KesselheimAS, DarbyD, StuddertDM, GlynnR, LevinR, et al. (2011) False Claims Act prosecution did not deter off-label drug use in the case of Neurontin. Health Aff (Millwood) 30: 2318–2327.

31. AlshurafaM, BrielM, AklEA, HainesT, MoayyediP, et al. (2012) Inconsistent definitions for intention-to-treat in relation to missing outcome data: systematic review of the methods literature. PLoS One 7: e49163 doi:10.1371/journal.pone.0049163.

32. AltmanDG (2009) Missing outcomes in randomized trials: addressing the dilemma. Open Med 3: 51–53.

33. Chan AW, Tetzlaff J, Altman DG, Gotzsche PC, Hrobjartsson A, et al. (2009) The SPIRIT initiative: defining standard protocol items for randomized trials. The Sixth International Congress on Peer Review and Biomedical Publication, Vancouver, BC. Available: http://www.peerreviewcongress.org/posters-0911.pdf. Accessed 20 December 2012.

34. ChanAW (2008) Bias, spin, and misreporting: time for full access to trial protocols and results. PLoS Med 5: e230 doi:10.1371/journal.pmed.0050230.

35. DoshiP, JeffersonT, Del MarC (2012) The imperative to share clinical study reports: recommendations from the Tamiflu experience. PLoS Med 9: e1001201 doi:10.1371/journal.pmed.1001201.

36. US FDA (2012) 21CFR314.430. Available: www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=314.430. Accessed 13 December 2012.

37. KesselheimAS, MelloMM (2007) Confidentiality laws and secrecy in medical research: improving public access to data on drug safety. Health Aff (Millwood) 26: 483–491.

38. TurnerEH (2004) A taxpayer-funded clinical trials registry and results database. PLoS Med 1: e60 doi:10.1371/journal.pmed.0010060.

39. ZarinDA, TseT, WilliamsRJ, CaliffRM, IdeNC (2011) The ClinicalTrials.gov results database - update and key issues. N Engl J Med 364: 852–860.

40. ClinicalTrials.gov (2009). Elaboration of definitions of responsible party and applicable clinical trial. Available: prsinfo.clinicaltrials.gov/ElaborationsOnDefinitions.pdf. Accessed 13 December 2012.

41. US FDA (2007) Food and Drug Administration Amendments Act of 2007, publication L. number 110-85. Available: http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=110_cong_public_laws&docid=f:publ085.110.pdf. Accessed 19 November 2009.

42. RisingK, BacchettiP, BeroL (2008) Reporting bias in drug trials submitted to the Food and Drug Administration: review of publication and presentation. PLoS Med 5: e217; discussion e217 doi:10.1371/journal.pmed.0050217.

43. TurnerEH, MatthewsAM, LinardatosE, TellRA, RosenthalR (2008) Selective publication of antidepressant trials and its influence on apparent efficacy. N Engl J Med 358: 252–260.

44. UnluM (2010) It is time: why the FDA should start disclosing drug trial data. Mich Telecomm Tech L Rev 16: 511–545.

45. PottA (2011) EMA's response to articles. BMJ 342: d3838.

46. European Medicines Agency. Release of data from clinical trials. Available: http://www.ema.europa.eu/ema/index.jsp?curl=pages/special_topics/general/general_content_000555.jsp&mid=WC0b01ac0580607bfa. Accessed 4 December 2012.

47. European Medicines Agency (2010) European Medicines Agency policy on access to documents (related to medicinal products for human and veterinary use). Available: http://www.ema.europa.eu/docs/en_GB/document_library/Other/2010/11/WC500099473.pdf. Accessed 4 December 2012.

48. DickersinK, RennieD (2012) The evolution of trial registries and their use to assess the clinical trial enterprise. JAMA 307: 1861–1864.

49. DrazenJM (2012) Transparency for clinical trials–the TEST Act. N Engl J Med 367: 863–864.

Štítky
Interné lekárstvo

Článok vyšiel v časopise

PLOS Medicine


2013 Číslo 1
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Kurzy

Zvýšte si kvalifikáciu online z pohodlia domova

Aktuální možnosti diagnostiky a léčby litiáz
nový kurz
Autori: MUDr. Tomáš Ürge, PhD.

Všetky kurzy
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#