Researcher Financial Conflicts Influence Flu Drug StudiesNicole Ostrow
Researchers with financial ties to flu drug companies more often reported positive findings in their studies of the treatments, a new analysis found.
Seven of eight studies that analyzed previous research and whose researchers had financial ties to the drug industry were considered favorable to the flu treatments, including Roche Holding AG’s Tamiflu and GlaxoSmithKline Plc’s Relenza, according to research today in the Annals of Internal Medicine. That compares with five favorable findings of 29 reviews from researchers who didn’t report similar financial conflicts of interest.
“This is a huge discrepancy,” said Florence Bourgeois, the senior study author and an assistant professor of pediatrics at Boston Children’s Hospital and Harvard Medical School, in a telephone interview. “While we can’t comment specifically about what the effect of the conflicts of interest are, it raises concerns and questions around how this came about.”
Today’s findings add to previous studies that have questioned the effectiveness and safety of the treatments and pointed out flaws in how some of the earlier trials have been conducted. The results are the first to examine the potential influence of financial conflicts of interest in systematic reviews of these treatments, the authors said.
“For them to reach nearly polar opposite conclusions is sort of a big deal because systematic reviews are considered the pinnacle of evidence-based medicine,” said Adam Dunn, the lead study author and a senior research fellow at the Australian Institute of Health Innovation at the University of New South Wales in Sydney.
Christine Laine, editor in chief of the Annals and a senior vice president at the American College of Physicians in Philadelphia, said there’s a lot of confusion for doctors because of the conflicting findings among the studies of the flu medicines. Today’s results provide some insight into why the literature on this topic has been “inconsistent.”
“It’s well known that clinical trials where the people doing them have conflicts of interest are more likely to report favorable results,” she said in a telephone interview. “This is an extension to what we’ve seen in other areas. People should be aware of what the potential conflicts of interest are of the people that are doing the scholarly work, whether the scholarly work is a primary research study or a work synthesizing work that’s already out there.”
Austine Graff, a spokeswoman for Basel, Switzerland-based Roche’s Genentech unit, said the company regularly works with established experts across many therapeutic areas.
“We believe that partnerships between the medical community and companies, like ours, who discover and develop medicines are critically important to our shared goals of advancing scientific knowledge and delivering new medicines to patients in need,” she said in an e-mail today. “Our ability to engage with doctors, researchers and opinion leaders in robust dialogue on approved and investigational medicines is vital to our research and development efforts. Genentech’s professional relationships with experts are within all existing pharmaceutical industry and regulatory guidelines.”
Glaxo said it wouldn’t directly comment on the study about the financial ties. “We believe that clinical trial data for Relenza supports its effectiveness against flu and that when used appropriately, in the right patient, it can reduce duration of flu symptoms,’’ said Glaxo spokesman Robert Perry.
Researchers in the study included 37 systematic reviews from 2005 to 2014 that analyzed previous studies. The reviews ranged from those supporting the efficacy of the medicines for prevention and early treatment of the flu or advocating for national stockpiling of the treatments to those that recommended the medicines not be used routinely or discouraging national stockpiling.
The U.S. has spent about $1.3 billion, and the U.K. 424 million pounds ($680 million), stockpiling the drugs following a 2009 outbreak of the H1N1 swine flu.
Dunn said even with these results, studies from partnerships between drug companies and researchers shouldn’t be ignored because not all conflicts of interest lead to bias.
For patients, Bourgeois said, they should discuss with their doctors whether to receive the treatments. A study in April in the British Medical Journal, which analyzed 170,000 pages of clinical-trial data, found Tamiflu helped reduce flu symptoms but also caused side effects including vomiting and delirium.
‘‘What we don’t want is for researchers and clinicians to discount a study simply because there are conflicts of interest,” she said. “We should think of other ways these conflicts of interest are managed.”