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抗抑郁药安慰剂对照试验的临床研究报告和出版物中广泛选择性报告生活质量。

Extensive selective reporting of quality of life in clinical study reports and publications of placebo-controlled trials of antidepressants.

机构信息

Nordic Cochrane Centre, Copenhagen, Denmark.

Institute for Scientific Freedom, Copenhagen, Denmark.

出版信息

Int J Risk Saf Med. 2021;32(2):87-99. doi: 10.3233/JRS-200051.

Abstract

BACKGROUND

Selective reporting of trial results is common.

OBJECTIVE

To study selective reporting in clinical study reports, company trial registers and publications of quality of life in placebo-controlled trials of antidepressants.

METHODS

We compared clinical study reports of four antidepressants (fluoxetine, duloxetine, paroxetine and sertraline) obtained from two European drug regulators, data from online company registers, and publications received or retrieved from Eli Lilly and GlaxoSmithKline. Pfizer was also contacted but did not provide any publications.

RESULTS

We included 15 trials (19,015 pages) and 4717 patients. Six trials had used SF-36, seven EQ-5D and two both instruments. Nine of the 15 CSRs (60%) displayed selective reporting. In the companies' online registers, there was selective reporting for all 15 trials (100%). We received 20 publications from Eli Lilly and retrieved six from the GlaxoSmithKline register. There was selective reporting in 24 of the 26 publications (92%). Despite extensive selective reporting, we found only small differences between placebo and active drugs.

CONCLUSIONS

Access to the full raw data from clinical trials and to case report forms for all patients are needed to evaluate the effect of antidepressants on quality of life. Regulatory agencies should refuse to approve drugs or new indications based on incomplete reporting.

摘要

背景

试验结果的选择性报告很常见。

目的

研究抗抑郁药安慰剂对照试验中,临床研究报告、公司试验登记册和生活质量出版物中的选择性报告。

方法

我们比较了来自两个欧洲药品监管机构的四种抗抑郁药(氟西汀、度洛西汀、帕罗西汀和舍曲林)的临床研究报告、来自在线公司登记册的数据,以及从 Eli Lilly 和 GlaxoSmithKline 收到或检索到的出版物。Pfizer 也被联系过,但没有提供任何出版物。

结果

我们纳入了 15 项试验(19015 页)和 4717 名患者。6 项试验使用了 SF-36,7 项使用了 EQ-5D,2 项同时使用了这两种工具。15 项 CSR 中的 9 项(60%)显示了选择性报告。在公司的在线登记册中,所有 15 项试验均有选择性报告(100%)。我们从 Eli Lilly 收到了 20 份出版物,并从 GlaxoSmithKline 登记册中检索了 6 份。26 份出版物中有 24 份(92%)存在选择性报告。尽管选择性报告广泛存在,但我们仅发现安慰剂和活性药物之间存在微小差异。

结论

需要获得临床试验的全部原始数据和所有患者的病例报告表,以评估抗抑郁药对生活质量的影响。监管机构应拒绝基于不完整报告批准药物或新适应症。

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