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由制药行业赞助的评估单克隆抗体的临床试验结论:一项元研究。

Conclusions of clinical trials assessing monoclonal antibodies and sponsored by pharmaceutical industry: a meta-research study.

作者信息

Ornelas Rachel Campos, Pazini Débora de Souza, Pacheco Rafael Leite, Martimbianco Ana Luiza Cabrera, Riera Rachel

机构信息

Universidade Federal de Juiz de Fora - Governador Valadares (MG), Brazil.

Hospital Sírio-Libanês - São Paulo (SP), Brazil.

出版信息

Rev Assoc Med Bras (1992). 2024 Dec 2;70(11):e20241022. doi: 10.1590/1806-9282.20241022. eCollection 2024.

Abstract

OBJECTIVE

The objective of this study was to describe and critically appraise the conclusions of randomized clinical trials assessing monoclonal antibodies sponsored by the pharmaceutical industry.

METHODS

This is a meta-research study on conclusions' characteristics of randomized clinical trials with monoclonal antibodies as interventions sponsored by the pharmaceutical industry.

RESULTS

A total of 82 publications were considered. Notably, 79.3% (65/82) of the trials were fully funded by the pharmaceutical industry, and sponsors had data and publishing rights in 70.7% (58/82). Among the fully sponsored studies, 78.5% (51/65) presented conclusions with a drug-favorable direction of the effect, and 30.8% (20/65) made some recommendations for clinical practice, of which 95% (19/20) were favorable to the drug. In relation to the partially funded studies, drug-favorable direction of effect was present in 68.8% (11/16) of conclusions, and 18.8% (3/16) recommended the drug for the practice, in which 66.7% (2/3) favored the drug. Positive direction of effect was more present in trials in which the sponsor owned data and publication (81.0%; 47/58), compared to trials where the funder did not (63.3%; 14/22). Only 13.4% (11/82) of included studies recognize the uncertainty in the estimates in the conclusions, and 37.4% (31/82) had a statement regarding the need for future studies.

CONCLUSIONS

Most of the included randomized clinical trials on monoclonal antibodies funded by the industry concluded a drug-favorable direction of effect. Recommendations for practice were common, while recognition of uncertainty and statements regarding the need for future studies were less frequently present in the conclusion.

摘要

目的

本研究的目的是描述并批判性地评估由制药行业赞助的评估单克隆抗体的随机临床试验的结论。

方法

这是一项关于以单克隆抗体为干预措施、由制药行业赞助的随机临床试验结论特征的元研究。

结果

共纳入82篇出版物。值得注意的是,79.3%(65/82)的试验由制药行业全额资助,70.7%(58/82)的试验中赞助商拥有数据和发表权。在完全由行业赞助的研究中,78.5%(51/65)得出的结论显示药物效果呈有利方向,30.8%(20/65)对临床实践提出了一些建议,其中95%(19/20)对药物有利。在部分资助的研究中,68.8%(11/16)的结论显示药物效果呈有利方向,18.8%(3/16)建议在实践中使用该药物,其中66.7%(2/3)对药物有利。与赞助商不拥有数据和发表权的试验(63.3%;14/22)相比,赞助商拥有数据和发表权的试验中,更多试验得出的结论显示效果呈积极方向(81.0%;47/58)。纳入的研究中只有13.4%(11/82)在结论中认识到估计值存在不确定性,37.4%(31/82)有关于未来研究必要性的声明。

结论

纳入的大多数由行业资助的单克隆抗体随机临床试验得出的结论显示药物效果呈有利方向。对实践的建议很常见,而结论中对不确定性的认识以及关于未来研究必要性的声明则较少出现。

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