Avandia: Money or Patient Safety? That is the Question.

An analysis of authors who published reports on GlaxoSmithKline’s Avandia diabetes pill shows that those with ties to the industry were more likely to conclude that the drug didn’t increase the risk of myocardial infarction compared with authors with no industry ties, according to a study presented at the American College of Preventive Medicine annual meeting, TheHeart.org reports.

The analysis, which was presented as a poster by Mohammed Hassan Murad of the Mayo Clinic,
reviewed 202 articles that addressed the possible association between MI risk and Avandia in diabetes patients. Articles selected for review addressed the findings of two studies, a meta-analysis of small trials and a subsequent larger trial, that contributed to the controversy, TheHeart.org writes.

Of the papers evaluated, 107, or 53 percent, included a conflict-of-interest statement and 90, or 45 percent, had a conflicting financial relationship. Among authors who concluded Avandia doesn’t increase the risk of MI, 91 percent had financial ties to makers of diabetes meds and 86 percent had relationships with Glaxo, TheHeart.org continues. Among authors of articles offering unfavorable reviews, only 25 percent had financial relationships with makers of diabetes meds and 18 percent had relationships with Glaxo that were disclosed in the papers.

Murad noted that in some cases, when an online search was conduced for some authors, they found some who listed financial conflicts in other publications that weren’t disclosed in their Avandia paper. “Disclosure rates of conflicting financial relationships were misleadingly low despite their clear and strong linkage with authors’ expressed views,” Murad noted. “These findings underscore the need for further progress in reform for the scientific record to be trusted. The quality of care patients receive is clearly affected by these findings.”

The study demonstrates the problem with pairing of researchers with financial interests in a company and studies involving that company’s product, according to David Katz of Yale University’s Prevention Research Center. “If the researcher has a direct financial interest in the item being studied, the researcher—who, unlike the funder, is responsible for interpreting the data—will share the funder’s bias,” Katz, who wasn’t involved in the analysis, tells TheHeart.org. “The trend in the literature indicates that most people do not adequately resist this inclination.”