Massive production of meta-analyses of antidepressants with industry authorship or industry-related conflicts

Article type
Authors
Ebrahim S1, Bance S2, Athale A3, Malachowski C4, Ioannidis J5
1Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California, United States of America; Department of Clinical Epidemiology & Biostatistics, and Anesthesia, McMaster University, Hamilton, Ontario, Canada, Canada
2Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Canada
3Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada, Canada
4Department of Rehabilitation Science, University of Toronto, Toronto, Ontario Canada, Canada
5Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California, United States of America, Canada
Abstract
Background:
As meta-analyses have become highly influential for guiding clinical practice, they may be used as marketing tools by the industry.

Objectives:
To identify how many recent meta-analyses of antidepressant trials in depression are authored or sponsored by the industry or have authors with conflicts of interest; and evaluate whether this may affect the overall interpretation of their results.

Methods:
We searched MEDLINE to identify all published meta-analyses of randomized controlled trials evaluating antidepressants in patients with depressive conditions from 1 January 2007 to 5 March 2014. We extracted data pertaining to author’s affiliations, conflicts of interests and whether the abstract of the meta-analysis included a negative concluding statement as to whether the antidepressant(s) were effective or safe.

Results:
Of the 1111 citations, we retrieved 262 in full text, and eventually identified 187 meta-analyses that were eligible. One hundred and thirty four (72%) meta-analyses had authors who were industry employees and/or had conflicts of interest for a for-profit organization. One hundred and twenty nine meta-analyses (69%) did not include any caveats or negative statements in the concluding statement of the abstract. Meta-analyses having at least one author employed by a for-profit organization or having financial conflicts of interest with the manufacturer of the assessed drug were significantly associated with fewer negative statements about the assessed antidepressant in the abstract’s concluding statement (p<0.001) (Table 1).

Conclusions:
There is a massive production of meta-analyses of antidepressants in depression performed by the industry or by authors with financial conflicts of interest with industry and these meta-analyses almost never include any negative statements about antidepressants.