# \[e-drug\] Full Drug Trial Disclosure

**URL:** <https://talk.edrugplus.org/t/e-drug-full-drug-trial-disclosure/19863>\
**Category:** e-drug\
**Created:** [June 15, 2004, 12:50pm UTC](https://talk.edrugplus.org/t/e-drug-full-drug-trial-disclosure/19863 "2004-06-15T12:50:46Z")\
**Posts on this page:** 1\
**Page:** 1

<div class="post-metadata">

**Author:** ![E-drug](https://avatars.discourse-cdn.com/v4/letter/e/ecd19e/32.png) [@E-drug](https://talk.edrugplus.org/u/E-drug)\
**Post date:** [June 15, 2004, 12:50pm UTC](https://talk.edrugplus.org/t/e-drug-full-drug-trial-disclosure/19863/1 "2004-06-15T12:50:46Z")

</div>

E-DRUG: Full Drug Trial Disclosure  
----------------------------------  
[To avoid publication bias of "positive" clinical trials, there have been  
several proposals to set up a compulsory system of CT registries. Several  
countries already have such plans. Now also the USA starts discussing.

Also note the message that GSK has put all(?) clinical data on depression in  
youth on its website!  
E-drug found them at [http://www.gsk.com/media/paroxetine.htm](http://www.gsk.com/media/paroxetine.htm)

Copied as fair use from today's New York Times. WB]

June 15, 2004  
Group Weighs Plan for Full Drug-Trial Disclosure  
By BARRY MEIER

An organization of top medical journals is considering a proposal that would  
require drug makers to register clinical trials at their start in a public  
database in order for results, whether successful or not, to be later  
considered for publication, according to three people working with the  
group.

Pharmaceutical companies are not generally required now to disclose  
results of a trial or even whether one was conducted. Some academic  
researchers have long argued that fuller registries of drug trials are  
needed because companies, as well as medical journals and scientists, tend  
to spotlight only trials that show positive results.

The plan, if adopted by the organization, the International Committee of  
Medical Journal Editors, is likely to put pressure on pharmaceutical  
makers to disclose more about the trials they run. The group includes 12  
major medical journals like The Journal of the American Medical  
Association, The New England Journal of Medicine, The Lancet and The  
Annals of Internal Medicine.

The recent discussion among the journal editors about a trial registry  
comes amid public controversy about clinical trial data after the  
disclosures that the results of antidepressant tests in children were not  
adequately publicized.

Because the medical journals in the group are prestigious, and publication  
of the results of a clinical trial in them carries much weight, companies  
frequently use articles from them as marketing tools to persuade doctors  
to prescribe a drug. If the International Committee of Medical Journal  
Editors adopts the proposal for a registry, drug companies not wanting to  
participate could still seek to have their research published in other  
less-prominent medical journals, but the research might not get as much  
attention from physicians.

A spokesman for the Pharmaceutical Research and Manufacturers Association  
of America, a group representing drug makers, said it was not aware of the  
proposal being considered by medical journal editors to require  
registration of trials, so it could not comment on it. In the past, the  
group has not supported a registry, although a few companies have adopted  
a registry.

Many drug companies without registries have noted that they voluntarily  
disclose the results of all clinical trials they conduct, either at  
scientific conferences or through publications.

But critics say that there is no central registry where clinical trials  
and their results are available, making it difficult for researchers to  
track all studies that have been done on a single drug.

Ideally, advocates of clinical trial registries say, such databases would  
show when a trial was started, list its objectives and then update that  
information with the trial's results or the reason it was terminated.

A proposal to mandate trial registration as a prerequisite for publication  
was discussed last week at a meeting of the journal editors' group, said  
the three people working with the organization who insisted on anonymity  
because, they said, the proposal was still under discussion and because  
the group was not planning to announce any change unless it was adopted.

A decision could come in the summer, one person said.

In a related development, policy makers at the American Medical  
Association, which represents many of the nation's doctors, are expected  
to vote as early as today on a proposal that would urge the government to  
create a public registry of clinical trials and their results, a spokesman  
for the A.M.A. said.

Yesterday, GlaxoSmithKline, the manufacturer of the antidepressant Paxil,  
released on its company Web site the reports of clinical tests of that  
drug in children and adolescents suffering from psychological conditions  
including depression.

The action follows a civil lawsuit filed this month by the New York State  
attorney general, Eliot Spitzer, that accused the company of misleading  
doctors by publicizing a favorable study of Paxil for pediatric depression  
while playing down other trials that showed the drug did not work better  
than a placebo.

GlaxoSmithKline officials have denied that they selectively disclosed  
trial findings.

Regulators in this country and elsewhere are now scrambling to review  
unpublished test data on Paxil and several other popular antidepressants  
to see if the drugs pose dangers.

In a statement issued yesterday, Mr. Spitzer said that the company's  
actions had not resolved his lawsuit but called it a positive move. "This  
is a positive first step toward changing a dangerous industry practice,"  
he said.

A decision by the International Committee of Medical Journal Editors to  
consider for publication only clinical trials that have been registered  
from the start would be the organization's latest effort to push for  
greater disclosure of data.

Two years ago, the group published a joint editorial calling on companies  
to provide university researchers with a greater role in designing trials  
and access to the analysis of results. That same editorial also pointed to  
the fact that the results of some trials were never published.

"The results of the unfinished trial may be buried rather than published  
if they are unfavorable to the sponsor's product," the editorial stated.  
"Such issues are not theoretical. There have been a number of recent  
public examples of such problems, and we suspect that many more go  
unreported."

But some academic researchers have also argued that medical journals are  
themselves part of the problem, even if unwittingly so. A growing number  
of studies have found that clinical trials published in leading medical  
journals tend to show positive results about the drug or medical devices  
being tested, a phenomenon referred to as publication bias.

As a result, those researchers say, physicians who rely on medical  
journals for information about drugs and medical devices may get an  
incomplete view of their effectiveness or safety because they may be  
unaware of other less favorable or inconclusive studies.

In an interview this month, Dr. Alan Goldhammer, associate vice president  
for regulatory affairs for the Pharmaceutical Research and Manufacturers  
Association of America, said that to date the organization had not  
supported the idea of a public registry for clinical trials. He said the  
association might reconsider its stance in light of the antidepressant  
controversy.

Another trade group, the Association of the British Pharmaceutical  
Industry, recommended to its members last year that they voluntarily  
create trial registries. A spokesman for the group said recently that 8 of  
its 80 members had created such databases.

--  
To send a message to E-Drug, write to: e-drug@healthnet.org  
To subscribe or unsubscribe, write to: majordomo@healthnet.org  
in the body of the message type: subscribe e-drug OR unsubscribe e-drug  
To contact a person, send a message to: e-drug-help@healthnet.org  
Information and archives: [http://www.essentialdrugs.org/edrug](http://www.essentialdrugs.org/edrug)
