The corporate bias and the molding of prescription practices : the case of hypertension
Autor(a) principal: | |
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Data de Publicação: | 2009 |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/21244 |
Resumo: | Drug management of hypertension has been a noticeable example of the influence of the pharmaceutical industry on prescription practices. The worldwide leading brands of blood pressure-lowering agents are angiotensin receptor-blocking agents, although they are considered to be simply substitutes of angiotensin-converting enzyme (ACE) inhibitors. Commercial strategies have been based on the results of clinical trials sponsored by drug companies. Most of them presented distortions in their planning, presentation or interpretation that favored the drugs from the sponsor, i.e., corporate bias. Atenolol, an ineffective blood pressure agent in elderly individuals, was the comparator drug in several trials. In a re-analysis of the INSIGHT trial, deaths appeared to have been counted twice. The LIFE trial appears in the title of more than 120 reproductions of the main and flawed trial, as a massive strategy of scientific marketing. Most guidelines have incorporated the corporate bias from the original studies, and the evidence from better designed studies, such as the ALLHAT trial, have been largely ignored. In trials published recently corporate influences have touched on ethical limits. In the ADVANCE trial, elderly patients with type 2 diabetes and cardiovascular disease or risk factors, allocated to placebo, were not allowed to use diuretic and full doses of an ACE inhibitor, despite the sound evidence of benefit demonstrated in previous trials. As a consequence, they had a 14% higher mortality rate than the participants allocated to the active treatment arm. This reality should be modified immediately, and a greater independence of the academy from the pharmaceutical industry is necessary. |
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Fuchs, Flávio Danni2010-04-24T04:15:55Z20090100-879Xhttp://hdl.handle.net/10183/21244000726688Drug management of hypertension has been a noticeable example of the influence of the pharmaceutical industry on prescription practices. The worldwide leading brands of blood pressure-lowering agents are angiotensin receptor-blocking agents, although they are considered to be simply substitutes of angiotensin-converting enzyme (ACE) inhibitors. Commercial strategies have been based on the results of clinical trials sponsored by drug companies. Most of them presented distortions in their planning, presentation or interpretation that favored the drugs from the sponsor, i.e., corporate bias. Atenolol, an ineffective blood pressure agent in elderly individuals, was the comparator drug in several trials. In a re-analysis of the INSIGHT trial, deaths appeared to have been counted twice. The LIFE trial appears in the title of more than 120 reproductions of the main and flawed trial, as a massive strategy of scientific marketing. Most guidelines have incorporated the corporate bias from the original studies, and the evidence from better designed studies, such as the ALLHAT trial, have been largely ignored. In trials published recently corporate influences have touched on ethical limits. In the ADVANCE trial, elderly patients with type 2 diabetes and cardiovascular disease or risk factors, allocated to placebo, were not allowed to use diuretic and full doses of an ACE inhibitor, despite the sound evidence of benefit demonstrated in previous trials. As a consequence, they had a 14% higher mortality rate than the participants allocated to the active treatment arm. This reality should be modified immediately, and a greater independence of the academy from the pharmaceutical industry is necessary.application/pdfengBrazilian journal of medical and biological research = Revista brasileira de pesquisas médicas e biológicas. Vol. 42, n. 3 (mar. 2009), p. 224-228HipertensãoPressão arterialEnsaios clínicos como assuntoÉticaHypertensionBlood pressure agentsClinical trialsEthicsCorporate biasThe corporate bias and the molding of prescription practices : the case of hypertensioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/otherinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT000726688.pdf.txt000726688.pdf.txtExtracted Texttext/plain22641http://www.lume.ufrgs.br/bitstream/10183/21244/2/000726688.pdf.txta0c3fdaeb66c4224a3e3ab5f1d74bf48MD52ORIGINAL000726688.pdf000726688.pdfTexto completo (inglês)application/pdf51079http://www.lume.ufrgs.br/bitstream/10183/21244/1/000726688.pdf9b6529a6aa4b0ecdddbf3d93aad2ba91MD51THUMBNAIL000726688.pdf.jpg000726688.pdf.jpgGenerated Thumbnailimage/jpeg2010http://www.lume.ufrgs.br/bitstream/10183/21244/3/000726688.pdf.jpg269615a40af0ab9020481bdb470889b1MD5310183/212442023-08-18 03:40:35.356028oai:www.lume.ufrgs.br:10183/21244Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2023-08-18T06:40:35Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
The corporate bias and the molding of prescription practices : the case of hypertension |
title |
The corporate bias and the molding of prescription practices : the case of hypertension |
spellingShingle |
The corporate bias and the molding of prescription practices : the case of hypertension Fuchs, Flávio Danni Hipertensão Pressão arterial Ensaios clínicos como assunto Ética Hypertension Blood pressure agents Clinical trials Ethics Corporate bias |
title_short |
The corporate bias and the molding of prescription practices : the case of hypertension |
title_full |
The corporate bias and the molding of prescription practices : the case of hypertension |
title_fullStr |
The corporate bias and the molding of prescription practices : the case of hypertension |
title_full_unstemmed |
The corporate bias and the molding of prescription practices : the case of hypertension |
title_sort |
The corporate bias and the molding of prescription practices : the case of hypertension |
author |
Fuchs, Flávio Danni |
author_facet |
Fuchs, Flávio Danni |
author_role |
author |
dc.contributor.author.fl_str_mv |
Fuchs, Flávio Danni |
dc.subject.por.fl_str_mv |
Hipertensão Pressão arterial Ensaios clínicos como assunto Ética |
topic |
Hipertensão Pressão arterial Ensaios clínicos como assunto Ética Hypertension Blood pressure agents Clinical trials Ethics Corporate bias |
dc.subject.eng.fl_str_mv |
Hypertension Blood pressure agents Clinical trials Ethics Corporate bias |
description |
Drug management of hypertension has been a noticeable example of the influence of the pharmaceutical industry on prescription practices. The worldwide leading brands of blood pressure-lowering agents are angiotensin receptor-blocking agents, although they are considered to be simply substitutes of angiotensin-converting enzyme (ACE) inhibitors. Commercial strategies have been based on the results of clinical trials sponsored by drug companies. Most of them presented distortions in their planning, presentation or interpretation that favored the drugs from the sponsor, i.e., corporate bias. Atenolol, an ineffective blood pressure agent in elderly individuals, was the comparator drug in several trials. In a re-analysis of the INSIGHT trial, deaths appeared to have been counted twice. The LIFE trial appears in the title of more than 120 reproductions of the main and flawed trial, as a massive strategy of scientific marketing. Most guidelines have incorporated the corporate bias from the original studies, and the evidence from better designed studies, such as the ALLHAT trial, have been largely ignored. In trials published recently corporate influences have touched on ethical limits. In the ADVANCE trial, elderly patients with type 2 diabetes and cardiovascular disease or risk factors, allocated to placebo, were not allowed to use diuretic and full doses of an ACE inhibitor, despite the sound evidence of benefit demonstrated in previous trials. As a consequence, they had a 14% higher mortality rate than the participants allocated to the active treatment arm. This reality should be modified immediately, and a greater independence of the academy from the pharmaceutical industry is necessary. |
publishDate |
2009 |
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2009 |
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2010-04-24T04:15:55Z |
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eng |
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Brazilian journal of medical and biological research = Revista brasileira de pesquisas médicas e biológicas. Vol. 42, n. 3 (mar. 2009), p. 224-228 |
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