Funding and conclusions of network meta-analyses on targeted therapies in inflammatory diseases: an overview.

Objectives: To explore the association between industry funding and network meta-analyses' (NMAs) conclusion, and the use in Clinical Practice Guidelines (CPGs) of NMAs.
Study Design and Setting: This was an overview of NMAs and CPGs. We searched PubMed/MEDLINE, Epistemonikos, and several guideline databases up to February 18th 2023. We included CPGs from the last 5 years and NMAs of randomized controlled trials that evaluated targeted therapies in immune-mediated inflammatory diseases. Data extraction and outcome assessments were done in duplicate by independent authors.
Results: We included 216 NMAs and 99 CPGs. 31% (67/216) were industry-funded. The proportion of industry-funded NMAs that cited one treatment as being best was 44% (25/57) compared to 26% (30/116) for nonindustry-funded (OR = 2.24 [1.15-4.39]; aOR = 1.76 [0.81-3.81]). The abstract's conclusion of 39/67 (58%) industry-funded and 69/149 (46%) nonindustry-funded NMAs were considered unsupported by the results (OR = 1.61 [0.90-2.89]; aOR = 1.40 [0.71-2.78]). All industry-funded NMAs that cited one treatment as best cited their own sponsored drug. 59/99 (60%) CPGs included at least one NMA, with 23/59 (39%) of them citing industry-funded NMAs.
Conclusions: We did not find evidence that industry-funded NMAs were more likely to have unsupported conclusions or to cite only one treatment as being best in their conclusions compared to non-industry-funded NMAs. However, almost all industry-funded NMAs favored their own treatments. Even though 40% of the CPGs did not rely on NMA, over a third of those who did used industry-funded NMAs. Limitations include the possible misclassification due to undisclosed funding and potential confounders that have not been accounted for.
Competing Interests: Declaration of competing interest Robin Guelimi reports financial support was provided by Public Assistance Hospitals Paris. and the Association for Interdisciplinary Meta-Research and Open Science. LLC, ES, and SA are co-authors of this work and authors of several studies that are included in the submitted overview. L.L.C., E.S., and S.A. are authors of several studies that are included in this overview. L.L.C. took part in the selection process, but none of them were involved in the extraction of data or in the assessment of the quality of a work they took a part in. L.L.C. and E.S. received a grant from the French Ministry of Health (PHRC-N AOM22145). L.L.C. is the co-ordinating editor of the Cochrane Skin. F.N. received funding from the French National Research Agency (ANR-17-CE36-0010), the French ministry of health and the French ministry of research. He is a work package leader in the OSIRIS project (Open Science to Increase Reproducibility in Science). The OSIRIS project has received funding from the European Union's Horizon Europe research and innovation programme under the grant agreement No. 101094725. He is a work package leader for the doctoral network MSCA-DN SHARE-CTD (HORIZON-MSCA-2022-DN-01 101120360) funded by the EU. YZZN received a grant from the NIHR Manchester Biomedical Research Centre (NIHR203308). R.G., A.M., T.B., and G.P. had no conflict of interest to declare. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)