Intended for healthcare professionals

Rapid response to:

Analysis

Ensuring safe and effective drugs: who can do what it takes?

BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.c7258 (Published 11 January 2011) Cite this as: BMJ 2011;342:c7258

Rapid Response:

Correction

In our recent Analysis[1], we mentioned the existence of a large
oseltamivir (Tamiflu) trial carried out by Roche Shanghai (ML16369) about
which Roche Basel--the company's headquarters, with whom we are in
correspondence--seemed unaware, as it was missing in the list of 101 Roche
-supported and Roche-sponsored trials that Roche Basel provided us.

Since publication of our article, we have become aware of two
additional trials that Roche Basel failed to disclose to us. They were
noticed in the course of our ongoing review of regulatory documents.

Details about these trials remain scant. They are designated as open
-label Phase III pediatric clinical trials testing the bioavailability and
bioequivalence of Tamiflu. We do not know how large these trials were, or
precisely when they took place. We do know, however, where they took
place.

* Protocol WP15979: Clinical Pharmacology Unit, Produits Roche S.A.,
1, Place de l'Hopital B.P. 20, F-67064 Strasbourg Cedex, France

* Protocol WP16137: Charterhouse Clinical Research Unit Ltd. The
Stamford Hospital (formerly the Royal Masonic), Ravenscourt Park, London,
W6 0TN, United Kingdom

Discovery of three manufacturer-funded trials which the manufacturer
failed to disclose to us confirms how important it is that independent
investigators take a role in constructing a complete list of trials as a
first step in any rigorous systematic review. It is not sufficient to
rely on trust. Nor is it sufficient to rely on automated database
searches: while ML16369 was published[2], WP15979 and WP16137 appear to
have remained unpublished. Only a handsearch and careful reading of
regulatory documents brought their existence to light.

The discovery of these additional trials also highlights the
unacceptable state of research ethics: some trialists apparently feel it
is acceptable to conduct experiments on minors, but not to disseminate the
results of this research.

Tom Jefferson, Peter Doshi, Matthew Thompson, Carl Heneghan

References

1. Jefferson T, Doshi P, Thompson M, Heneghan C. Ensuring safe and
effective drugs: who can do what it takes? BMJ. 2011;342:c7258.

2. Li L, Cai B, Wang M, Zhu Y. A double-blind, randomized, placebo-
controlled multicenter study of oseltamivir phosphate for treatment of
influenza infection in China. Chin. Med. J. 2003 Jan;116(1):44-48.

Competing interests: We are authors of the Analysis piece, and the same competing interests statement applies: All authors have completed the unified competing interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare no support from any organisation for the submitted work. In 1998-9, TJ was an ad hoc consultant for Hoffman-La Roche; all authors are co-applicants for a NIHR grant to carry out the Cochrane review.

27 January 2011
Peter Doshi
doctoral student
Tom Jefferson, Matthew Thompson, Carl Heneghan
Massachusetts Institute of Technology