British MPs raise alarm over drug trials, say only half data published
by alethoRT | January 5, 2014
British
MPs have voiced concern that doctors and researchers are being denied
access to around half the results from all clinical trials. An
influential parliamentary committee has condemned the selectiveness as
damaging medicine as a whole.
This
apparently standard practice of withholding critical medical test
information impairs decision-making by professionals, worsens patients’
treatment and prevents independent assessment of medicines, the MPs wrote. And the practice, they say, dates back all the way to the 1980s.
In
the report, the MPs write that they are “surprised and concerned to
discover that information is routinely withheld from doctors and
researchers about the methods and results of clinical trials on
treatments currently prescribed in the United Kingdom. This problem has
been noted for many years in the professional academic literature, with
many promises given, but without adequate action being taken by
government, industry or professional bodies.”
“This
has ramifications for the whole of medicine. The ability of doctors,
researchers and patients to make informed decisions about treatments is
being undermined,” said Richard Bacon, a senior member on the committee
that published the report.
The
MPs argue that this is a great problem also because the issue of access
to clinical trials from previous years is absent from all new
proposals. And test results on humans provide researchers with key
evidence to support or oppose the use of a given medicine. There are
unprecedented dangers when this framework is not operating as intended,
they said.
Compounding
the problem further, MPs say, is that aside from the non-publication of
all clinical trial tests, for some reason positive results started
popping up twice as much as negative ones. This is bad when all trial
results on all uses of all chemicals should be provided, the report
argues.
As
a result, the committee’s MPs have given strong recommendations to the
government and the country’s health bodies – among them, firstly, that
the full results of clinical trials from now on be disseminated to all
doctors and researchers in the UK, with full audits carried out
regularly to check for transgressions; and secondly, that the Department
of Health and the Medicines and Healthcare products Regulatory Agency
(MHRA) ensure that all past and future trial results and the methods
used to achieve them be published in a unified register for further use.
Bacon
expressed alarm that the absence of past results invariably impact
doctors’ decisions on treatment. “Regulators and the industry have made
proposals to open up access, but these do not cover the issue of access
to the results of trials in the past which bear on the efficacy and
safety of medicines in use today," he said.
The
worrying implication here is that so much medicine has been tested and
approved over the past few decades, but only half of it we know the full
truth about, it turns out.
One
particular medicine that became a focus for alarm was Tamiflu – the
popular flu medicine that gained popularity in 2009-10 during the great
flu pandemic. Apparently, the UK Department of Health, without having
access to exhaustive information on the medicine, had made a
424-million-pound decision to stockpile it between the years 2006-7 and
2012-13.
That
kind of attitude, the MPs argue, is predicated on judgment, rather than
real science. There is still no agreement on how the popular medicine
works and disagreement on whether full information was provided to
regulators by the MHRA during the licensing process. As it turns out
from studies conducted by the non-profit NGO, Cochrane Collaboration,
Tamiflu “did not reduce influenza-related lower respiratory tract
complications.”
The
organization is now in talks with Roche to receive the full details of
Tamiflu’s testing, which will be included in a thorough upcoming review
on its effectiveness. Both the government and the medical bodies will
take part, as MPs share the think tank’s concern when it wrote that “we
find it perplexing that the regulators continue to state that they had
all the available evidence.”
Regarding
Tamiflu and the wider practice as a whole, Bacon recommended that
“before spending money in future to maintain the stockpile, the
department needs to review what level of coverage is appropriate. It
should look at the level of stockpiling in other countries, bearing in
mind that the patent for the medicine runs out in 2016."

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