Asthma Healing

By ERIC NAGOURNEY
Published: November 13, 2007

Inhalers are an effective treatment for asthma and other respiratory diseases, but they can have adverse side effects. The conclusions of studies on these effects apparently depend in part on who pays for the study.

A review of more than 500 studies has found that independently backed studies of the inhalers, formally known as inhaled corticosteroids, are up to four times as likely to find adverse effects as studies paid for by drug companies. The paper appears in the Oct. 22 issue of The Archives of Internal Medicine.

Even randomized clinical trials — the “gold standard” for clinical research — were two and a half times as likely to find adverse effects if a drug company did not pay for the work. Moreover, when authors of studies with drug company financing did report adverse events, they were less likely than authors of independently backed studies to interpret them as clinically significant. But when the researchers did a statistical analysis that eliminated the effect of study design, the disparities were no longer apparent. This suggests that design features chosen before the study begins might lead to a certain kind of finding about adverse effects.

Reviews of drug-company backed studies of other drugs have found similar results.

Many medical journals now require authors to disclose their financial relationships. The senior author of the review, Dr. F. Javier Nieto, professor of population and health studies at the University of Wisconsin, recommended requiring “that the disclosure is made in the abstract, right up front.”