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. 2009;4(3):e5092.
doi: 10.1371/journal.pone.0005092. Epub 2009 Mar 31.

Obesity, the endocannabinoid system, and bias arising from pharmaceutical sponsorship

John M McPartland  1
Affiliations

Obesity, the endocannabinoid system, and bias arising from pharmaceutical sponsorship

John M McPartland. PLoS One. 2009.

Abstract

Background: Previous research has shown that academic physicians conflicted by funding from the pharmaceutical industry have corrupted evidence based medicine and helped enlarge the market for drugs. Physicians made pharmaceutical-friendly statements, engaged in disease mongering, and signed biased review articles ghost-authored by corporate employees. This paper tested the hypothesis that bias affects review articles regarding rimonabant, an anti-obesity drug that blocks the central cannabinoid receptor.

Methods/principal findings: A MEDLINE search was performed for rimonabant review articles, limited to articles authored by USA physicians who served as consultants for the company that manufactures rimonabant. Extracted articles were examined for industry-friendly bias, identified by three methods: analysis with a validated instrument for monitoring bias in continuing medical education (CME); analysis for bias defined as statements that ran contrary to external evidence; and a tally of misrepresentations about the endocannabinoid system. Eight review articles were identified, but only three disclosed authors' financial conflicts of interest, despite easily accessible information to the contrary. The Takhar CME bias instrument demonstrated statistically significant bias in all the review articles. Biased statements that were nearly identical reappeared in the articles, including disease mongering, exaggerating rimonabant's efficacy and safety, lack of criticisms regarding rimonabant clinical trials, and speculations about surrogate markers stated as facts. Distinctive and identical misrepresentations regarding the endocannabinoid system also reappeared in articles by different authors.

Conclusions: The findings are characteristic of bias that arises from financial conflicts of interest, and suggestive of ghostwriting by a common author. Resolutions for this scenario are proposed.

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Conflict of interest statement

Competing Interests: The author previously received research and/or salary support from the Cannabinoid Research Institute, a research division of GW Pharmaceuticals (www.gwpharm.com).

References

    1. NIH. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. NIH Publication No. 98-4083. 1998 Available: http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.htm. Accessed Feb 29, 2008.
    1. Strawbridge WJ, Wallhagen MI, Shema SJ. New NHLBI clinical guidelines for obesity and overweight: will they promote health? Am J Public Health. 2000;90:340–343. - PMC - PubMed
    1. Prentice AM, Jebb SA. Beyond body mass index. Obes Rev. 2001;2:141–147. - PubMed
    1. MacPherson K, Silverman E. Fat's overlap. Newark Star-Ledger [Newspaper] Feb 17, 1997 1997
    1. NAASO. Understanding and treating obesity. Obesity On Line. 2004 Available: http://www.obesityonline.org/meetings/treating_obesity/index.cfm#Accredi.... Accessed Dec 10, 2006 [site no longer online]