Purpose Accuracy and usefulness of drug advertisements in medical journals have been controversial for over 100 years. In previous studies of antihypertensive and lipid-lowering drug advertisements, only 45% of claims were substantiated by compelling evidence (RCT - randomized control trials, or better) and 18% were irretrievable. We attempted to verify the quality of claims in advertisements published in three rheumatologic journals and examine the level of evidence and relevance of references to determine the truth in advertising.
Methods A consecutive 12-month sample of advertisements in 3 rheumatologic journals, from the United States (Arthritis and Rheumatism), Canada (Journal of Rheumatology), and the United Kingdom (Annals of the Rheumatic Diseases) was reviewed to determine how research results were presented in pharmaceutical advertisements.
Results We identified 44 different advertisements for 19 different rheumatic drugs. Overall, 6% (Annals of the Rheumatic Diseases) to 8% (Arthritis and Rheumatism, Journal of Rheumatology) of all journal pages consisted of advertisements. Mean number of pages per advertisements was 3.2 with biologic advertisements averaging 4 pages. Almost half (47%) of advertisements were for biologic agents, compared to bisphosphonates (12.5%), COX-2/NSAIDs (21%) secretagogues (9%), nonbiologic DMARDs (MTX and LEF) (2%), and viscosupplementation (1%). Over half (58%) of the advertising claims were supported by RCTs. One hundred percent of RCTs cited as references were funded by the sponsoring pharmaceutical company. Almost half (45%) of advertisements only presented one claim. One-quarter (25%) of claims were not substantiated by the references cited. Ten percent of claims quoted prescribing information as their primary reference in addition to "data on file. " References cited as "data on file " were unable to be retrieved 16% of the time, and 3.4% of claims were unsupported by any reference.
Conclusions Our audit demonstrates inadequate accuracy and usefulness of drug advertisments, similar to previous studies of nonrheumatic pharmaceutical advertising. Physicians should be cautious in assessment of advertised claims when many references cited are not RCTs and appear to be evidence based.
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