Are large prospective trials on antidepressants in mental disorders seeding trials? A descriptive study of trials registered on ClinicalTrials.gov

Objectives This descriptive study of registered trials aimed to identify large clinical trials on antidepressants for mental disorders: (1) to assess what proportion could be labelled as ‘seeding trials’ (trials for marketing purposes) and (2) to describe their methodological characteristics and out...

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Main Authors: Ioana-Alina Cristea, Astrid Chevance, Florian Naudet, Daniele Fanelli, Samuel Martineau
Format: Article
Language:English
Published: BMJ Publishing Group 2023-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/8/e062913.full
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author Ioana-Alina Cristea
Astrid Chevance
Florian Naudet
Daniele Fanelli
Samuel Martineau
author_facet Ioana-Alina Cristea
Astrid Chevance
Florian Naudet
Daniele Fanelli
Samuel Martineau
author_sort Ioana-Alina Cristea
collection DOAJ
description Objectives This descriptive study of registered trials aimed to identify large clinical trials on antidepressants for mental disorders: (1) to assess what proportion could be labelled as ‘seeding trials’ (trials for marketing purposes) and (2) to describe their methodological characteristics and outcomes.Design A search was conducted across all trials registered on ClinicalTrials.gov by drug name in March 2017.Setting All trials registered in the database of ClinicalTrials.gov were screened. Large registered studies were received and studies focusing prospectively on the effects of antidepressants in mental health disorders. Specific data items were extracted automatically, and subsequently inspected, corrected and completed by hand.Participants Prospective studies were selected focusing on the effects of antidepressants in any mental health disorder with 800 participants or more planned for inclusion.Main outcome measures Three members from the study team independently assessed the following ‘seeding trial’ characteristics in each registered study: a high level of involvement of the product manufacturer in the study design, in the data analysis and reporting of the study, an abnormally low ratio of patient numbers to study site, spin and/or omissions of clinically relevant findings in the abstracts, and conclusions that focused on secondary endpoints and surrogate markers. Secondary outcomes were the exploration of a functional outcome and suicidality.Results 31 trials were identified from clinical trials database. 18/31 were published (58%). 8 of these 18 (44%) studies were identified as possible seeding trials. 13/31 (42%) large trials planned to explore functioning and 5/31 (16%) suicidality.Conclusions Large trials are rare in the field of antidepressant research. Some could be ‘seeding trials’. Few explored suicidality. Identifying seeding trials from incomplete data entries in registries, especially when almost half of the studies were still unpublished, posed considerable challenges. The delay between our research and publication limits the strength of our conclusions.PROSPERO registration number CRD42017065591.
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spelling doaj-art-f5d7e6764d264eddbb3558d28a7836b32024-11-14T13:45:07ZengBMJ Publishing GroupBMJ Open2044-60552023-08-0113810.1136/bmjopen-2022-062913Are large prospective trials on antidepressants in mental disorders seeding trials? A descriptive study of trials registered on ClinicalTrials.govIoana-Alina Cristea0Astrid Chevance1Florian Naudet2Daniele Fanelli3Samuel Martineau4Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy5 Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, FranceInserm, CIC 1414 (Centre d’Investigation Clinique de Rennes), Rennes 1 University, Rennes, FranceDepartment of Methodology, London School of Economics and Political Science, London, UKUniversity of Rennes, CHU Rennes, Inserm, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, CIC 1414 (Centre of Clinical Investigation of Rennes), Rennes, FranceObjectives This descriptive study of registered trials aimed to identify large clinical trials on antidepressants for mental disorders: (1) to assess what proportion could be labelled as ‘seeding trials’ (trials for marketing purposes) and (2) to describe their methodological characteristics and outcomes.Design A search was conducted across all trials registered on ClinicalTrials.gov by drug name in March 2017.Setting All trials registered in the database of ClinicalTrials.gov were screened. Large registered studies were received and studies focusing prospectively on the effects of antidepressants in mental health disorders. Specific data items were extracted automatically, and subsequently inspected, corrected and completed by hand.Participants Prospective studies were selected focusing on the effects of antidepressants in any mental health disorder with 800 participants or more planned for inclusion.Main outcome measures Three members from the study team independently assessed the following ‘seeding trial’ characteristics in each registered study: a high level of involvement of the product manufacturer in the study design, in the data analysis and reporting of the study, an abnormally low ratio of patient numbers to study site, spin and/or omissions of clinically relevant findings in the abstracts, and conclusions that focused on secondary endpoints and surrogate markers. Secondary outcomes were the exploration of a functional outcome and suicidality.Results 31 trials were identified from clinical trials database. 18/31 were published (58%). 8 of these 18 (44%) studies were identified as possible seeding trials. 13/31 (42%) large trials planned to explore functioning and 5/31 (16%) suicidality.Conclusions Large trials are rare in the field of antidepressant research. Some could be ‘seeding trials’. Few explored suicidality. Identifying seeding trials from incomplete data entries in registries, especially when almost half of the studies were still unpublished, posed considerable challenges. The delay between our research and publication limits the strength of our conclusions.PROSPERO registration number CRD42017065591.https://bmjopen.bmj.com/content/13/8/e062913.full
spellingShingle Ioana-Alina Cristea
Astrid Chevance
Florian Naudet
Daniele Fanelli
Samuel Martineau
Are large prospective trials on antidepressants in mental disorders seeding trials? A descriptive study of trials registered on ClinicalTrials.gov
BMJ Open
title Are large prospective trials on antidepressants in mental disorders seeding trials? A descriptive study of trials registered on ClinicalTrials.gov
title_full Are large prospective trials on antidepressants in mental disorders seeding trials? A descriptive study of trials registered on ClinicalTrials.gov
title_fullStr Are large prospective trials on antidepressants in mental disorders seeding trials? A descriptive study of trials registered on ClinicalTrials.gov
title_full_unstemmed Are large prospective trials on antidepressants in mental disorders seeding trials? A descriptive study of trials registered on ClinicalTrials.gov
title_short Are large prospective trials on antidepressants in mental disorders seeding trials? A descriptive study of trials registered on ClinicalTrials.gov
title_sort are large prospective trials on antidepressants in mental disorders seeding trials a descriptive study of trials registered on clinicaltrials gov
url https://bmjopen.bmj.com/content/13/8/e062913.full
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