Financial Conflicts of Interest Among the Authors of the Clinical Practice Guidelines for Rheumatoid Arthritis in Japan

ObjectiveTo assess the financial relationships between pharmaceutical companies and authors of the 2020 Japan College of Rheumatology Clinical Practice Guidelines (CPG) for the Management of Rheumatoid Arthritis and to evaluate the quality of evidence supporting the guideline recommendations.MethodsThis retrospective study evaluated financial relationships between all 27 authors of the CPG and pharmaceutical companies in Japan. Personal payments from pharmaceutical companies to these authors between 2016 and 2020 were extracted from publicly disclosed databases for each pharmaceutical company. The quality of the evidence supporting the CPG recommendations was also assessed.ResultsAll 27 authors received personal payments from pharmaceutical companies, totaling $3,683,048 over five years. The median and mean payments per author were $101,624 and $136,409, respectively. Speaking compensations accounted for more than 80% of all personal payments. More than 77.8% (21 authors), 66.7% (18 authors), and 51.9% (14 authors) received more than $10,000, $50,000, and $100,000 in total payments over the five years, respectively. Nevertheless, these financial relationships between the CPG authors and pharmaceutical companies were not disclosed. More than 81.8% of the CPG recommendations were supported by low-or very-low-quality evidence. Of the strong recommendations, 66.7% were supported by low-or very-low-quality evidence. ConclusionEven though all CPG authors received substantial amounts of personal payments from pharmaceutical companies, these conflicts of interest (COIs) were not disclosed in the CPG. These findings underscore the urgent need for policy interventions to enhance transparency, integrity, and reliability in the development of CPGs in Japan.

Automated summary

This study assessed the financial relationships between pharmaceutical companies and authors of the Japan College of Rheumatology Clinical Practice Guidelines for the Management of Rheumatoid Arthritis and evaluated the quality of evidence supporting the guideline recommendations. The findings revealed that all authors received substantial personal payments from pharmaceutical companies, but these conflicts of interest were not disclosed in the guidelines. Additionally, the majority of the guideline recommendations were supported by low or very-low-quality evidence.