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The quality of reporting of phase II and III trials for new antipsychotics: a systematic review

Published online by Cambridge University Press:  02 June 2014

M. X. Patel ,
S. Collins ,
J. Hellier ,
G. Bhatia  and
R. M. Murray
M. X. Patel*
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
S. Collins
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
J. Hellier
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
G. Bhatia
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
R. M. Murray
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
*
* Address for correspondence: Dr M. X. Patel, Department of Psychosis Studies, PO Box 68, Institute of Psychiatry, King's College London, 16 De Crespigny Park, London SE5 8AF, UK. (Email: [email protected])
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Abstract

Background

The findings of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study and the Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS) called previous trials of antipsychotics into question, including pre-licensing trials. Concerns regarding methodological robustness and quality of reporting increased. This systematic review aimed to examine the quality of reporting of phase II and III trials for new antipsychotics in the aftermath of the CATIE and CUtLASS studies.

Method

Electronic searches were conducted in EMBASE, Medline and Cochrane databases and also ClinicalTrials.gov for antipsychotic trials (published between January 2006 and February 2012). Phase II and III randomized controlled trials (RCTs) for iloperidone, asenapine, paliperidone, olanzapine, lurasidone and pomaglumetad methionil were selected for schizophrenia and schizoaffective disorder. The reporting of the methodology was evaluated in accordance with Consolidated Standards of Reporting Trials (CONSORT) guidelines.

Results

Thirty-one articles regarding 32 studies were included. There was insufficient reporting of design in 47% of studies and only 13% explicitly stated a primary hypothesis. Exclusion criteria were poorly reported for diagnosis in 22% of studies. Detail regarding comparators, particularly placebos, was suboptimal for 56% of studies, and permitted concomitant medication was often not reported (19%). Randomization methods were poorly described in 56% of studies and reporting on blinding was insufficient in 84% of studies. Sample size calculations were insufficiently reported in 59% of studies.

Conclusions

The quality of reporting of phase II and III trials for new antipsychotics does not reach the standards outlined in the CONSORT guidelines. Authors often fail to adequately report design and methodological processes, potentially impeding the progress of research on antipsychotic efficacy. Both policymakers and clinicians require high quality reporting before decisions are made regarding licensing and prescribing of new antipsychotics.

Keywords

Antipsychotic agentsclinical trialsCONSORTmethodologyschizophreniasystematic review
Type
Review Articles
Information
Psychological Medicine , Volume 45 , Issue 3 , February 2015 , pp. 467 - 479
Copyright
Copyright © Cambridge University Press 2014 

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