Thrombolysis for Acute Myocardial Infarction: Drug Review

David K. Cundiff

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In This Article

Possible Conflict of Interest and Bias

A potential bias arose when corporate sponsors designed and funded randomized studies of thrombolytic agents and then expected to reap a financial return for investors when the studies had the anticipated positive results. Some investigators participating in trials had potential conflicts of interest regarding financial reimbursement for the research as well as future speaking honoraria, pharmaceutical stock appreciation, and further grants for clinical research. Some studies had little or no explicit safeguards against researcher financial conflict of interest.[66] Investigators in the GUSTO trial (SK vs t-PA) addressed this issue by declaring a moratorium on receiving honoraria for speaking engagements, payment for consulting, travel, or reimbursement of any kind from any of the 5 corporate sponsors until 1 year after publication of the results of the trial.[66] This recognition of the problem and moratorium on indirect forms of investigator financial remuneration was a step in the right direction but hardly eliminated potential bias in studies of thrombolytics in treating AMI.

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