Conclusions
All the authors of CPG for rheumatoid arthritis developed by the Japan
College of Rheumatology received personal payments from the
pharmaceutical companies five years before its publication. The total
amounts of personal payments were more than $3.6 million.
Non-disclosure of financial COIs and the low quality of evidence
supporting the majority of recommendations in the CPG raise significant
ethical and clinical concerns. These findings call for immediate policy
interventions to enhance the transparency, integrity, and reliability of
clinical practice guidelines in rheumatology in Japan.