Objective:
To assess the financial relationships between pharmaceutical companies and authors of the 2020 Japan College of Rheumatology Clinical Practice Guideline for the Management of Rheumatoid Arthritis and to evaluate the quality of evidence supporting the guideline recommendations.
Methods:
This cross-sectional 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 database and each pharmaceutical company. The quality of evidence supporting the CPG recommendations was also assessed.
Results :
All 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 strong recommendations, 66.7% were supported by low or very low-quality evidence.
Conclusion :
Despite that all CPG authors received substantial amounts of personal payments from pharmaceutical companies, these 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 clinical practice guidelines in Japan.