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Failure to disclose industry funding impacts outcomes in randomized controlled trials of platelet-rich plasma

  • SPORTS MEDICINE
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Platelet-rich plasma (PRP) represents a highly profitable biological therapy. Platelet-rich plasma is widely used to treat musculoskeletal disorders despite mixed evidence of its efficacy. As evidenced by literature from other domains, industry funding may influence the results of clinical trials. The objective of the current study was to determine the association between industry funding and positive results for randomized controlled trials (RCTs) assessing the efficacy of PRP in musculoskeletal disorders.

Methods

A search of four databases was conducted. Included studies were RCTs comparing PRP to any non-PRP comparator in adults (18 years old or over) with musculoskeletal disorders and had full text available in English. Studies were excluded if they were published before 2016 or were non-human trials. A multivariate binomial logistic regression model was created to explore predictors of statistically significant findings. Covariates included the presence of industry funding, sample size, and length of study follow-up. 1440 records were screened with 87 trials included in the final analysis.

Results

Of the 87 studies, 61 (70%) reported a statistically significant primary outcome. The presence of industry funding was not predictive of a statistically significant primary outcome [OR = 0.36, 95% CI 0.096–1.36, (n.s.)]. Studies that did not state whether industry funding was present had a higher chance of reporting a statistically significant primary outcome (OR = 3.61, 95% CI 1.1–11.9, p = 0.035). Sample size and length of follow-up were not predictive of a statistically significant primary outcome.

Conclusion

The results of the current study conclude that industry funding had no impact on the reporting of positive results for RCTs investigating PRP in musculoskeletal disorders. However, not disclosing sources of funding was associated with a higher likelihood of reporting positive results. The results of trials that fail to disclose funding sources should be interpreted with caution in the PRP literature.

Level of evidence

I.

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Abbreviations

RCT:

Randomized controlled trial

PRP:

Platelet-rich plasma

SD:

Standard deviation

IQR:

Interquartile range

OR:

Odds ratio

CI:

Confidence interval

PROM:

Patient reported outcome measure

CoI:

Conflict of interest

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No funding was received in preparation of this manuscript.

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Authors and Affiliations

  1. Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada

    Kaitlyn Chou & Jaydev Vemulakonda

  2. Division of Orthopaedic Surgery, Department of Surgery, McMaster University, St. Joseph’s Hospital, Room G522, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada

    Aaron Gazendam & Mohit Bhandari

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  4. Mohit Bhandari
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All authors contributed to conception and design, acquisition of data, or analysis and interpretation of data for this manuscript. All authors were involved in the drafting or revising of the manuscript and have given it final approval for publication.

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Correspondence to Aaron Gazendam.

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Conflict of interest

MB receives institutional support from the Canadian Institute of Health Research, National Institute of Health, Michael DeGroote Institute for Pain Research and Care and Physicians’ Services Incorporated Foundation.

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Chou, K., Gazendam, A., Vemulakonda, J. et al. Failure to disclose industry funding impacts outcomes in randomized controlled trials of platelet-rich plasma. Knee Surg Sports Traumatol Arthrosc 31, 626–631 (2023). https://doi.org/10.1007/s00167-022-07118-9

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