Industry affiliation influence on randomized controlled trials for platelet-rich plasma in the treatment of lateral epicondylitis: a systematic review

Abstract

BackgroundExplicit funding and industry affiliation is believed to potentially impact medical research. There’ve been an increasing number of studies that have evaluated this relationship. The purpose of this study is to determine whether industry affiliation influences the outcomes of randomized controlled trials (RCTs) that investigate the effectiveness of platelet-rich plasma (PRP) on the treatment of lateral epicondylitis. Study DesignSystematic Review. Economic/Decision Analysis. MethodsA search of PubMed, SPORTDiscus, and SCOPUS was performed using the search terms “lateral epicondylitis” and “platelet-rich plasma” as well as “tennis elbow” and “platelet-rich plasma.” Only studies from 2010-present were considered. Final texts were then analyzed for industry affiliation and treatment efficacy. When determining whether a study was industry affiliated, explicit financial supporters of the study, stated conflict of interests, American Academy of Orthopaedic Surgeons (AAOS) disclosures, and the Centers for Medicare & Medicaid Services (CMS) open payments database were assessed. Study outcomes were categorized as favorable, analogous, or unfavorable based on achieving a statically significant (p < 0.05) comparing PRP vs control. ResultsA total of 26 studies were used. Of these, 20 were industry nonaffiliated and 6 were industry affiliated. There were 15 studies (2 affiliated and 13 nonaffiliated) that reported PRP as favorable compared to the comparison (corticosteroid, analogous whole blood, or normal saline). The endpoints were 6 and 12 months after usage of PRP or the comparison. Quantitative data analysis yielded results that weren’t statistically significant between industry nonaffiliated and affiliated groups. The p-values for 6-month VAS, 12-month VAS, 6-month DASH, 12-month DASH, 6-month PRTEE, and 12-month PRTEE were 0.577, 0.635, 0.554, 0.465, 0.273, and 0.157, respectively. ConclusionDespite our results indicating that industry affiliation doesn’t have an impact on outcomes of RCT’s examining the treatment of lateral epicondylitis with PRP, it’s important for future studies to evaluate affiliations when making treatment recommendations.