Results of Randomized Controlled Trials of Platelet-Rich Plasma in Lower Extremity Tendinopathy Are Not Influenced By Industry Sponsorship

Abstract

To determine whether industry affiliation influences the results of randomized controlled trials (RCTs) studying the use of platelet-rich plasma (PRP) for the treatment of patellar or Achilles tendinopathy. PubMed, Scopus, Cochrane, and Medline databases were searched in July 2023 for RCTs published between 2009 and July 2023 investigating PRP for treatment of patellar or Achilles tendinopathy. Industry affiliation (IA) was determined by analyzing each study's funding or conflict of interest section. Author disclosures were searched on The American Academy of Orthopaedic Surgeons (AAOS) disclosure database and the Centers for Medicare & Medicaid Services open payments database. An IA designation was given if an author had a relevant disclosure or if the company funding the study manufactured PRP. Otherwise, a non-industry affiliated (NIA) designation was given. Fisher exact analysis was used to determine if PRP had a favorable, no significant, or unfavorable effect on outcome. Analysis was done on 22 studies (10 IA and 12 NIA), with 17 (77.3%) studies reporting a conflict of interest or funding for the research, 4 (18.2%) reporting no conflict of interest, and 1 (4.5%) with no reporting. Of the 22 included studies, 8 (36.4%) reported favorable outcomes regarding PRP utilization and 14 (63.6%) reported no significant effect. Favorable outcomes were found in 4 (40.0%) of the 10 IA studies and no significant effect was reported in 6 (60.0%). The 12 NIA studies included 4 (33.3%) with favorable results and 8 (66.7%) with no significant effect. The comparison between industry affiliation and results reported was not statistically significant (p = 1). Results of RCTs evaluating use of PRP on lower extremity tendinopathy were not influenced by industry sponsorship. The majority of biomedical research is funded through industry sponsorship. While this relationship is necessary as technologies are developed, it is important to scrutinize studies for evidence of industry bias to understand how this bias may be affecting study results published in the literature.