Researchers say drug companies should disclose adverse events before licensing

Following the withdrawal of the painkiller and anti-inflammatory drug rofecoxib (Vioxx), researchers writing in the British Medical Journal argued that patients would be safer if drug companies disclosed adverse events before licensing.

Single phase drug trials are simply not big enough to detect relatively uncommon but important adverse events, which may affect large numbers of people in routine clinical use, wrote Paul Dieppe and colleagues.

Furthermore, the impact of undetected adverse events is likely to be made worse if widely marketed new drugs are prescribed haphazardly and rapidly to large numbers of people. Within five months of the launch of rofecoxib, more than 42,000 patients had been prescribed the drug in England alone.

To prevent further similar episodes, drug companies should be legally required to make all data on serious adverse events from clinical studies available to the public immediately after completion of the research, said the authors. This will allow independent, timely, and updated systematic reviews of serious adverse events.

They also suggest phased introduction of new drugs in independent, large-scale, randomized trials before licensing, together with better post-marketing surveillance.

“Although these measures will not be popular with pharmaceutical companies, they will limit the numbers of patients exposed to unknown hazards and provide robust and unbiased evidence on adverse events before a drug is fully licensed,” they concluded.

SOURCE: “Lessons from the withdrawal of rofecoxib,” Paul A Dieppe, et al., British Medical Journal, Oct. 16, 2004.