Conflicts of interest reporting in trials and guidelines addressing corticosteroid injections for knee osteoarthritis.

OBJECTIVE: This study aimed to characterize conflict of interest disclosure practices in trials and guidelines recommending corticosteroid injections for knee osteoarthritis. METHODS: Three databases (Cumulative Index to Nursing and Allied Health Literature, Ovid MEDLINE ALL, and Embase) were queried for randomized controlled trials from inception to April 2025 that assessed corticosteroid injection treatment effect for knee osteoarthritis. Clinical practice guidelines were retrieved from a recent systematic review. Study details, authors, affiliations, and conflict of interest disclosures were extracted. Transparency and appropriateness with addressing disclosures were assessed for every manuscript and disclosures were examined and compared with three national public conflict of interest disclosure databases. All conflicts were categorized and proportions calculated. RESULTS: Seventy-five trials and 14 guidelines were included. Twenty-nine percent of trials (n=22) and 14.3% of guidelines (n=2) had no conflict of interest statement. Ten trials (13.3%) and six guidelines (42.9%) reported a conflict of interest for at least one author. Eleven trials (14.7%) and six guidelines (42.9%) had discrepancies between disclosures in manuscripts versus reports in public databases. Forty-three trial authors (34.1%) and 19 (9.4%) guideline authors had discrepancies between disclosures in the manuscripts versus public databases. CONCLUSION: Conflict of interest reporting practices in trials and guidelines assessing effectiveness of corticosteroid injections for knee osteoarthritis are poor with a lack of transparency. Quality and thoroughness with reporting conflicts of interest is necessary to best understand industry influence on treatment recommendations.

Duke Scholars

Author Daniel I. Rhon Orthopaedic Surgery