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dc.contributor.authorBourgeois, Florence
dc.contributor.authorHong, Kyungwan
dc.contributor.authorLee, Haeyoung
dc.contributor.authorShamseer, Larissa
dc.contributor.authorSpence, O'Mareen
dc.contributor.authorJefferson, Tom
dc.contributor.authorDoshi, Peter
dc.contributor.authorJones, Mark A., B.Sc., Ph.D.en_US
dc.date.accessioned2020-07-01T12:54:26Z
dc.date.available2020-07-01T12:54:26Z
dc.date.issued2020-03-17
dc.identifier.urihttp://hdl.handle.net/10713/13213
dc.description.abstractPurpose: Trustworthy reporting of quadrivalent human papillomavirus (HPV) vaccine trials is the foundation for assessing the vaccine’s risks and benefits. However, several pivotal trial publications incompletely reported important methodological details and inaccurately described the formulation that the control arms received. Under the Restoring Invisible and Abandoned Trials initiative (RIAT), we aim to restore the public record regarding the content and rationale of the controls used in the trials. Methods: We assembled a cohort (five randomised controlled trials) described as placebo-controlled using clinical study reports (CSRs) obtained from the European Medicines Agency. We extracted the content and rationale for the choice of control used in each trial across six data sources: trial publications, register records, CSR synopses, CSR main bodies, protocols and informed consent forms. Results: Across data sources, the controlwas inconsistently reported as ‘placebo’- containing aluminium adjuvant (sometimes with dose information). Amorphous aluminium hydroxyphosphate sulfate (AAHS) was not mentioned in any trial registry entry, but was mentioned in all publications and CSRs. In three of five trials, consent forms described the control as an ‘inactive’ substance. No rationale for the selection of the control was reported in any trial publication, register, consent form, CSR synopsis or protocol. Three trials reported the rationale for choice of control in CSRs: to preserve blinding and assess the safety of HPV virus-like particles as the ‘safety profile of (AAHS) is well characterised’. Conclusions: The stated rationale of using AAHS control—to characterise the safety of the HPV virus-like particles—lacks clinical relevance. A nonplacebo control may have obscured an accurate assessment of safety and the participant consent process of some trials raises ethical concerns. Trial registration numbers NCT00092482, NCT00092521, NCT00092534, NCT00090220, NCT00090285.en_US
dc.description.sponsorshipLaura and John Arnold Foundationen_US
dc.description.urihttps://doi.org/10.1136/bmjebm-2019-111331en_US
dc.language.isoenen_US
dc.publisherBMJen_US
dc.relation.ispartofBMJ Evidence-Based Medicineen_US
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectAAHSen_US
dc.subjectamorphous aluminum hydroxyphosphate sulfateen_US
dc.subjectqHPVen_US
dc.subjectquadrivalent human papillomavirus vaccineen_US
dc.subjectRestoring Invisible and Abandoned Trialsen_US
dc.subjectRIATen_US
dc.subject.meshAdjuvants, Pharmaceuticen_US
dc.subject.meshPapillomavirus Vaccinesen_US
dc.subject.meshPlacebosen_US
dc.subject.meshRandomized Controlled Trials as Topic--ethicsen_US
dc.titleAdjuvant-containing control arms in pivotal quadrivalent human papillomavirus vaccine trials: restoration of previously unpublished methodologyen_US
dc.typeArticleen_US
dc.identifier.doi10.1136/bmjebm-2019-111331
dc.source.journaltitleBMJ Evidence-Based Medicine
dc.source.beginpagebmjebm
dc.source.endpage2019


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