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Guo W, Zhou Z, Liang Y, Xu C, Zeng L, Dong Z, Mu R. Effects of socio-economic factors on research over systemic sclerosis: an analysis based on long time series of bibliometric data. Orphanet J Rare Dis 2021; 16:517. [PMID: 34930365 PMCID: PMC8686627 DOI: 10.1186/s13023-021-02149-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022] Open
Abstract
Background Systemic sclerosis (SSc) is a rare detrimental disease warranting global research efforts. Evaluating how socio-economic factors impact country research output on SSc could help to identify solutions advancing research. Methods Publication production on SSc during 1969–2018 and data for structural and policy factors for WHO member countries were collected from public sources. Associations between SSc research output and country-level factors were investigated through panel regression. Difference-in-differences analysis further assessed the causal effects of rare disease legislation. Results SSc publications demonstrated exponential growth (r = 0.9410, as against an r = 0.8845 after linear adjustment), but were concentrated in high-income countries (HICs). Ten countries, nine of which were HICs, published 12,261 (77.5%) SSc publications but another 87 countries produced none. Gross domestic products (GDP), population and expenditure on research and development were positively associated with SSc publications (p < 0.001). Higher health expenditure was only found to be associated with increased SSc publications in HICs (p < 0.001). Rare disease legislation increased annual publication production by 62.8% (95% CI 0.390–0.867; p < 0.001) averagely. In middle-income countries (MICs), the effect was especially swift and lasting. No significant impact was found with GDP per capita, female percentage, and political indicators. Conclusions SSc research output increased over time with substantial country disparities. Effective health policies facilitating research should be expanded especially among MICs to accelerate research advancement. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-02149-w.
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Affiliation(s)
- Wei Guo
- Department of Rheumatology and Immunology, Peking University Third Hospital, 49 North Hua Yuan Road, Hai Dian District, Beijing, 100191, China
| | - Zeyu Zhou
- School of Economics, Peking University, 5 Yi He Yuan Road, Hai Dian District, Beijing, 100871, China
| | - Yinhe Liang
- School of Economics, Central University of Finance and Economics, Beijing, China
| | - Chuanhui Xu
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Lin Zeng
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Zhiyong Dong
- School of Economics, Peking University, 5 Yi He Yuan Road, Hai Dian District, Beijing, 100871, China.
| | - Rong Mu
- Department of Rheumatology and Immunology, Peking University Third Hospital, 49 North Hua Yuan Road, Hai Dian District, Beijing, 100191, China.
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Iudici M, Jarlborg M, Lauper K, Müller-Ladner U, Smith V, Allanore Y, Balbir-Gurman A, Doria A, Airò P, Walker UA, Riccieri V, Vonk MC, Gabrielli A, Hoffmann-Vold AM, Szücs G, Martin T, Distler O, Courvoisier DS. Representativeness of Systemic Sclerosis Patients in Interventional Randomized Trials: an analysis of the EUSTAR database. Rheumatology (Oxford) 2021; 61:743-755. [PMID: 33989387 DOI: 10.1093/rheumatology/keab437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/10/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To estimate the extent of and the reasons for ineligibility in randomized controlled trials (RCTs) of systemic sclerosis (SSc) patients included in the EUSTAR database, and to determine the association between patient's features and generalizability of study results. METHODS We searched Clinicaltrials.gov for all records on interventional SSc-RCTs registered from January 2013 to January 2018. Two reviewers selected studies, and information on the main trial features were retrieved. Data from 8046 patients having a visit in the EUSTAR database since 2013 were used to check patient's eligibility. The proportion of potentially eligible patients per trial, and the risk factors for ineligibility were analyzed. Complete-, worst- and best-case analyses were performed. RESULTS Of the 37 RCTs included, 43% were conducted in Europe, 35% were industry-funded, and 87% investigated pharmacological treatments. Ninety-one percent of 8046 patients included could have participated in at least one RCT. In complete-case analysis, the median [range] proportion of eligible patients having the main organ complication targeted by each study was 60% [10-100] in the overall sample of trials, ranging from 50% [32-79] for trials on skin fibrosis to 90% [34-77] for those targeting Raynaud's phenomenon. Among the criteria checked, treatment- and safety-related but not demographic were the main barriers to patient's recruitment. Older age, absence of Raynaud's phenomenon, and lower mRSS were independently associated with the failure to fulfill criteria for any of the included studies. CONCLUSIONS Patient's representativeness in SSc-RCTs is highly variable and is driven more by treatment- and safety-related rather than demographic criteria.
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Affiliation(s)
- Michele Iudici
- Rheumatology Unit, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Matthias Jarlborg
- Rheumatology Unit, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Kim Lauper
- Rheumatology Unit, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Ulf Müller-Ladner
- Justus-Liebig-University of Giessen, Campus Kerckhoff, Bad Nauheim, Germany
| | - Vanessa Smith
- Department of Internal Medicine, Ghent University, Ghent, Belgium.,Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center (IRC), Ghent, Belgium
| | - Yannick Allanore
- Service de Rhumatologie, Cochin Hospital, APHP, Paris Descartes University, Paris, France
| | | | - Andrea Doria
- Department of Rheumatology, University of Padova, Padova, Italy
| | - Paolo Airò
- Rheumatology and Clinical Immunology, Spedali Civili, Brescia, Italy
| | - Ulrich A Walker
- Department of Rheumatology, University Hospital Basel, Basel, Switzerland
| | - Valeria Riccieri
- Dipartimento di Scienze Cliniche Internistiche Anestesiologiche e Cardiovascolari, Sapienza University of Rome, Rome, Italy
| | - Madelon C Vonk
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | - Gabriella Szücs
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Thierry Martin
- Clinical immunology department, Hôpitaux Universitaires de Strasbourg, Centre National de Référence des Maladies Systémiques et Auto-immunes Rares Grand-Est Sud-Ouest (RESO), Strasbourg, France
| | - Oliver Distler
- Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Delphine S Courvoisier
- Rheumatology Unit, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
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