Data show no evidence that chronic disease treatment efficacies depend on number of comorbidities plos plosmedicine
rarely report whether the efficacy of treatment differs by the number of comorbidities or the presence of specific comorbidities.
In the new study, the researchers used existing data from 120 industry-sponsored randomized controlled phase 3 and 4 clinical trials carried out between 1990 and 2017. The dataset included a total of 128,331 participants and spanned 23 common long-term conditions, including asthma, diabetes, hypertension, osteoporosis, and migraine.
Across trials, the percentage of participants with three or more comorbidities ranged from 2.3% to 57% . Overall, the new study found no evidence of comorbidities modifying treatment efficacy across any of the 23 conditions studied. However, the authors noted that the trials were not designed to assess variation in treatment efficacy by comorbidity.
"The standard assumption used in evidence syntheses is that efficacy is constant across subgroups, although this is often criticized," the authors say."Our findings suggest that for modest levels of comorbidities, this assumption is reasonable." Co-author Peter Hanlon adds,"Many people live with multiple long-term conditions, however deciding on the most appropriate treatment for these people is often challenging becauserarely report whether treatments work as well in people with multiple conditions and clinical guidelines rarely address the specific needs of these people.
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