Evidence mapPaperPMID 40563069Full record

ArticlePharmaceutical medicine2025

Safety Warnings on the Same Harmful Effects of Medicines: A Comparison of Four National Regulators.

Lucy T Perry, Alice Bhasale, Ashleigh Hooimeyer, Eliza J McEwin, Annim Mohammad, Barbara Mintzes

Abstract readComparative Study
In one paragraph

Article in Pharmaceutical medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Lucy T PerrySchool of Pharmacy and Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, D17 John Hopkins Drive, Camperdown, NSW, 2006, Australia. lper0180@uni.sydney.edu.au.ORCID 0000-0002-3337-1321
Alice BhasaleSchool of Pharmacy and Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, D17 John Hopkins Drive, Camperdown, NSW, 2006, Australia.ORCID 0000-0002-5387-8760
Ashleigh HooimeyerSchool of Pharmacy and Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, D17 John Hopkins Drive, Camperdown, NSW, 2006, Australia.ORCID 0000-0002-8526-1837
Eliza J McEwinSchool of Pharmacy and Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, D17 John Hopkins Drive, Camperdown, NSW, 2006, Australia.ORCID 0000-0003-2225-3474
Annim MohammadSchool of Pharmacy and Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, D17 John Hopkins Drive, Camperdown, NSW, 2006, Australia.ORCID 0000-0003-3744-2219
Barbara MintzesSchool of Pharmacy and Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, D17 John Hopkins Drive, Camperdown, NSW, 2006, Australia.ORCID 0000-0002-8671-915X

Funding

CIHR PJT-153275National Health and Medical Research Council APP 1122332
6 · The paper itself

Abstract

backgroundSafety advisories provide critical information to clinicians and patients on the harms of medicines. Previous research has shown that national regulators vary in their decisions to issue safety warnings. However, it is not known whether clinicians receive similar information when regulators communicate about the same medicines' harms.

aimOur aim was to assess whether content provided to clinicians in safety advisories on risk, fatal outcomes, evidence and clinician advice was comparable.

methodsThis retrospective content analysis examines safety advisories issued by the Australian Therapeutic Goods Administration, Health Canada, the United Kingdom Medicines and Healthcare products Regulatory Agency, and the US Food and Drug Administration between 2007 and 2016. Content was extracted from advisories issued on the same medicine and harm (n = 40), including evidence, risk quantification, fatal outcomes and clinician advice. A case study on pioglitazone and bladder cancer illustrates differences in regulatory communications.

resultsVariation was seen in the detail and presentation of information on evidence, deaths, risk quantification and advice to clinicians. Specific advice to clinicians was provided in 70% (96/155) of advisories with no significant differences between regulators (p = 0.19). Evidence of harm was presented in 81% (130/160) of advisories and risk quantification in 61% (98/160). The type of evidence presented and directness of information differed however. In the pioglitazone case study, for example, regulators differed in how bladder cancer risks were characterised and advice provided.

conclusionsOur analysis of safety advisories on the same harms of medicines indicates that while regulators provide similar content elements in safety advisories, risk messages to clinicians vary. This may lead to differences in knowledge and awareness between countries and potentially impact public health outcomes. Further transparency around regulatory decisions on safety advisories is needed.

Indexed as

Drug LabelingDrug-Related Side Effects and Adverse ReactionsAustraliaCanadaHumansRetrospective StudiesUnited KingdomUnited StatesUnited States Food and Drug Administration

Identifiers

PMID40563069
PMCPMC12443859

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.