Differences in an Author’s Conflict of Interest Disclosures

To the Editor: It has been brought to my attention that there were differences in my financial disclosures in a number of articles recently published in JAMA, and this warrants explanation.

The original research report by Preiss et al¹ dealt with statins, and in that article I reported that the TIMI Study Group in which I work has received research support through the Brigham and Women's Hospital from Merck, Astra-Zeneca, and Pfizer, each of which manufactures and sells a statin.

In a Commentary on the role of digoxin,² Dr Gheorghiade and I mention and comment on a wide variety of drugs used in the treatment of heart failure (β-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, aldosterone-blocking agents). Because 1 or more of these agents are manufactured by virtually every pharmaceutical company, I listed all with which I had any connection at that time.

A more recent Commentary was quite general.³ It focused on a pathophysiological approach for assessing patients with heart failure. The drugs mentioned are generic—nitroglycerin, dobutamine, and esmolol—and I did not perceive a possible conflict of interest.

In a recent Editorial on reductions in heart failure hospitalizations,⁴ Dr Gheorghiade and I mention eplerenone and tolvaptan. The former is manufactured by Pfizer, from which we no longer receive any support. The latter is manufactured by Otsuka, with which I have had no contact. Again, I did not perceive any conflict of interest.

However, the relationships present during the 36 months prior to submission of the latter 2 articles include research support from Merck, AstraZeneca, Johnson & Johnson, Beckman Coulter, Eli Lilly, Roche Diagnostics, sanofi-aventis, Daiichi Sankyo, GlaxoSmithKline, Bristol-Myers Squibb, and Pfizer as well as participation in symposia, advisory board meetings, and/or consultancies for the following companies: Eli Lilly, Merck, Genzyme, Amorcyte, CVRx (no compensation), The Medicines Company, CV Therapeutics, Daiichi Sankyo, MC Communications, Ortho McNeil, Ikaria, Menarini International, CardioRentis, and sanofi-aventis.

These were not listed because I did not consider them to be relevant to these 2 articles. I did not understand that all financial interests, regardless of their perceived relevance, had to be disclosed. I now understand the requirements for financial disclosure.

I hope that this clears up any possible misunderstanding.