An overview of methodological flaws of real-world studies investigating drug safety in the post-marketing setting

Expert Opin Drug Saf. 2023 Jan-Jun;22(5):373-380. doi: 10.1080/14740338.2023.2219892. Epub 2023 May 29.

Abstract

Introduction: The evaluation of the post-marketing safety profile of drugs is a continuous monitoring process for approved and marketed medicines and it is crucial for detecting new adverse drug reactions. As such, real-world studies are essential to complement pre-marketing evidence with information concerning drug risk-benefit profile and use in wider patient populations and they have a great potential to support post-marketing drug safety evaluations.

Areas covered: A detailed description of the main limitations of real-world data sources (i.e. claims databases, electronic healthcare records, drug/disease registers and spontaneous reporting system databases) and of the main methodological challenges of real-world studies in generating real-world evidence is provided.

Expert opinion: Real-world evidence biases can be ascribed to both the methodological approach and the specific limitations of the different real-world data sources used to carry out the study. As such, it is crucial to characterize the quality of real-world data, by establishing guidelines and best practices for the assessment of data fitness for purpose. On the other hand, it is important that real-world studies are conducted using a rigorous methodology, aimed at minimizing the risk of bias.

Keywords: pharmacoepidemiology; pharmacovigilance; real-world data; real-world evidence; real-world studies.

Publication types

  • Review

MeSH terms

  • Databases, Factual
  • Delivery of Health Care*
  • Drug-Related Side Effects and Adverse Reactions* / epidemiology
  • Humans
  • Pharmacovigilance
  • Product Surveillance, Postmarketing / methods
  • Risk Assessment