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Closeout of the HALT-PKD trials
Charity G Moore1, Susan Spillane2, Gertrude Simon3
1Carolinas HealthCare System, Charlotte, NC, USA.
Background:
The HALT Polycystic Kidney Disease Trials Network consisted of two randomized, double blind, placebo-controlled trials among patients with autosomal dominant polycystic kidney disease. The trials involved 5-8years of participant follow-up with interventions in blood pressure and antihypertensive therapy. We provide a framework for designing and implementing closeout near the end of a trial while ensuring patient safety and maintaining scientific rigor and study morale.
Methods:
We discuss issues and resolutions for determining the last visit, tapering medications, and unblinding of participants to study allocation and results. We also discuss closure of clinical sites and Data Coordinating Center responsibilities to ensure timely release of study results and meeting the requirements of regulatory and funding authorities.
Results:
Just over 90% of full participants had a 6-month study visit prior to their last visit preparing them for trial closeout. Nearly all patients wanted notification of study results (99%) and treatment allocation (99%). All participants were safely tapered off study and open label blood pressure medications. Within 6months, the trials were closed, primary papers published, and 805 letters distributed to participants with results and allocation. DCC obligations for data repository and clinicaltrials.gov reporting were completed within 12months of the last study visit.
Conclusions:
Closeout of our trials involved years of planning and significant human and financial resources. We provide questions for investigators to consider when planning closeout of their trials with focus on (1) patient safety, (2) dissemination of study results and (3) compliance with regulatory and funding responsibilities.
Insights
Planning successful clinical trial closeouts for autosomal dominant polycystic kidney disease (ADPKD) trials requires careful attention to patient safety, result dissemination, and regulatory compliance. This framework ensures a smooth transition and ethical conclusion for participants and researchers.
Area of Science:
- Nephrology
- Clinical Trials
- Pharmacology
Background:
- Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder.
- The HALT Polycystic Kidney Disease Trials Network conducted two large-scale, randomized, placebo-controlled trials.
- These trials focused on blood pressure management and antihypertensive therapy over 5-8 years.
Purpose of the Study:
- To provide a framework for designing and implementing clinical trial closeouts.
- To ensure patient safety, scientific rigor, and study morale during trial termination.
- To address logistical and ethical considerations for ending large clinical trials.
Main Methods:
- Discussed issues and resolutions for determining final participant visits.
- Outlined procedures for medication tapering and participant unblinding.
- Detailed Data Coordinating Center responsibilities for site closure and results dissemination.
Main Results:
- Over 90% of participants completed a pre-closeout visit.
- Nearly all participants (99%) desired notification of study results and treatment allocation.
- All participants were safely tapered off medications; trials closed, papers published, and results distributed within 6 months.
Conclusions:
- Clinical trial closeout requires extensive planning and resources.
- Key considerations include patient safety, timely dissemination of findings, and regulatory compliance.
- A structured approach ensures ethical and efficient trial termination.
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