支持批准用于治疗系统性风湿性疾病的药物的RCT中的对照组,2012-2022年
Yang Liu1,2, Yan Xie3, Yunhe Qin4
1Tsinghua Clinical Research Institute, School of Medicine, Tsinghua University, Beijing, China.
JAMA network open
|November 22, 2023
概括
大多数系统性类风湿病药物的随机临床试验缺乏最佳的对照组,需要改进试验设计以准确评估疗效. 这凸显了在药物开发中更好地选择对照组的关键需求.
科学领域:
- 类风湿病学 类风湿病学
- 临床药理学 临床药理学
- 药物开发 药物开发
背景情况:
- 随机临床试验 (RCT) 对于评估创新药物至关重要.
- 最佳的对照组对于准确评估药物疗效至关重要.
- 在系统性风湿性疾病 (SRD) 药物批准的关键RCT中评估对照组质量存在差距.
研究的目的:
- 确定在美国新批准的SRD药物中使用最佳对照组的关键RCT的比例.
- 分析过去十年SRD药物批准试验中的对照组质量.
主要方法:
- 支持FDA批准的SRD药物的关键RCT的分析 (2012年1月 - 2022年10月).
- 评估试验设计,持续时间,对照组和主要终点.
- 对照组质量的评估与已公布的指南相比.
主要成果:
- 在44种SRD药物的65个关键RCT中,只有16个使用了最佳对照组.
- 55项试验缺少活跃对照组,其中85.5%被认为是低于最佳的.
- 在56项全身性关节炎试验中的49项使用了低于最佳的对照 (主要是安慰剂).
结论:
- 在SRD药物批准RCT中,对照组的质量需要显著改善.
- 优先考虑适当的对照组选择对于准确评估创新药物的疗效至关重要.
- 将科学进步转化为临床实践需要强大的试验方法.
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