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Schütz H, Burger DA, Cobo E, Dubins DD, Farkás T, Labes D, Lang B, Ocaña J, Ring A, Shitova A, Stus V, Tomashevskiy M. Group-by-Treatment Interaction Effects in Comparative Bioavailability Studies. AAPS J 2024; 26:50. [PMID: 38632178 DOI: 10.1208/s12248-024-00921-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Abstract
Comparative bioavailability studies often involve multiple groups of subjects for a variety of reasons, such as clinical capacity limitations. This raises questions about the validity of pooling data from these groups in the statistical analysis and whether a group-by-treatment interaction should be evaluated. We investigated the presence or absence of group-by-treatment interactions through both simulation techniques and a meta-study of well-controlled trials. Our findings reveal that the test falsely detects an interaction when no true group-by-treatment interaction exists. Conversely, when a true group-by-treatment interaction does exist, it often goes undetected. In our meta-study, the detected group-by-treatment interactions were observed at approximately the level of the test and, thus, can be considered false positives. Testing for a group-by-treatment interaction is both misleading and uninformative. It often falsely identifies an interaction when none exists and fails to detect a real one. This occurs because the test is performed between subjects in crossover designs, and studies are powered to compare treatments within subjects. This work demonstrates a lack of utility for including a group-by-treatment interaction in the model when assessing single-site comparative bioavailability studies, and the clinical trial study structure is divided into groups.
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Affiliation(s)
- Helmut Schütz
- Center for Medical Data Science of the Medical University of Vienna, 1090, Vienna, Austria.
- Faculty of Pharmacy, Universidade de Lisboa, 1649-004, Lisbon, Portugal.
- BEBAC, Neubaugasse 36/11, 1070, Vienna, Austria.
| | - Divan A Burger
- University of Pretoria, Pretoria, South Africa
- Syneos Health, Bloemfontein, South Africa
| | - Erik Cobo
- Department of Statistics and Operations Research, Universitat Politecnica de Catalunya, Barcelona, Catalunya, Spain
| | - David D Dubins
- Leslie Dan Faculty of Pharmacy, Toronto, Ontario, Canada
| | | | | | - Benjamin Lang
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany
| | - Jordi Ocaña
- Department of Genetics, Microbiology and Statistics, Universitat de Barcelona, Barcelona, Catalunya, Spain
| | - Arne Ring
- University of the Free State, Bloemfontein, South Africa
- Hexal - a Sandoz Brand, Holzkirchen, Germany
| | | | - Volodymyr Stus
- Zakłady Farmaceutyczne Polpharma S.A., Starogard Gdanski, Poland
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