1
|
Moorthy V, Abubakar I, Qadri F, Ogutu B, Zhang W, Reeder J, Farrar J. The future of the global clinical trial ecosystem: a vision from the first WHO Global Clinical Trials Forum. Lancet 2024; 403:124-126. [PMID: 38128557 DOI: 10.1016/s0140-6736(23)02798-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Vasee Moorthy
- Science Division, World Health Organization, 1211 Geneva, Switzerland.
| | | | - Firdausi Qadri
- icddr,b (International Centre for Diarrhoeal Disease Research), Dhaka, Bangladesh
| | | | - Wei Zhang
- Science Division, World Health Organization, 1211 Geneva, Switzerland
| | - John Reeder
- Science Division, World Health Organization, 1211 Geneva, Switzerland
| | - Jeremy Farrar
- Science Division, World Health Organization, 1211 Geneva, Switzerland
| |
Collapse
|
2
|
Koenig F, Spiertz C, Millar D, Rodríguez-Navarro S, Machín N, Van Dessel A, Genescà J, Pericàs JM, Posch M. Current state-of-the-art and gaps in platform trials: 10 things you should know, insights from EU-PEARL. EClinicalMedicine 2024; 67:102384. [PMID: 38226342 PMCID: PMC10788209 DOI: 10.1016/j.eclinm.2023.102384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/22/2023] [Accepted: 12/04/2023] [Indexed: 01/17/2024] Open
Abstract
Platform trials bring the promise of making clinical research more efficient and more patient centric. While their use has become more widespread, including their prominent role during the COVID-19 pandemic response, broader adoption of platform trials has been limited by the lack of experience and tools to navigate the critical upfront planning required to launch such collaborative studies. The European Union-Patient-cEntric clinicAl tRial pLatform (EU-PEARL) initiative has produced new methodologies to expand the use of platform trials with an overarching infrastructure and services embedded into Integrated Research Platforms (IRPs), in collaboration with patient representatives and through consultation with U.S. Food and Drug Administration and European Medicines Agency stakeholders. In this narrative review, we discuss the outlook for platform trials in Europe, including challenges related to infrastructure, design, adaptations, data sharing and regulation. Documents derived from the EU-PEARL project, alongside a literature search including PubMed and relevant grey literature (e.g., guidance from regulatory agencies and health technology agencies) were used as sources for a multi-stage collaborative process through which the 10 more important points based on lessons drawn from the EU-PEARL project were developed and summarised as guidance for the setup of platform trials. We conclude that early involvement of critical stakeholder such as regulatory agencies or patients are critical steps in the implementation and later acceptance of platform trials. Addressing these gaps will be critical for attaining the full potential of platform trials for patients. Funding Innovative Medicines Initiative 2 Joint Undertaking with support from the European Union's Horizon 2020 research and innovation programme and EFPIA.
Collapse
Affiliation(s)
- Franz Koenig
- Medical University of Vienna, Center for Medical Data Science, Vienna, Austria
| | | | - Daniel Millar
- Former Employee, Janssen Research & Development, LLC, Raritan, NJ, USA
| | | | | | | | - Joan Genescà
- Vall d’Hebron Institute for Research, Barcelona, Spain
- Liver Unit, Vall d’Hebron University Hospital, Barcelona, Spain
- Spanish Network of Biomedical Research Centers, Digestive and Liver Diseases (CIBERehd), Madrid, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Juan M. Pericàs
- Vall d’Hebron Institute for Research, Barcelona, Spain
- Liver Unit, Vall d’Hebron University Hospital, Barcelona, Spain
- Spanish Network of Biomedical Research Centers, Digestive and Liver Diseases (CIBERehd), Madrid, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Martin Posch
- Medical University of Vienna, Center for Medical Data Science, Vienna, Austria
| |
Collapse
|
3
|
Langbroek-Amersfoort A, Schootemeijer S, Bouten L, Bloem BR, De Vries NM. Exercise Made Accessible: the Merits of Community-Based Programs for Persons with Parkinson's Disease. Curr Neurol Neurosci Rep 2023; 23:695-715. [PMID: 37792207 PMCID: PMC10673991 DOI: 10.1007/s11910-023-01303-0] [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] [Accepted: 09/10/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE OF REVIEW Many studies have identified positive effects of physiotherapy and exercise for persons with Parkinson's disease (PD). Most work has thus far focused on the therapeutic modality of exercise as used within physiotherapy programs. Stimulated by these positive findings, there is now a strong move to take exercise out of the clinical setting and to deliver the interventions in the community. Although the goals and effects of many such community-based exercise programs overlap with those of physiotherapy, it has also become more clear that both exercise modalities also differ in various ways. Here, we aim to comprehensively review the evidence for community-based exercise in PD. RECENT FINDINGS Many different types of community-based exercise for people with PD are emerging and they are increasingly being studied. There is a great heterogeneity considering the types of exercise, study designs, and outcome measures used in research on this subject. While this review is positive regarding the feasibility and potential effects of community-based exercise, it is also evident that the general quality of these studies needs improvement. By focusing on community-based exercise, we hope to generate more knowledge on the effects of a wide range of different exercise modalities that can be beneficial for people with PD. This knowledge may help people with PD to select the type and setting of exercise activity that matches best with their personal abilities and preferences. As such, these insights will contribute to an improved self-management of PD.
Collapse
Affiliation(s)
- Anneli Langbroek-Amersfoort
- Center of Expertise for Parkinson & Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sabine Schootemeijer
- Center of Expertise for Parkinson & Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lars Bouten
- Center of Expertise for Parkinson & Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bastiaan R Bloem
- Center of Expertise for Parkinson & Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nienke M De Vries
- Center of Expertise for Parkinson & Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands.
| |
Collapse
|
4
|
Clarke NW, James ND. How to Compose Platform Trials. Eur Urol Focus 2023; 9:715-718. [PMID: 37925327 DOI: 10.1016/j.euf.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 10/16/2023] [Indexed: 11/06/2023]
Abstract
Platform trials are adaptive randomised controlled trials that address multiple questions using a single protocol, which reduces the time taken to reach a meaningful trial endpoint. This mini review provides a description of how to conceive, design, and carry out a platform trial in urology, using experience gained in the STAMPEDE trial. PATIENT SUMMARY: Clinical trials to test how well a new drug or treatment works can take a long time before meaningful results can be assessed. Trials with a platform design can test multiple treatments using just one protocol and control, which reduces the time taken to reach a trial endpoint.
Collapse
Affiliation(s)
- Noel W Clarke
- Department of Urology, The Christie Hospital, Manchester, UK.
| | - Nicholas D James
- Department of Clinical Oncology, Royal Marsden NHS Foundation Trust, London, UK; Institute of Cancer Research, London, UK
| |
Collapse
|