Ohashi Yasuo
Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, Univ. Tokyo.
Gan To Kagaku Ryoho. 2007 Feb;34(2):312-5.
ICHE 5 released in 1998 opened the possibility of utilizing foreign clinical trials data for getting approval in Japan and the concept of "bridging" studies have been discussed intensively with less emphasis on statistical aspects. In this presentation, statistical methodology for assessing similarity between a bridging study and a bridged study is reviewed including our new proposals: concept of overlap coefficient for assessing overlap of two distributions and application of propensity-score matching for selecting a similar patient subpopulation from a global database. For accelerating development, international collaborative studies become more preferred approach than bridging as illustrated in the sentence "Best bridging is no bridging" by R. Puzdur; an approach for determining the sample size from Japan is proposed, which keeps the probability of producing an apparent heterogeneity (a reverse direction of treatment effect) low (say, 10-20%). Finally, requirements for success of international collaborative studies including incentives of researchers and data management are discussed.
1998年发布的国际人用药品注册技术协调会(ICH)5号指导原则开启了利用国外临床试验数据在日本获批的可能性,“桥接”研究的概念也得到了深入讨论,而较少强调统计方面。在本报告中,回顾了评估桥接研究与被桥接研究之间相似性的统计方法,包括我们的新提议:用于评估两个分布重叠的重叠系数概念,以及应用倾向得分匹配从全球数据库中选择相似患者亚组。为了加速研发,国际合作研究比桥接研究更受青睐,正如R. Puzdur所说的“最佳桥接是不桥接”这句话所表明的;提出了一种从日本确定样本量的方法,该方法可降低产生明显异质性(治疗效果的相反方向)的概率(例如,10%-20%)。最后,讨论了国际合作研究成功的要求,包括研究人员的激励措施和数据管理。