Viereck Christopher, Boudes Pol
Quadratum Consulting Services, LLC in Basking Ridge, NJ 07920, United States.
Contemp Clin Trials. 2009 Jul;30(4):293-9. doi: 10.1016/j.cct.2009.03.010. Epub 2009 Apr 5.
We compared the clinical trial transparency practices of US/European pharma by analyzing the publicly-accessible clinical trial results databases of major drugs (doripenem, varenicline, lapatinib, zoledronic acid, adalimumab, insulin glargine, raltegravir, gefitinib). We evaluated their accessibility and utility from the perspective of the lay public. We included databases on company websites, http://www.clinicalstudyresults.org, http://www.clinicaltrials.gov and http://clinicaltrials.ifpma.org. Only 2 of 8 company homepages provide a direct link to the results. While the use of common terms on company search engines led to results for 5 of the 8 drugs following 2-4 clicks, no logical pathway was identified. The number of clinical trials in the databases was inconsistent: 0 for doripenem to 45 for insulin glargine. Results from all phases of clinical development were provided for 2 (insulin glargine and gefitinib) of the 8 drugs. Analyses of phase III reports revealed that most critical elements of the International Conference of Harmonization E3 Structure and Content of Synopses for Clinical Trial Reports were provided for 2 (varenicline, lapatinib) of the 8 drugs. For adalimumab and zoledronic acid, only citations were provided, which the lay public would be unable to access. None of the clinical trial reports was written in lay language. User-friendly support, when provided, was of marginal benefit. Only 1 of the databases (gefitinib) permitted the user to find the most recently updated reports. None of the glossaries included explanations for adverse events or statistical methodology. In conclusion, our study indicates that the public faces significant hurdles in finding and understanding clinical trial results databases.
我们通过分析主要药物(多立培南、伐尼克兰、拉帕替尼、唑来膦酸、阿达木单抗、甘精胰岛素、雷特格韦、吉非替尼)的可公开获取的临床试验结果数据库,比较了美国/欧洲制药公司的临床试验透明度做法。我们从普通大众的角度评估了这些数据库的可及性和实用性。我们纳入了公司网站、http://www.clinicalstudyresults.org、http://www.clinicaltrials.gov和http://clinicaltrials.ifpma.org上的数据库。8个公司主页中只有2个提供了结果的直接链接。虽然在公司搜索引擎上使用通用术语在2至4次点击后能找到8种药物中5种药物的结果,但未发现逻辑路径。数据库中的临床试验数量不一致:多立培南为0项,甘精胰岛素为45项。8种药物中有2种(甘精胰岛素和吉非替尼)提供了临床开发各阶段的结果。对III期报告的分析表明,8种药物中有2种(伐尼克兰、拉帕替尼)提供了国际协调会议E3临床试验报告摘要的结构和内容的大多数关键要素。对于阿达木单抗和唑来膦酸,仅提供了参考文献,普通大众无法获取。没有一份临床试验报告是用通俗易懂的语言撰写的。提供的用户友好型支持作用不大。只有1个数据库(吉非替尼)允许用户查找最新更新的报告。没有一个术语表包含不良事件或统计方法的解释。总之,我们的研究表明,公众在查找和理解临床试验结果数据库方面面临重大障碍。