Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedics, University of British Columbia, British Columbia, Canada.
J Neurotrauma. 2012 Sep 20;29(14):2367-74. doi: 10.1089/neu.2012.2479.
We previously conducted a survey to gather the opinions and perspectives of scientific and clinical researchers on what levels of preclinical evidence were needed to justify translating a promising neuroprotective or neuroregenerative therapy in spinal cord injury (SCI) into a human clinical trial (Kwon et al., 2010 ). Here we conducted an analogous survey of individuals living with SCI in which we gathered their expectations for the levels of preclinical evidence achieved by researchers in substantiating the neuroprotective and neuroregenerative therapies being offered to them in clinical trials. In total, 214 individuals with SCI completed the survey, and their responses were compared to the responses of the 235 scientists and clinicians who completed our previous survey. SCI individuals were more likely than SCI researchers to opine that demonstrating efficacy and safety in rodent models of SCI alone is sufficient to proceed with clinical trials. However, SCI individuals also reported strong support for large animal and primate model studies, and in the case of the latter, were actually more in agreement for the need for primate studies than researchers. SCI individuals also reported strong support for independent replication studies. In general, individuals with SCI had high expectations for the levels of preclinical evidence required to justify translating novel therapies into clinical trials. These expectations should be considered in the decisions to translate specific experimental therapies for SCI.
我们之前进行了一项调查,以收集科学和临床研究人员对在脊髓损伤 (SCI) 中将有前途的神经保护或神经再生疗法转化为人体临床试验所需的临床前证据水平的意见和看法(Kwon 等人,2010)。在这里,我们对患有 SCI 的个体进行了类似的调查,收集了他们对研究人员在临床试验中为他们提供的神经保护和神经再生疗法所达到的临床前证据水平的期望。共有 214 名 SCI 患者完成了调查,将他们的回答与 235 名完成我们之前调查的科学家和临床医生的回答进行了比较。与 SCI 研究人员相比,SCI 患者更倾向于认为仅在 SCI 的啮齿动物模型中证明疗效和安全性就足以进行临床试验。然而,SCI 患者也强烈支持大型动物和灵长类动物模型研究,在后一种情况下,实际上比研究人员更支持灵长类动物研究的必要性。SCI 患者还强烈支持独立复制研究。一般来说,患有 SCI 的个体对将新疗法转化为临床试验所需的临床前证据水平寄予厚望。在决定将特定的 SCI 实验疗法转化为临床试验时,应该考虑这些期望。