Lapchak Paul A
Director of Translational Research, Cedars-Sinai Medical Center, Department of Neurology, Davis Research Building, D-2091, 110 N, George Burns Road, Los Angeles, CA 90048, USA.
J Neurol Neurophysiol. 2012;3. doi: 10.4172/2155-9562.1000e111.
The approval of new therapies to treat neurodegenerative disease conditions by the Food and Drug administration (FDA) has been hindered by many failed clinical trials, which were based upon "significant" efficacy in preclinical or translational studies. Additional problems during drug development related to significant adverse events and unforeseen toxicity have also hampered drug development. Recent reviews of preclinical data suggests that many studies have over-estimated efficacy due to poor or inadequate study design, exclusion of important data (negative or neutral) and lack of study randomization and blinding. This article describes in detail a set of recommendations to improve the quality of science being conducted in laboratories worldwide, with the goal of documenting in the peer-reviewed literature, including Journal of Neurology and Neurophysiology, the scientific basis for the continued development of specific strategies to treat neurodegenerative diseases such as Stroke, Alzheimer's disease, Huntington's disease, Parkinson's disease, Spinal cord injury, and Amyotrophic lateral sclerosis. The minimum recommendations for effective translational research include the need for model justification, study group randomization and blinding, power analysis calculations, appropriate statistical analysis of all data sets, and a conflict of interest statement by investigators. It will also be beneficial to demonstrate reproducible efficacy in multiple species and in studies done by independent laboratories.
食品药品监督管理局(FDA)对治疗神经退行性疾病新疗法的批准一直受到许多失败临床试验的阻碍,这些试验是基于临床前或转化研究中的“显著”疗效。药物研发过程中与严重不良事件和意外毒性相关的其他问题也阻碍了药物研发。最近对临床前数据的审查表明,由于研究设计不佳或不充分、重要数据(阴性或中性)的排除以及缺乏研究随机化和盲法,许多研究高估了疗效。本文详细描述了一系列提高全球实验室科研质量的建议,目的是在同行评审文献(包括《神经病学杂志》和《神经生理学杂志》)中记录治疗诸如中风、阿尔茨海默病、亨廷顿舞蹈病、帕金森病、脊髓损伤和肌萎缩侧索硬化等神经退行性疾病特定策略持续发展的科学依据。有效转化研究的最低建议包括模型合理性论证、研究组随机化和盲法、功效分析计算、对所有数据集进行适当的统计分析以及研究者的利益冲突声明。在多个物种以及独立实验室进行的研究中证明可重复的疗效也将是有益的。