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8 年来提交给意大利博洛尼亚大学医院伦理委员会的药品非商业试验:更新规则和建议的时机。

Non-commercial trials on medicines submitted to the Ethics Committee of the University Hospital of Bologna (Italy) along 8 years of activity: time to update rules and recommendations.

机构信息

University of Bologna, Bologna, Italy.

Unit of Pharmacology, Department of Medical and Surgical Sciences, University of Bologna, Via Irnerio 48, 40126, Bologna, Italy.

出版信息

Eur J Clin Pharmacol. 2019 Oct;75(10):1415-1420. doi: 10.1007/s00228-019-02706-0. Epub 2019 Jun 18.

Abstract

PURPOSE

In Italy, the non-commercial trials on medicines are regulated by the Ministry Decree 17 December, 2004. Its intent is of encouraging the independent research for the improvement of clinical practice. We aimed to analyze the main features of the proposals of non-commercial clinical trials on medicines submitted to the Independent Ethics Committee (IEC) of the University Hospital of Bologna in the period 2010-2017.

METHODS

Data were extracted from IEC registry and were organized with an ad hoc database. The relationships between the variables were examined using contingency tables. When appropriate, we applied the chi-square statistical test for the comparison of the categorical variables.

RESULTS

Over the 8-year period, the IEC evaluated 2931 studies, of which 1156 (39.4%) related to clinical trials on medicines; 245 (21.2%) out of the latter were non-commercial ones. A percentage of 49.8 of the trials were of phase II; 137 trials (55.9%) were promoted by hospitals, medical schools or institutes for research, hospitalization and health care. Non-profit organizations and scientific societies were promoters of 88 trials (35.9%). Most phase I and phase II trials received additional support from pharmaceutical companies.

CONCLUSIONS

Our results show a not negligible industrial influence on non-commercial trials through additional support, mostly to those of phase II. An update of the present legislation on this matter is desirable, adopting clearer rules on the relations sponsor-industry.

摘要

目的

在意大利,非商业性药物试验受 2004 年 12 月 17 日颁布的部级法令监管。其目的是鼓励独立研究以改善临床实践。我们旨在分析 2010-2017 年间提交给博洛尼亚大学医院独立伦理委员会(IEC)的非商业性药物临床试验提案的主要特征。

方法

数据从 IEC 登记处提取,并使用专门的数据库进行组织。使用列联表检查变量之间的关系。在适当的情况下,我们应用卡方统计检验比较分类变量。

结果

在 8 年期间,IEC 评估了 2931 项研究,其中 1156 项(39.4%)涉及药物临床试验;在后者中,245 项(21.2%)是非商业性的。二期试验占试验的 49.8%;137 项试验(55.9%)由医院、医学院或研究所、住院和医疗保健机构发起。非营利组织和科学协会发起了 88 项试验(35.9%)。大多数一期和二期试验得到了制药公司的额外支持。

结论

我们的结果表明,通过额外支持,工业界对非商业性试验产生了相当大的影响,主要是对二期试验。在这方面,更新现行法规是可取的,采用更明确的赞助商-行业关系规则。

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