Abraham Mickey E, Povolotskiy Roman, Gold Justin, Ward Max, Gendreau Julian L, Mammis Antonios
Department of Neurosurgery, University of California, San Diego, USA.
Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, USA.
Cureus. 2020 Aug 25;12(8):e10029. doi: 10.7759/cureus.10029.
Introduction Hydrocephalus is a significant public health concern estimated to affect 380,000 new individuals annually. In addition, it exhibits an increasingly high financial burden for the healthcare industry. Clinical trials are the gold standard for evaluating preventative and therapeutic strategies to bring potential treatments to the forefront of clinical practice. Methods A study of the ClinicalTrials.gov was conducted in April 2019 to examine all current and previously reported clinical trials studying hydrocephalus. Studies were reviewed to extrapolate information to characterize the current state of research being conducted for hydrocephalus. Results In total, 80 clinical trials met inclusion criteria and were analyzed: 48.8% were observation and 51.2% were interventional. Of those, 55% have been completed while 30.0% are still recruiting, and 15.0% are not yet recruiting. The United States has the most clinical trials (42.0%) and a plurality of trials has a sample size of 0-50 participants. The majority of studies included only adults (53.8%). Of those studies, 54.0% were cohort and the majority were prospective (74.0%). Of the different types of hydrocephalus, normal pressure hydrocephalus and pediatric hydrocephalus have generated the most interest for research comprising a majority of the clinical trial registry. While 44 of the trials are complete, only 20 have published results in peer-reviewed literature highlighting the need for improvement in publishing study results even if the results of the trials are null. Conclusion Most clinical trials to date have pertained to the treatment of normal pressure hydrocephalus and pediatric hydrocephalus. While great advancements have been made for the treatment of hydrocephalus, there remains much room for improvements in therapeutic interventional modalities as well as ensuring the reporting of all undertaken clinical trials.
引言
脑积水是一个重大的公共卫生问题,据估计每年影响38万新增患者。此外,它给医疗行业带来的经济负担也日益加重。临床试验是评估预防和治疗策略的金标准,能将潜在治疗方法推向临床实践前沿。
方法
2019年4月对ClinicalTrials.gov进行了一项研究,以审查所有当前和先前报告的研究脑积水的临床试验。对研究进行了评估,以推断信息来描述当前脑积水研究的现状。
结果
总共有80项临床试验符合纳入标准并进行了分析:48.8%为观察性试验,51.2%为干预性试验。其中,55%已完成,30.0%仍在招募,15.0%尚未招募。美国进行的临床试验最多(42.0%),且多项试验的样本量为0至50名参与者。大多数研究仅纳入成年人(53.8%)。在这些研究中,54.0%为队列研究,且大多数是前瞻性的(74.0%)。在不同类型的脑积水中,正常压力脑积水和小儿脑积水引发了最多的研究兴趣,占临床试验注册的大部分。虽然44项试验已完成,但只有20项在同行评审文献中发表了结果,这凸显了即使试验结果为阴性,在发表研究结果方面仍需改进。
结论
迄今为止,大多数临床试验都与正常压力脑积水和小儿脑积水的治疗有关。虽然在脑积水治疗方面已取得了巨大进展,但在治疗干预方式以及确保报告所有进行的临床试验方面仍有很大改进空间。