Center for Reverse Translational Research, Osaka Habikino Medical Center, Osaka Prefectural Hospital Organization, Habikino, Japan.
Institute of Innovative Medical Technology, Kita-ku, Osaka, Japan.
Tissue Eng Part B Rev. 2023 Aug;29(4):358-368. doi: 10.1089/ten.TEB.2022.0126. Epub 2023 Apr 21.
Sharing the methods and results of clinical trials with full transparency is an ethical obligation for those involved in clinical research. In this regard, ClinicalTrials.gov requires reporting of results to the registry within 1 year of completion of the trial. However, a poor result reporting rate has been pointed out, with approximately half the trial results not been reported. It has been suggested that one of the reasons behind this could be the influence of sponsors who conduct the clinical trials. In the course of our previous trend analysis on regenerative medicine for stroke (STR) using ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP) portal site as data sources, we suspected whether the results of gene and/or cell therapy trials are poorly reported. For this reason, a multivariate analysis using data from ClinicalTrials.gov was performed to identify the factors suppressing the result reporting rate, expanding our study to four different kinds of neurological diseases and regenerative medicine as a treatment modality when small-molecule compounds and biologics were set up as controls, in addition to the sponsor type factor. As a result, we found gene and/or cell therapy (therapeutic modality) in addition to STR (disease area), trials completed in 2005-2007, and clinical phases II and IV as independent factors that suppressed the rate of reporting results to ClinicalTrials.gov. On the other hand, big pharmaceutical companies were identified as a factor that increased the reporting result rate to ClinicalTrials.gov. When we applied result reporting publications through PubMed as an index, our study data revealed that the following factors were not identified as the cause for a decrease in the reporting result rate: STR (as disease area), trials completed between 2005 and 2007, and gene/cell therapy (as treatment modality). In this context, our findings indicate that gene/cell therapy has led to the suppression of the result reporting rate to ClinicalTrials.gov. This confirmed our initial suspicion of the low result reporting rate of gene/cell therapy trials. We believe that further studies are required to elucidate the factors affecting the result reporting rate from the perspective of disease area and treatment modality. Impact Statement Several studies have addressed the poor result reporting rate of clinical trials, which still remains an issue. Regenerative medicine holds great promise for the future and the process of its practical application is expected to be challenging. Although having a limited disease area and small sample size, to the best of our knowledge, this is the first study to point out insufficient result reporting of clinical trials of regenerative medicine from the perspective of treatment modality. This report highlights an issue for discussing the path toward its translation through an overview of various factors in comparison with conventional treatment modalities.
临床试验方法和结果的完全透明是参与临床研究人员的道德义务。在这方面,ClinicalTrials.gov 要求在试验完成后 1 年内向注册处报告结果。然而,临床试验结果报告率较差已经被指出,大约一半的试验结果没有被报告。有人认为,造成这种情况的原因之一可能是进行临床试验的赞助商的影响。在我们之前使用 ClinicalTrials.gov 和国际临床试验注册平台(ICTRP)门户网站作为数据源对中风再生医学(STR)进行的趋势分析过程中,我们怀疑基因和/或细胞治疗试验的结果报告是否较差。出于这个原因,我们使用来自 ClinicalTrials.gov 的数据进行了多变量分析,以确定抑制结果报告率的因素,将我们的研究扩展到四种不同的神经疾病和再生医学作为治疗方式,除了赞助商类型因素之外。结果,我们发现基因和/或细胞治疗(治疗方式)除了 STR(疾病领域)之外,2005-2007 年完成的试验以及 II 期和 IV 期临床试验是抑制向 ClinicalTrials.gov 报告结果的独立因素。另一方面,大型制药公司被确定为增加向 ClinicalTrials.gov 报告结果的因素。当我们将通过 PubMed 作为索引的结果报告出版物应用于我们的研究数据时,我们的研究数据表明,以下因素并未被确定为报告结果率下降的原因:STR(作为疾病领域)、2005 年至 2007 年完成的试验,以及基因/细胞治疗(作为治疗方式)。在这种情况下,我们的发现表明基因/细胞治疗导致了向 ClinicalTrials.gov 报告结果的抑制。这证实了我们对基因/细胞治疗试验结果报告率较低的初步怀疑。我们认为,需要进一步研究从疾病领域和治疗方式的角度阐明影响结果报告率的因素。 影响声明 几项研究已经解决了临床试验结果报告率较差的问题,但这仍然是一个问题。再生医学具有广阔的前景,其实际应用过程预计将具有挑战性。尽管疾病领域有限且样本量较小,但据我们所知,这是第一项从治疗方式角度指出再生医学临床试验结果报告不足的研究。本报告通过与传统治疗方式进行比较,概述了各种因素,为讨论其转化途径提供了一个问题。