Department of Statistics, University of California, Irvine, CA, USA.
Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA.
J Alzheimers Dis. 2024;98(2):729-738. doi: 10.3233/JAD-231283.
In randomized clinical trials (RCTs), monitoring adverse events (AEs) and serious AEs (SAEs) is critical. All Alzheimer's disease (AD) RCTs require participants to enroll with a study partner.
We examined AE reporting rates in mild-to-moderate AD trials and their associations with study partner type.
We estimated AE reporting rates using placebo data from seven independent RCTs conducted by the Alzheimer's Disease Cooperative Study. We assessed the heterogeneity of reporting rates as a function of visits using generalized estimating equations. In the primary analysis, we tested the hypotheses that the rates of reporting differed by study partner type and time they spent with the participant weekly using Poisson regression with robust variance estimation. In all regression models, log-transformed total patient years was included.
The estimated reporting rates were 2.83 (95% CI: 2.66, 3.02), 1.18 (95% CI: 1.09, 1.28), 0.23 (95% CI: 0.19, 0.27), and 0.28 (95% CI: 0.24, 0.33) events per participant year for grade 1-3 AEs and SAEs, respectively. We estimated that greater number of visits per year was associated with increased reporting for grade 1-2 AEs and SAEs. We did not find evidence to suggest that AE reporting differed by study partner type or by time the study partner spent with the participant.
Study partner type and time the study partner spent with the participant did not appear to impact AE reporting. Estimated reporting rates may be useful to evaluate safety in future studies, particularly those with no control arm and similar visit frequencies.
在随机临床试验 (RCT) 中,监测不良事件 (AE) 和严重不良事件 (SAE) 至关重要。所有阿尔茨海默病 (AD) RCT 都要求参与者与研究伙伴一起注册。
我们检查了轻度至中度 AD 试验中 AE 报告率及其与研究伙伴类型的关联。
我们使用由阿尔茨海默病合作研究进行的七项独立 RCT 的安慰剂数据估计 AE 报告率。我们使用广义估计方程评估报告率随访问的异质性。在主要分析中,我们使用泊松回归和稳健方差估计检验了以下假设:报告率因研究伙伴类型和每周与参与者共度的时间而异。在所有回归模型中,均包含对数转换的总患者年数。
估计的报告率分别为 2.83(95%CI:2.66,3.02)、1.18(95%CI:1.09,1.28)、0.23(95%CI:0.19,0.27)和 0.28(95%CI:0.24,0.33),分别为 1-3 级 AE 和 SAE 每患者年事件数。我们估计每年就诊次数的增加与 1-2 级 AE 和 SAE 的报告增加有关。我们没有发现证据表明 AE 报告因研究伙伴类型或研究伙伴与参与者共度的时间而异。
研究伙伴类型和研究伙伴与参与者共度的时间似乎并未影响 AE 报告。估计的报告率可能有助于评估未来研究的安全性,特别是那些没有对照组和相似就诊频率的研究。