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大流行背景下临床试验能力建设——拉丁美洲快速启动现场准备项目的结果。

Clinical trial capacity building in a pandemic-outcome of a rapid site readiness project in Latin America.

机构信息

Institute for Global Health, University of Siena, Siena, Italy.

Department of Pediatrics, Oxford University, Oxford, United Kingdom.

出版信息

Front Public Health. 2024 Apr 25;12:1179268. doi: 10.3389/fpubh.2024.1179268. eCollection 2024.

Abstract

BACKGROUND

Latin America (Latam) has a tradition of large-scale vaccine trials. Because of fluctuating demand, many sites have downsized their infrastructure. Therefore, BMGF launched a clinical trial site-readiness initiative early in the coronavirus-2019 (COVID-19) pandemic including Latam countries between August and September 2020. This survey evaluated clinical development performance measures pre/post initiative (September 2022).

RESULTS

20/21 prequalified sites participated in COVID-19 vaccine/drug development trials. 156 clinical trials (140 COVID-19 vaccine/drug trials) were initiated in the 2 years since prequalification, compared to 176 in the 5 years before. 33,428/37,810 participants were included in COVID-19 programs. The number of enrolled subjects/day across sites quadrupled from 15 (1-35) to 63 (5-300). The dropout rate was 6.8%. Study approval timelines were reduced from 60 (12-120) to 35 (5-90) days. Mean qualified staff was increased from 24 (6-80) to 88 (22-180).

CONCLUSION

Clinical trial sites across Latam were successfully prequalified to participate in COVID-19 developments. For the 100 days mission of vaccine availability in a new pandemic sufficient and well-trained clinical trial sites readily available are essential. This is only achievable if sites-especially in low/middle-income countries-are maintained active through a constant flow of vaccine studies.

摘要

背景

拉丁美洲(拉塔姆)有着大规模疫苗试验的传统。由于需求波动,许多站点已经缩小了其基础设施规模。因此,全球基金在 2020 年 8 月至 9 月间为包括拉丁美洲国家在内的地区启动了一项临床试验站点准备倡议。本调查评估了该倡议前后(2022 年 9 月)的临床开发绩效指标。

结果

20/21 个有资格的站点参与了 COVID-19 疫苗/药物开发试验。在获得资格后的 2 年内,有 156 项临床试验(140 项 COVID-19 疫苗/药物试验)启动,而在此前的 5 年中,只有 176 项。在 COVID-19 项目中,共有 33428/37810 名参与者。站点纳入的受试者/天数量从 15(1-35)增加到 63(5-300),增加了四倍。脱落率为 6.8%。研究批准时间从 60(12-120)天减少到 35(5-90)天。合格员工人数从 24(6-80)人增加到 88(22-180)人。

结论

拉丁美洲各地的临床试验站点成功获得资格,参与 COVID-19 的开发。在新大流行中实现疫苗供应的 100 天任务中,充足且训练有素的临床试验站点是必不可少的。如果站点——尤其是中低收入国家的站点——通过不断进行疫苗研究保持活跃,这才是可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6961/11079433/946bafed535b/fpubh-12-1179268-g001.jpg

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