Ineichen Benjamin V, Furrer Eva, Grüninger Servan L, Zürrer Wolfgang E, Macleod Malcolm R
Centre for Reproducible Science, University of Zurich, Zurich, Switzerland.
Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland.
PLoS Biol. 2024 Jun 13;22(6):e3002667. doi: 10.1371/journal.pbio.3002667. eCollection 2024 Jun.
There is an ongoing debate about the value of animal experiments to inform medical practice, yet there are limited data on how well therapies developed in animal studies translate to humans. We aimed to assess 2 measures of translation across various biomedical fields: (1) The proportion of therapies which transition from animal studies to human application, including involved timeframes; and (2) the consistency between animal and human study results. Thus, we conducted an umbrella review, including English systematic reviews that evaluated the translation of therapies from animals to humans. Medline, Embase, and Web of Science Core Collection were searched from inception until August 1, 2023. We assessed the proportion of therapeutic interventions advancing to any human study, a randomized controlled trial (RCT), and regulatory approval. We meta-analyzed the concordance between animal and human studies. The risk of bias was probed using a 10-item checklist for systematic reviews. We included 122 articles, describing 54 distinct human diseases and 367 therapeutic interventions. Neurological diseases were the focus of 32% of reviews. The overall proportion of therapies progressing from animal studies was 50% to human studies, 40% to RCTs, and 5% to regulatory approval. Notably, our meta-analysis showed an 86% concordance between positive results in animal and clinical studies. The median transition times from animal studies were 5, 7, and 10 years to reach any human study, an RCT, and regulatory approval, respectively. We conclude that, contrary to widespread assertions, the rate of successful animal-to-human translation may be higher than previously reported. Nonetheless, the low rate of final approval indicates potential deficiencies in the design of both animal studies and early clinical trials. To ameliorate the efficacy of translating therapies from bench to bedside, we advocate for enhanced study design robustness and the reinforcement of generalizability.
关于动物实验对医学实践的价值,目前仍存在争议,然而,关于动物研究中开发的疗法在转化为人类应用方面的效果,相关数据却很有限。我们旨在评估跨多个生物医学领域的两种转化指标:(1)从动物研究过渡到人类应用的疗法比例,包括涉及的时间框架;(2)动物研究和人类研究结果之间的一致性。因此,我们进行了一项综合综述,纳入了评估疗法从动物到人类转化的英文系统综述。检索了Medline、Embase和Web of Science核心合集,检索时间从数据库创建至2023年8月1日。我们评估了推进到任何人类研究、随机对照试验(RCT)以及获得监管批准的治疗性干预措施的比例。我们对动物研究和人类研究之间的一致性进行了荟萃分析。使用10项系统综述清单来探究偏倚风险。我们纳入了122篇文章,描述了54种不同的人类疾病和367种治疗性干预措施。32%的综述聚焦于神经系统疾病。从动物研究推进到人类研究的疗法总体比例为50%,推进到RCT的比例为40%,推进到获得监管批准的比例为5%。值得注意的是,我们的荟萃分析表明,动物研究和临床研究中的阳性结果之间的一致性为86%。从动物研究到任何人类研究、RCT以及获得监管批准的中位转化时间分别为5年、7年和10年。我们得出结论,与普遍观点相反,从动物到人类的成功转化率可能高于先前报道。尽管如此,最终批准率较低表明动物研究和早期临床试验的设计可能存在潜在缺陷。为了提高疗法从实验室到临床的转化效果,我们主张加强研究设计的稳健性并增强可推广性。
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