Meringolo Maria, Delle Monache Sergio, Martella Giuseppina, Peppe Antonella
Santa Lucia Foundation, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy.
Faculty of Medicine and Surgery, Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy.
Neurol Int. 2024 Dec 24;17(1):1. doi: 10.3390/neurolint17010001.
BACKGROUND/OBJECTIVES: Drug development involves multiple stages, spanning from initial discovery to clinical trials. This intricate process entails understanding disease mechanisms, identifying potential drug targets, and evaluating the efficacy and safety of candidate drugs. Clinical trials are designed to assess the effects of drugs on humans, focusing on determining safety profiles, appropriate modes of administration, and comparative efficacy against placebos. Notably, neuroscience drug development encounters distinct challenges, including the complex nature of diseases, limitations imposed by the blood-brain barrier, the absence of reliable predictive preclinical models, and regulatory hurdles. Ethical and safety considerations are pivotal due to the potential cognitive and motor effects of CNS-active drugs.
Our manuscript outlines the procedures for CNS clinical trials and highlights the key elements of study design, methodological considerations, and ethical frameworks. To achieve our objectives, we considered the official websites of regulatory authorities, the EQUATOR network, and recent publications in the field. The paper includes key elements such as criteria for subject selection, methods of evaluation, variable analysis, and statistical methodology approaches.
We want to furnish a concise and comprehensive guide tailored to individuals new to CNS clinical trials, providing foundational elements necessary for the design and execution of such trials. The manuscript seeks to outline sources of relevant materials and elucidate adaptability, particularly in instances where sponsors may be absent.
By meeting the needs of less-experienced researchers or those with limited resources, the intention is to facilitate an understanding of the intricate nature of the process and offer guidance on appropriately navigating its complexities. It is essential to note that this manuscript does not aim to be exhaustive but endeavors to serve as a structured checklist. Through its approach, the manuscript aspires to offer guidance and support to individuals navigating the challenges inherent in this intricate domain.
背景/目的:药物研发涉及多个阶段,从最初的发现到临床试验。这一复杂过程需要了解疾病机制、确定潜在的药物靶点,并评估候选药物的疗效和安全性。临床试验旨在评估药物对人体的影响,重点是确定安全性概况、合适的给药方式以及与安慰剂相比的疗效。值得注意的是,神经科学药物研发面临着独特的挑战,包括疾病的复杂性、血脑屏障带来的限制、缺乏可靠的临床前预测模型以及监管障碍。由于中枢神经系统活性药物可能产生认知和运动影响,伦理和安全考量至关重要。
我们的手稿概述了中枢神经系统临床试验的程序,并强调了研究设计、方法学考量和伦理框架的关键要素。为实现我们的目标,我们参考了监管机构的官方网站、EQUATOR网络以及该领域的近期出版物。本文包括受试者选择标准、评估方法、变量分析和统计方法等关键要素。
我们希望为刚接触中枢神经系统临床试验的人员提供一份简洁而全面的指南,提供此类试验设计和实施所需的基础要素。该手稿旨在概述相关材料的来源,并阐明适应性,特别是在可能没有申办方的情况下。
通过满足经验较少的研究人员或资源有限者的需求,旨在促进对该过程复杂性的理解,并为适当应对其复杂性提供指导。必须指出的是,这份手稿并非旨在详尽无遗,而是力图成为一份结构化的清单。通过其方法,该手稿渴望为应对这一复杂领域固有挑战的人员提供指导和支持。