Zirwas Matthew, Trickett Cynthia, Gorelick Joe, Wang Kejia, Wittstock Keith, Rosenberg Chaya, DiRuggiero Douglas
Dr. Zirwas is with DOCS Dermatology in Bexley, Ohio.
Ms. Trickett is with North Dallas Dermatology Associates in Dallas, Texas.
J Clin Aesthet Dermatol. 2025 Mar-Apr;18(3-4 Suppl 1):S16-S23.
Clinical trials are designed to evaluate the efficacy and safety of new drugs. However, greater focus is often placed on efficacy rather than safety. This review article discusses the fundamentals involved in evaluating the safety of a new drug. In addition, the principal challenges involved in the collection, analysis, reporting, and interpretation of safety data in clinical trials are described using relevant examples. These challenges include the fact that clinical trials are generally limited in size and duration, exclude high-risk populations, and have limited statistical power to detect rare but potentially serious adverse events (AEs) that might occur in real-world situations. Reporting of safety data across clinical trials is also inconsistent. A thorough understanding of the interpretation of safety data, especially the appropriate use of exposure-adjusted incidence rates (EAIRs) in relation to AEs, as well as the importance of comparing rates to those reported in the general population and in patients with psoriasis, is vital for making a well-informed assessment of the safety of a new drug. The information provided in this article could be useful to healthcare providers who must evaluate a large volume of safety data when providing evidence-based treatment suggestions and recommendations to their patients.
临床试验旨在评估新药的疗效和安全性。然而,人们往往更关注疗效而非安全性。这篇综述文章讨论了评估新药安全性所涉及的基本原理。此外,还通过相关实例描述了临床试验中安全性数据收集、分析、报告和解读所涉及的主要挑战。这些挑战包括:临床试验的规模和持续时间通常有限,排除了高风险人群,并且检测在实际情况中可能发生的罕见但潜在严重不良事件(AE)的统计能力有限。跨临床试验的安全性数据报告也不一致。透彻理解安全性数据的解读,尤其是与AE相关的暴露调整发病率(EAIR)的恰当使用,以及将发病率与普通人群和银屑病患者中报告的发病率进行比较的重要性,对于全面了解新药的安全性至关重要。本文提供的信息对于在为患者提供循证治疗建议和推荐时必须评估大量安全性数据的医疗服务提供者可能有用。