The early termination, for harm, of a major clinical trial

1990 ◽  
Vol 11 (4) ◽  
pp. 274
Author(s):  
Joel Verter
Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Yorokpa Joachim Doua ◽  
Hanneke Dominicus ◽  
Julius Mugwagwa ◽  
Suzelle Magalie Gombe ◽  
Jude Nwokike

1988 ◽  
Vol 9 (1) ◽  
pp. 47-63 ◽  
Author(s):  
Joyce A. Cramer ◽  
Joseph F. Collins ◽  
Richard H. Mattson

Author(s):  
Heinz Drexel ◽  
Basil S Lewis ◽  
Giuseppe M C Rosano ◽  
Christoph H Saely ◽  
Gerda Tautermann ◽  
...  

Abstract This review article aims to explain the important issues that data safety monitoring boards (DSMB) face when considering early termination of a trial and is specifically addressed to the needs of clinical and research cardiologists. We give an insight into the overall background and then focus on the three principal reasons for stopping trials, i.e. efficacy, futility, and harm. The statistical essentials are also addressed to familiarize clinicians with the key principles. The topic is further highlighted by numerous examples from lipid trials and antithrombotic trials. This is followed by an overview of regulatory aspects, including an insight into industry–investigator interactions. To conclude, we summarize the key elements that are the basis for a decision to stop a randomized clinical trial (RCT).


2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 394-394
Author(s):  
Monica Khunger ◽  
Sagar Rakshit ◽  
Katherine Tullio ◽  
Matt D. Galsky ◽  
Petros Grivas

394 Background: Clinical trial completion is critical for evaluating new therapies. Premature termination or withdrawal of clinical trials is common, impairs progress and results in waste of resources. We assessed features and reasons of early terminated and withdrawn cancer trials focusing on trials with ICI (anti-CTLA-4, anti-PD-1, anti-PD-L1). Methods: We reviewed all adult, intervention, cancer clinical trials registered in ClinicalTrials.gov from November 16, 2011 to April 16, 2015 to identify all early terminated and withdrawn trials. Reasons for termination were captured. Logistics regression model was used to identify factors associated with early termination or withdrawal. Discontinuation rate was compared between ICI and all trials (χ2); p < 0.05 was set as significant. Results: We identified 12875 clinical trials (35% industry-funded, 12% federal-funded; 772 in prostate and 386 in non-prostate GU cancers); 8.5% of all trials were prematurely terminated (5%) or withdrawn (3.5%); main reason for discontinuation was poor accrual (33%) followed by logistical reasons (26%). When comparing trials with ICI (n = 350) to all cancer trials, lower rate of termination or withdrawal was noted with ICI [5.4% vs 8.5%, p = 0.05]. Trials with ICI were less likely to discontinue due to poor accrual compared to all trials, but the difference was not significant (21% vs 33%, p = 0.4). Of the 1158 GU cancers trials, 75 (6.5%) were prematurely terminated and 56 (4.8%) withdrawn; reasons for discontinuation are shown in the table. Conclusions: Poor accrual represents the main cause of early termination of all cancer clinical trials. Premature termination/withdrawal rate appears lower in ICI trials which may be attributed to accrual differences. Clinical trial completion remains a high priority. [Table: see text]


PEDIATRICS ◽  
1989 ◽  
Vol 84 (4) ◽  
pp. 693-693
Author(s):  
Student

Two drugs used to treat heart rhythm irregularities in more than 200,000 Americans increased the risk of heart attack and death in a major clinical trial, Federal health officials said today. The Food and Drug Administration said it was immediately advising doctors to stop prescribing the drugs, Tambocor and Enkaid, for mild or moderate heart rhythm irregularities, or arrhythmias. The National Heart, Lung and Blood Institute said that more than twice as many patients getting the drugs suffered heart attacks or death as those taking dummy pills, making it necessary to suspend a major part of the test three years early. "Absolutely, unequivocally, this trial was a success because we have identified two drugs of a type that are more dangerous than the disease they are supposed to treat," Dr. Killip said in a telephone interview.


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