Trials

2021 ◽  
pp. 189-194
Author(s):  
Edward Shorter
Keyword(s):  
Clinical Trials ◽  
Mood Disorders ◽  
Pharmaceutical Companies ◽  
Subsequent Generation ◽  
Drug Trials ◽  
The 1950S

It is a great irony that none of the later drugs equaled those of the “golden years” of the 1950s, as though no subsequent generation of railway locomotives equaled the Iron Horse of the pioneers. Lithium remains the agent nonpareil for mood disorders but no subsequent “antidepressants” were ever the equal of imipramine and other tricyclics. The lack of progress in psychopharmacology was caused by the pharmaceutical industry’s taking over clinical trials. The 1962 Kefauver-Harris amendments triggered drug trials’ becoming so expensive that the incentive to try bold new experiments was minimal. The beginning of the great pivot of investigator-led to industry-led trials in the 1980s occurred as the “medical advisors” of pharmaceutical companies became responsible for collating the data as it came in from the various centers.

An Update on JAK Inhibitors

2019 ◽  
Vol 26 (10) ◽  
pp. 1806-1832 ◽  
Author(s):  
Francesca Musumeci ◽  
Chiara Greco ◽  
Ilaria Giacchello ◽  
Anna Lucia Fallacara ◽  
Munjed M. Ibrahim ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Tyrosine Kinases ◽  
Chemical Structure ◽  
Receptor Tyrosine Kinases ◽  
Myeloproliferative Neoplasms ◽  
Pharmaceutical Companies ◽  
Jak Inhibitors ◽  
Pyrimidine Derivatives ◽  
Janus Kinases ◽  
Structure Activity

Janus kinases (JAKs) are a family of non-receptor tyrosine kinases, composed by four members, JAK1, JAK2, JAK3 and TYK2. JAKs are involved in different inflammatory and autoimmune diseases, as well as in malignancies, through the activation of the JAK/STAT signalling pathway. Furthermore, the V617F mutation in JAK2 was identified in patients affected by myeloproliferative neoplasms. This knowledge prompted researchers from academia and pharmaceutical companies to investigate this field in order to discover small molecule JAK inhibitors. These efforts recently afforded to the market approval of four JAK inhibitors. Despite the fact that all these drugs are pyrrolo[2,3-d]pyrimidine derivatives, many compounds endowed with different heterocyclic scaffolds have been reported in the literature as selective or multi-JAK inhibitors, and a number of them is currently being evaluated in clinical trials. In this review we will report many representative compounds that have been published in articles or patents in the last five years (period 2013-2017). The inhibitors will be classified on the basis of their chemical structure, focusing, when possible, on their structure activity relationships, selectivity and biological activity. For every class of derivatives, compounds disclosed before 2013 that have entered clinical trials will also be briefly reported, to underline the importance of a particular chemical scaffold in the search for new inhibitors.

scholarly journals What We Learn from the CTAD 2018 (Clinical Trials Alzheimer’s Disease)

2018 ◽  
pp. 1-2
Author(s):  
B. Vellas ◽  
P. Aisen ◽  
M. Weiner ◽  
J. Touchon
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Clinical Trials ◽  
Safety Data ◽  
Phase Iii ◽  
Drug Trials ◽  
New Developments ◽  
Fda Guidance ◽  
Clinical Biomarkers ◽  
Early Alzheimer’S Disease

We are happy to publish the CTAD 2018 abstracts in the present JPAD issue. As you can see many new interesting studies are presented in this issue of the journal: from new drug trials to biomarkers, imaging studies, as well as new clinical outcomes. More specifically, we will have several hot topics presentation on: 1. Major drug trials using bace inhibitors (verubecestat, lanabecestat, atabecestat, elenbecestat…) in the early phase of the disease (APECS early trials…). Both clinical, biomarkers (MRI, CSF, PET) and safety data will be presented. 2. New data on blood biomarkers including a keynote from R. Bateman, and presentations from Araclon and Roche biomarkers. 3. Results from phase III and IIB trials including a novel and multi-targeted oligosaccharide in patients with mild-moderate AD in China; the AMBAR (Alzheimer’s Management By Albumin Replacement) study, the TOMMORROW trial: a trial to delay the onset of MCI due to AD and qualify a genetic biomarker algorithm, the 18-month STEADFAST trial of azeliragon in participants with mild Alzheimer’s Disease; a longitudinal 148-week extension 4. Results 18 from F-AV-1451-A16: a clinicopathological study of the correspondence between flortaucipir PET imaging and post-mortem assessment of tau pathology. 5. Latest developments in anti-amyloid monoclonal antibodies including aducanumab nonnegligible, and new results and data analyses of the BAN2401 study 201 in early AD. 6. New developments with safety and efficacy of lemborexant for sleep-wake regulation in patients with irregular sleep-wake rhythm disorders and Alzheimer’s Disease dementia. 7. Advances with the ABBV-8E12, a humanized anti-tau monoclonal antibody, for the treatment of early Alzheimer’s Disease. 8. Endpoints for early Alzheimer’s Disease clinical trials: interpretation and application of the draft FDA guidance. And many others… It is important to underline that a not negligible number of abstracts concern non amyloid targets (eg: Tau-related targets but also targets outside the classical AD cascade).

scholarly journals Biomarker assay validation for clinical trials: a questionnaire survey to pharmaceutical companies in Japan

Bioanalysis ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 55-60 ◽  
Author(s):  
Yoshiaki Ohtsu ◽  
Takehisa Matsumaru ◽  
Masataka Katashima ◽  
Masaaki Kakehi ◽  
Hiroyuki Kakuo ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Questionnaire Survey ◽  
Pharmaceutical Companies ◽  
Assay Validation

scholarly journals 32 Quantifying the Prevalence of Frailty in Drug Trials and the Relationship with Serious Adverse Events

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i7-i11
Author(s):  
P Hanlon ◽  
E Butterly ◽  
J Lewsey ◽  
S Siebert ◽  
F S Mair ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Adverse Events ◽  
Disease Severity ◽  
Negative Binomial ◽  
Frailty Index ◽  
Chronic Obstructive ◽  
Drug Trials ◽  
Phase 3 ◽  
Serious Adverse Events ◽  
Increased Risk

Abstract Introduction Frailty is common in clinical practice, but trials rarely report on participant frailty. Consequently, clinicians and guideline-developers assume frailty is largely absent from trials and have questioned the relevance of trial findings to frail people. Therefore, we examined frailty in phase 3/4 industry-sponsored clinical trials of pharmacological interventions for three exemplar conditions: type 2 diabetes mellitus (T2DM), rheumatoid arthritis (RA), and chronic obstructive pulmonary disease (COPD). Methods We constructed a 40-item frailty index (FI) in 19 clinical trials (7 T2DM, 8 RA, 4 COPD, mean age 42–65 years) using individual-level participant data. Participants with a FI >0.24 were considered “frail”. Baseline disease severity was assessed using HbA1c for T2DM, Disease Activity Score-28 (DAS28) for RA, and % predicted FEV1 for COPD. Using generalised gamma regression, we modelled FI on age, sex and disease severity. In negative binomial regression we modelled serious adverse event rates on FI, and combined results for each index condition in a random-effects meta-analysis. Results All trials included frail participants: prevalence 7–21% in T2DM trials, 33–73% in RA trials, and 15–22% in COPD trials. Increased disease severity and female sex were associated with higher FI in all trials. Frailty was associated with age in T2DM and RA trials, but not in COPD. Across all trials, and after adjusting for age, sex, and disease severity, higher FI predicted increased risk of serious adverse events; the pooled incidence rate ratios (per 0.1-point increase in FI scale) were 1.46 (95% CI 1.21–1.75), 1.45 (1.13–1.87) and 1.99 (1.43–2.76) for T2DM, RA and COPD, respectively. Conclusion Frailty is identifiable and prevalent among middle aged and older participants in phase 3/4 drug trials and has clinically important safety implications. Trial data may be harnessed to better understand chronic disease management in people living with frailty.

scholarly journals Evaluation of Knowledge, Attitudes and Experience of off-label Drug Prescribing Practice among Physicians in Baghdad City Hospitals

2019 ◽  
Vol 28 (2) ◽  
pp. 115-123
Author(s):  
Aysha M. Shanshal ◽  
Ahmed H. Ataimish
Keyword(s):  
Clinical Trials ◽  
Ethical Issues ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Pharmaceutical Companies ◽  
Cross Sectional ◽  
Off Label ◽  
Healthcare Settings ◽  
Prescribing Practice ◽  
Self Administered Questionnaire

Abstract The present study aims to assess the knowledge, attitude, and experience of off-label prescribing practice among physicians in Baghdad city hospitals. This cross-sectional study was performed through the period from November 1st 2018 to March 2019 at 17 hospitals, a self-administered questionnaire was utilized to collect data from the physicians, and the targeted hospitals were randomly selected at different regions in Baghdad City area. Out of the 400 distributed questionnaires to the physicians, 383 of them were returned completed, 57.2% indicated that they were reasonably familiar with the term “off label drug”, 57.7% mentioned that the most common medical reasons for the prescribing off-label drugs were unavailability of alternatives, 67.6%, 65.5% had concerns regarding its safety and efficacy respectively, 62.7% agreed that the (MOH) authority should provide an incentive to stimulate pharmaceutical companies to perform clinical trials in Iraqi patients, 49.1% believed that clinical trials that recruit volunteers involve ethical issues. Extensive efforts are required to implant programs, regulations and guidelines to control the off-label prescribing practice among the Iraqi healthcare providers who are authorized to prescribe medications at different healthcare settings.    

The Swiss Regulatory Framework for Paediatric Health Research

2008 ◽  
Vol 15 (2) ◽  
pp. 183-195
Author(s):  
Valerie Junod
Keyword(s):  
Clinical Trials ◽  
Health Research ◽  
Ethics Committees ◽  
Drug Trials ◽  
Pharmaceutical Firms ◽  
Risks And Benefits ◽  
Drug Agency ◽  
Swiss Law ◽  
Broad Array ◽  
Paediatric Health

AbstractMedical research on minors entails both risks and benefits. Under Swiss law, clinical trials on children, including nontherapeutic drug trials, are permissible. However, ethics committees must systematically verify that all clinical studies have a favorable risk-benefit profile. Additional safeguards are designed to ensure that children are not unnecessarily involved in research and that proper consent is always obtained. Federal Swiss law is undergoing revision to extend these protections beyond clinical trials to a broad array of health research. The Swiss drug agency also seeks to improve the incentives for pharmaceutical firms to develop new paediatric drugs and relevant paediatric drug labels.

Structure-based molecular insights into matrix metalloproteinase inhibitors in cancer treatments

2021 ◽  
pp. 00-00
Author(s):  
Haili Lin ◽  
Peng Xu ◽  
Mingdong Huang
Keyword(s):  
Clinical Trials ◽  
Matrix Metalloproteinases ◽  
Matrix Metalloproteinase ◽  
Protease Inhibitors ◽  
Anticancer Agents ◽  
Cancer Development ◽  
Pharmaceutical Companies ◽  
Matrix Metalloproteinase Inhibitors ◽  
Cancer Treatments ◽  
Metalloproteinase Inhibitors

Protease inhibitors are of considerable interest as anticancer agents. Matrix metalloproteinases (MMPs) were the earliest type of proteases considered as anticancer targets. The developments of MMP inhibitors (MMPIs) by pharmaceutical companies can be dated from the early 1980s. Thus far, none of the over 50 MMPIs entering clinical trials have been approved. This work summarizes the reported studies on the structure of MMPs and complexes with ligands and inhibitors, based on which, the authors analyzed the clinical failures of MMPIs in a structural biological manner. Furthermore, MMPs were systematically compared with urokinase, a protease-generating plasmin, which plays similar pathological roles in cancer development; the reasons for the clinical successes of urokinase inhibitors and the clinical failures of MMPIs are discussed.

scholarly journals Paediatric drugs trials in China

2020 ◽  
Vol 4 (1) ◽  
pp. e000618
Author(s):  
Guo-Xiang Hao ◽  
Xiao-Xiao Yuan ◽  
Wei Guo ◽  
Xi-Yu Quan ◽  
Xue-Jie Qi ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Drug Trials ◽  
Clinical Trial Registry ◽  
Non Profit ◽  
Paediatric Drug ◽  
Start Date ◽  
Size Number ◽  
Rational Drug ◽  
Registration Number ◽  
Research Stage

ObjectiveClinical trials of children’s drugs are of great significance to rational drug use in children. However, paediatric drugs trials in China are facing complex challenges. At present, the investigation data on registration status of paediatric drug trials in China are still relatively lacking, and relevant research is urgently needed.MethodsThe advanced retrieval function is used to retrieve clinical trials data in the Clinical Trial.gov and Chinese Clinical Trial Registry databases in 22 April 2019. Fifteen key items were analysed to describe trial characteristics, including: registration number, study start date (year), mode of funding, type of disease, medicine type, research stage, research design, sample size, number of experimental groups, placebo group, blind method, implementation centre, child specific, newborn specific and participant age.ResultsA total of 1388 clinical trials of paediatric drugs conducted in China were registered. The number of paediatric drug trials grew steadily over time, from less than 20 per year before 2005 to more than 100 per year after 2012. Most clinical trials were postmarketing (n=800, 57.6%), single-centre (n=1045, 75.3%), intervention studies (n=1161, 83.6%) without blinded methods (1169, 84.2%) and funded by non-profit organisations (n=838, 60.4%). The number of clinical trials for antineoplastic agents (n=254, 18.3%), anti-infectives (n=156, 11.2%) and vaccines (n=154, 11.1%) is the largest.ConclusionPaediatric drug trials in China made a significant progress in recent years. Innovative method and trial design optimisation should be encouraged to accelerate paediatric clinical research. Pharmaceutical companies need to be further stimulated to carry out more high-quality paediatric clinical trials with support of paediatric drug legislation.

Sign in / Sign up

Export Citation Format

Share Document