Premature termination of clinical trials in Spain: reasons, characteristics, and opportunities to improve.

Purpose: The aim of this study is to determine the rate of prematurely terminated clinical trials (CTs) and describe primary reasons and characteristics, and suggest strategies to improve. Methods: We performed a retrospective, observational, cross-sectional study including all CTs registered in the...

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Publicado en:European Journal of Clinical Pharmacology Vol. 79; no. 2; pp. 249 - 257
Autores principales: Filippi-Arriaga, Francesca, Boy, Ricardo Javier, Del Gobbo, Alejandro Díaz, Gallego, Alexis Rodríguez
Formato: research tables/charts Journal Article
Publicado: Springer Nature Feb2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2023
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00228-022-03437-5
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        atl: Premature termination of clinical trials in Spain: reasons, characteristics, and opportunities to improve.
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        au:
          Filippi-Arriaga, Francesca
          Boy, Ricardo Javier
          Del Gobbo, Alejandro Díaz
          Gallego, Alexis Rodríguez
        affil: Clinical Pharmacology Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain
      sug:
        subj:
          Clinical Trials
          Research Subject Recruitment Evaluation
          Risk Assessment
          Spain
          Human
          Retrospective Design
          Nonexperimental Studies
          Cross Sectional Studies
          Clinical Trial Registry
          Relative Risk
          Confidence Intervals
          Treatment Outcomes
          Business
          Decision Making
          Descriptive Statistics
          Placebos Therapeutic Use
          Aged
          Infant, Newborn
          Child, Preschool
          Child
          Neoplasms
          Digestive System Pathology
          Age Factors
          Multicenter Studies
          Aged: 65+ years
          Infant, Newborn: birth-1 month
          Child, Preschool: 2-5 years
          Child: 6-12 years
      ab: Purpose: The aim of this study is to determine the rate of prematurely terminated clinical trials (CTs) and describe primary reasons and characteristics, and suggest strategies to improve. Methods: We performed a retrospective, observational, cross-sectional study including all CTs registered in the Spanish Registry of Clinical Studies (REec) from January 1, 2013 to November 31, 2021. A descriptive analysis of reasons for premature termination was made. To assess characteristics associated with a premature termination, the relative risks (RR) with a 95% confidence interval were calculated. Results: In total, 21% (718) of CT were prematurely terminated. Reasons for premature termination included patient recruitment issues in 25% (179) of cases, efficacy or futility problems in 18% (132), and commercial or strategic decisions from the sponsor in 12% (87). Characteristics significantly associated with an increased risk of premature termination included the following: presence of placebo (RR 2.08); multiple study sites (RR 1.32); pediatric and geriatric populations (RR 1.29 children; RR 1.47 preschoolers; RR 1.92 newborns; RR 1.27 > 64 years of age). In addition, circumstances such as investigations in phase II (RR 1.21), of cancer (RR 1.37), and of digestive pathology (RR 1.65) were also associated with increased risk of premature termination. Conclusion: Recruitment of the study subjects in a CT must be meticulous and account for age of participants. In addition, CT study sites should be evaluated to ensure they have appropriate resources and the desired patient population. Based on intermediate analyses, CT protocols should describe the criteria to terminate a study due to futility. These approaches are essential to avoid harm to participants, ensure internal validity of studies, and improve the use of resources in CT development.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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