Specific recommendations to improve the design and conduct of clinical trials

Abstract

There are many reasons why the majority of clinical trials fail or have limited applicability to patient care. These include restrictive entry criteria, short duration studies, unrecognized adverse drug effects, and reporting of therapy assignment preferential to actual use. Frequently, experimental animal models are used sparingly and do not accurately simulate human disease. We suggest two approaches to improve the conduct, increase the success, and applicability of clinical trials. Studies can apply dosing of the investigational therapeutics and outcomes, determined from animal models that more closely simulate human disease. More extensive identification of known and potential risk factors and confounding issues, gleaned from recently organized “big data,” should be utilized to create models for trials. The risk factors in each model are then accounted for and managed during each study.

Placebo-resistant gut bacteria: Akkermansia muciniphila spp. and Familial Mediterranean fever disease

“…Additionally, the orchestration of placebo-controlled trials is a complex process (Howick, 2017), particularly in developing countries (Lepage et al, 2023;Kim et al, 2023). The success of clinical trials is influenced by diverse factors (Kupersmith and Jette, 2023;Jacobsen et al, 2023;Feldman et al, 2022), and despite the abundance of such trials, there remains a need to elucidate placebo effects in both healthy individuals and patients, particularly in studies related to the gut microbiota (Kleine-Borgmann et al, 2023).…”