Over 10,000 rare diseases have been identified, affecting approximately 1 in 10 Americans. Unfortunately, over 90% of these conditions lack a cure or disease-modifying treatment. Clinical trials serve as a beacon of hope, driving research forward and potentially uncovering effective therapies. Patients with rare diseases willingly participate in trials to slow disease progression or alleviate common adverse events like fatigue.
However, rare disease drug development presents significant challenges. These include small patient populations, geographic dispersion, treatment heterogeneity, study reproducibility issues, and ethical considerations. Conducting adequately powered clinical trials remains difficult due to the scarcity of patients. The traditional approach of testing one drug for one indication proves inefficient in this context.
To overcome these hurdles, novel statistical approaches have emerged. These methods allow for information sharing across disease subtypes with similar characteristics, such as shared genetic alterations. Examples include master protocols, Bayesian hierarchical models and meta-analytic predictive models. However, applying these approaches to randomized controlled trials, often necessary for regulatory approval, remains a challenge.
Enter Complex Innovative Trial Designs (CIDs). CIDs hold promise in clinical trials by enhancing efficiency and reducing drug development costs. The US 21st Century Cures Act and the Prescription Drug User Fee Act (PDUFA) VI actively encourage their use. The FDA’s CID Paired Meeting Program fosters discussions on alternative trial designs. In 2024, the FDA launched the Center for Clinical Trial Innovation (C3II) to promote innovative practices.
While there is no fixed definition of CIDs, simulations—rather than mathematical formulas—play a crucial role in estimating trial operating characteristics.
For further insights, explore our just-published white paper!
https://lnkd.in/erZipKqb
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Founder & CEO AtmosR
4mo« Think out of the box!! ». Rare disease treatments can not be developed in the same way as treatments for more common diseases …