Meta-analysis of blinded and unblinded studies for ongoing aggregate safety monitoring and evaluation.

Contemp Clin Trials

Clinical Safety Statistics, Merck & Co., Inc., Rahway, NJ, USA.

Published: August 2020


Category Ranking

98%

Total Visits

921

Avg Visit Duration

2 minutes

Citations

20

Article Abstract

During the course of clinical development, ongoing aggregate safety monitoring and evaluation are needed to understand the evolving safety profile and to ensure effective risk-management strategies for medicinal products. CIOMS reports and global regulatory guidance (including from ICH, US FDA, and EMA) compel sponsors for assessment of safety based on aggregate data. To identify and characterize the risks of medicinal products at a program level in a more timely and informed manner, aggregate safety evaluations should combine all available information, including from ongoing blinded trials, completed unblinded trials, and other data sources. In this article, we propose two Bayesian meta-analytic approaches for synthesizing blinded and unblinded studies in order to characterize the evolving safety profile of medicinal products at the program level. With the proposed approaches, sponsors can dynamically update knowledge of their product safety profiles as data accrue. Application of the procedures to a real and a hypothetical clinical trial program are provided to illustrate how the proposed approaches can be used to analyze a pre-specified event of interest and to screen for risk-elevated events.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cct.2020.106068DOI Listing

Publication Analysis

Top Keywords

aggregate safety
12
medicinal products
12
blinded unblinded
8
unblinded studies
8
ongoing aggregate
8
safety monitoring
8
monitoring evaluation
8
evolving safety
8
safety profile
8
products program
8

Similar Publications

To ensure safety, pharmaceuticals are rigorously tested for lipopolysaccharide (LPS) contamination, as this can trigger severe immune reactions in patients. Low Endotoxin Recovery (LER), describing the masking of spiked LPS controls in Limulus Amebocyte Lysate (LAL) assays, has been associated with the presence of chelating agents and surfactants in pharmaceutical formulations. The addition of excipients, such as Mg2, have shown the ability to mitigate the effects of LER, however, inconsistencies in various studies regarding the influence of the excipients on LPS aggregate characteristics and LER occurrence hinder a clear understanding of the mechanisms underlying LER.

View Article and Find Full Text PDF

Background: Current guidelines recommend clopidogrel in patients with chronic coronary syndrome (CCS) undergoing percutaneous coronary intervention (PCI), yet the comparative benefits are unclear.

Aims: The aim of this study was to evaluate the efficacy and safety of ticagrelor versus clopidogrel in patients with CCS undergoing PCI.

Methods: We searched PubMed/MEDLINE, EMBASE, CENTRAL databases from inception to February 15, 2025.

View Article and Find Full Text PDF

In recent years, amino acids have garnered extensive attention as environmentally friendly, small-dose additives for modulating hydrate formation and aggregation behavior. Amino acids, due to their amphiphilic nature, can adsorb at the gas-liquid interface and on hydrate crystal surfaces, thereby modifying interfacial properties and influencing crystal growth patterns. In our measurements, the amino acids displayed a concentration-dependent "double effect".

View Article and Find Full Text PDF

Applications of Federated Large Language Model for Adverse Drug Reactions Prediction: Scoping Review.

J Med Internet Res

September 2025

Department of Information Systems and Cybersecurity, The University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX, 78249, United States, 1 (210) 458-6300.

Background: Adverse drug reactions (ADR) present significant challenges in health care, where early prevention is vital for effective treatment and patient safety. Traditional supervised learning methods struggle to address heterogeneous health care data due to their unstructured nature, regulatory constraints, and restricted access to sensitive personal identifiable information.

Objective: This review aims to explore the potential of federated learning (FL) combined with natural language processing and large language models (LLMs) to enhance ADR prediction.

View Article and Find Full Text PDF

Background: Neighborhoods resulting from rapid urbanization processes are often saturated with eateries for local communities, potentially increasing exposure to unhealthy foods and creating diabetogenic residential habitats.

Objective: We examined the association between proximity of commercial food outlets to local neighborhood residences and type 2 diabetes (T2D) cases to explore how local T2D rates vary by location and provide policy-driven metrics to monitor food outlet density as a potential control for high local T2D rates.

Methods: This cross-sectional ecological study included 11,354 patients with active T2D aged ≥20 years geocoded using approximate neighborhood residence aggregated to area-level rates and counts by subdistricts (mukims) in Penang, northern Malaysia.

View Article and Find Full Text PDF