立陶宛和欧洲神经系统药物临床试验的趋势

Emilijus Žilinskas, Arūnas Vaitkevičius
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引用次数: 0

摘要

背景。随着全球神经系统疾病负担的不断加重,临床试验变得越来越重要。然而,在欧洲,特别是在立陶宛,还没有对神经系统药物临床试验进行过系统分析。本研究旨在评估欧洲和立陶宛神经系统药物临床试验的特点和注册动态。对来自欧盟药品监管机构临床试验登记处(EudraCT)的数据进行了分析。对 2012-2021 年期间登记在册的神经系统药物临床试验申请进行了审查。对以下方面进行了评估:试验阶段、赞助商身份、神经系统疾病(适应症)、试验预期样本量、试验设计以及成员国数量。2012-2021年间,欧洲共注册了2242项神经系统药物临床试验,占欧洲注册临床试验总数的6.49%。2012-2021年间,年注册率没有明显变化(R² = 0.039; p = 0.606)。大多数试验(72.18%)由商业制药公司赞助。大多数试验(31.73%)登记为 I 期试验。大多数试验(363 项,占 17.20%)是针对阿尔茨海默病和其他痴呆症的临床试验。在 2012-2021 年期间,阿尔茨海默病和其他痴呆症临床试验的年注册率显著下降(R² = 0.751,p = 0.001),而肌神经节和肌肉疾病以及运动神经元疾病临床试验的年注册率则相应上升(R² = 0.582,p = 0.010 和 R² = 0.635,p = 0.006)。商业试验的计划受试者人数较多(p = 0.014)。多个成员国参与商业试验的频率更高(p < 0.001)。2012-2021 年间,立陶宛共注册了 55 项神经系统药物临床试验,占立陶宛注册的所有临床试验的 8.08%。年注册率明显下降(R² = 0.401,p = 0.049)。立陶宛几乎所有的试验(55 项中的 53 项)都由商业公司赞助。大多数试验(23 项(42%))是针对中枢神经系统脱髓鞘疾病的试验。欧洲神经系统药物试验的年度注册率保持稳定,而立陶宛则有所下降。商业临床试验的参与人数更多,而且更常在多个成员国进行。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Neurologijos srityje vartojamų vaistinių preparatų klinikinių tyrimų tendencijos Lietuvoje ir Europoje
Background. As the global burden of neurological diseases has been increasing, clinical trials have become more important. Yet, no systematic analysis of clinical trials of neurological medicinal products has been done in Europe and, specifically, in Lithuania. The aim of this study is to evaluate the tendencies of characteristics and registration dynamics of clinical trials of neurological medicines in Europe and Lithuania.Materials and methods. Analysis of data from the clinical trials register of the European Union drug regulatory authorities (EudraCT) has been performed. Applications of clinical trials of neurological medicines included in the register during the period between 2012–2021 have been reviewed. The following aspects have been evaluated: the phase of the trial, the sponsor status, the neurological condition (indication), the expected sample size of the trial, the trial design, and the number of member countries.Results. 2,242 clinical trials of neurological medicines have been registered in Europe during the period of 2012–2021, and they comprised 6.49% of all clinical trials registered in Europe. The annual registration rates did not change significantly during the period of 2012–2021 (R² = 0.039; p = 0.606). The majority of the trials (72.18%) were sponsored by commercial pharmaceutical companies. Most trials (31.73%) were registered as phase I trials. The majority of the trials (363 (17.20%)) were clinical trials for Alzheimer’s disease and other dementias. During the period of 2012–2021, there was a significant decrease in the annual registration rate of clinical trials for Alzheimer’s disease and other dementias (R² = 0.751, p = 0.001) and an increase of clinical trials for myoneural junction and muscle diseases and motor neuron disease (R² = 0.582, p = 0.010 and R² = 0.635, p = 0.006, accordingly). Commercial trials had a higher planned number of subjects (p = 0.014). Multiple member states participated in commercial trials more frequently (p < 0.001). Fifty-five clinical trials of neurological medicines were registered in Lithuania during the period of 2012–2021, and they comprised 8.08% of all clinical trials registered in Lithuania. The annual registration rate has decreased significantly (R² = 0.401, p = 0.049). Almost all trials in Lithuania (53 out of 55) were sponsored by commercial companies. The majority of trials (23 (42%)) were trials for demyelinating diseases of the CNS.Conclusions. The annual registration rates of trials of neurological medicines remain stable in Europe while decreasing in Lithuania. Commercial clinical trials have more participants, and are more commonly conducted in multiple member states.
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