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Bauzon J, Lee G, Cummings J. Repurposed agents in the Alzheimer's disease drug development pipeline. Alzheimers Res Ther 2020; 12:98. [PMID: 32807237 PMCID: PMC7433208 DOI: 10.1186/s13195-020-00662-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/29/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Treatments are needed to address the growing prevalence of Alzheimer's disease (AD). Clinical trials have failed to produce any AD drugs for Food and Drug Administration (FDA) approval since 2003, and the pharmaceutical development process is both time-consuming and costly. Drug repurposing provides an opportunity to accelerate this process by investigating the AD-related effects of agents approved for other indications. These drugs have known safety profiles, pharmacokinetic characterization, formulations, doses, and manufacturing processes. METHODS We assessed repurposed AD therapies represented in Phase I, Phase II, and Phase III of the current AD pipeline as registered on ClinicalTrials.gov as of February 27, 2020. RESULTS We identified 53 clinical trials involving 58 FDA-approved agents. Seventy-eight percent of the agents in trials had putative disease-modifying mechanisms of action. Of the repurposed drugs in the pipeline 20% are hematologic-oncologic agents, 18% are drugs derived from cardiovascular indications, 14% are agents with psychiatric uses, 12% are drug used to treat diabetes, 10% are neurologic agents, and the remaining 26% of drugs fall under other conditions. Intellectual property strategies utilized in these programs included using the same drug but altering doses, routes of administration, or formulations. Most repurposing trials were supported by Academic Medical Centers and were not funded through the biopharmaceutical industry. We compared our results to a European trial registry and found results similar to those derived from ClinicalTrials.gov. CONCLUSIONS Drug repurposing is a common approach to AD drug development and represents 39% of trials in the current AD pipeline. Therapies from many disease areas provide agents potentially useful in AD. Most of the repurposed agents are generic and a variety of intellectual property strategies have been adopted to enhance their economic value.
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Affiliation(s)
- Justin Bauzon
- School of Medicine, University of Nevada, Las Vegas (UNLV), Las Vegas, NV, 89154, USA
| | - Garam Lee
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, 89106, USA
| | - Jeffrey Cummings
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, 89106, USA.
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada, Las Vegas (UNLV), Las Vegas, NV, 89154, USA.
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Kumari S, Mohan A, Saberwal G. Hidden duplicates: 10s or 100s of Indian trials, registered with ClinicalTrials.gov, have not been registered in India, as required by law. PLoS One 2020; 15:e0234925. [PMID: 32559240 PMCID: PMC7304601 DOI: 10.1371/journal.pone.0234925] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 06/04/2020] [Indexed: 12/25/2022] Open
Abstract
Background This study’s primary goal was based on the fact that since 15 June 2009 it has been mandatory to register regulatory trials running in India with Clinical Trials Registry–India (CTRI). Were all such trials, registered with ClinicalTrials.gov (CTG) after 2009, that included India as a location, also registered with CTRI? We first had to determine how to correctly identify a trial that was registered in both the registries, but that lacked the relevant secondary ID. Therefore the secondary goal of this study was to identify the best method to do this. Methods We used a control set of 1013 trials that cross-referenced a record in the other registry. We used two algorithms to–in a blinded fashion–identify CTRI matches for the 1013 CTG records. 80% of the predictions were correct. Using the same methodology, we identified matches for the CTG trials without known CTRI matches. We then used a logistic regression model to predict which of these matches were correct. Results (i) 3664 CTG records listed India as a location, but did not list any CTRI ID, and were not identified by any CTRI records either. (ii) The best single field to find a CTRI match for a CTG trial was the title field. (iii) Between 50 and 300 of 581 relevant CTG trials were not registered with CTRI. Conclusions This is the first study to use hidden duplicates to determine that the law on trial registration has been broken (in India). Similar studies need to be done for trials run in other countries.
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Affiliation(s)
- Sangeeta Kumari
- Institute of Bioinformatics and Applied Biotechnology, Biotech Park, Bengaluru, Karnataka, India
| | - Abhilash Mohan
- Institute of Bioinformatics and Applied Biotechnology, Biotech Park, Bengaluru, Karnataka, India
| | - Gayatri Saberwal
- Institute of Bioinformatics and Applied Biotechnology, Biotech Park, Bengaluru, Karnataka, India
- * E-mail:
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Dammo N, Harpe SE. Characteristics of studies of pharmacist services registered in ClinicalTrials.gov. J Am Pharm Assoc (2003) 2020; 60:609-617. [PMID: 31902662 DOI: 10.1016/j.japh.2019.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 11/22/2019] [Accepted: 12/01/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the characteristics of studies of pharmacist services registered in ClinicalTrials.gov. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS ClinicalTrials.gov and MEDLINE databases were searched to identify studies of pharmacist services. Registration information was obtained from the Aggregate Analysis of ClinicalTrials.gov (AACT) database. Studies were excluded if the ClinicalTrials.gov submission date was after December 31, 2018; there were no U.S. study sites; pharmacist services were not mentioned; or pharmacist involvement was limited to medication dispensing, randomization, or measuring study outcomes. OUTCOME MEASURES Characteristics of registered studies from ClinicalTrials.gov and AACT data, categories of pharmacist services, changes in registration and focus of pharmacist services over time, and relationships between funding source and result availability and between the focus of pharmacist services and types of outcomes and types of pharmacist interventions. RESULTS Overall 401 studies were identified for initial review, with 151 included for detailed review. Pharmacist services were the only intervention in 68 studies (45.0%), a separate intervention in 14 (9.3%), and part of a combined intervention in 40 (26.5%). In 29 studies (19.2%), pharmacist services were not the focus. Registered studies primarily were interventional, randomized, and open-label; included behavioral or "other" interventions; were conducted in the outpatient setting; and were sponsored by "other" sources. The most common health conditions were hypertension and diabetes. Only 29 of the 104 completed studies (27.9%) posted results. Clinical outcomes were the most common primary (80; 53.0%) and secondary outcomes (66; 58.9%). Medication management (69; 45.7%) and patient education or counseling (88; 58.3%) were the most common types of pharmacist interventions. CONCLUSION This analysis of ClinicalTrials.gov identified 151 studies of pharmacist services in the United States registered through the end of 2018. Given the breadth of the pharmacy services literature, there is room for improvement in the registration of these types of studies.
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Masic I, Jankovic SM, Kurjak A, Donev DM, Zildzic M, Sinanovic O, Hozo I, Milicevic S, Hasukic S, Mujanovic E, Arnautovic K, Trnacevic S, Mesic E, Biscevic M, Sefic M, Gerc V, Kucukalic A, Hrgovic Z, Bergsland J, Grujic M. Balkan Clinical Research Registry: Established by Academy of Medical Sciences of Bosnia and Herzegovina. Med Arch 2020; 74:412-415. [PMID: 33603263 PMCID: PMC7879344 DOI: 10.5455/medarh.2020.74.412-415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: From 2013 the World Medical Association’s Declaration of Helsinki explicitly requires pre-registration of a study involving human subjects. The registration gives a chance for improvement of design and avoidance of bias. Objective: The aim of this article was to describe process of bearing decision to create regional registry of clinical studies for Balkan countries. Methods: After finding relevant studies about research registries and designing the concept and structure of future regional registry an article was published in IJBH journal. The article was than used as basis for discussion at 2020 meeting of Academy of Medical Sciences of Bosnia and Herzegovina (AMSBH), and final decision was made by the Academy to create the research registry. Results: Regional registry of clinical studies will be under the auspices of AMSBH and web-based, with the option of online registration of new studies. The data required to be entered in the moment of registration relate to key elements of research plan: topic, variables, sample, type of the study and the study population. After applying for registration of a clinical study, the authors will soon receive the review made by the AMSBH expert committee. The application could be accepted, rejected or returned for major or minor revision. After an application is accepted, it will be deposited in the searchable database and given the registration number. Conclusion: The AMSBH’s decision to create the regional registry of clinical studies will satisfy needs of researchers from Balkan countries in the first place, who share cultural and lingual similarities. It will also help with increasing standards of clinical research in the region.
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Affiliation(s)
- Izet Masic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.,World Academy of Art and Science, Washington, USA.,International Academy of Health Science Informatics, Geneva, Switzerland
| | - Slobodan M Jankovic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.,Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Asim Kurjak
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.,World Academy of Art and Science, Washington, USA.,European Academy of Sciences and Arts, Salzburg, Austria.,International Academy of Perinatal medicine, Zagreb, Croatia.,Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - Doncho M Donev
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.,European Academy of Sciences and Arts, Salzburg, Austria.,Faculty of Medicine, Ss Cyril and Methodius University, Skopje, R.N. Macedonia
| | - Muharem Zildzic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Osman Sinanovic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.,Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - Izet Hozo
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.,Faculty of Medicine, University of Split, Split, Croatia
| | - Snjezana Milicevic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.,Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Sefik Hasukic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.,Department of Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Emir Mujanovic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.,Medical center Bayer, Tuzla, Tuzla, Bosnia and Herzegovina
| | - Kenan Arnautovic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.,Semmes Murphey Leaders in Brain and Spine Care, Memphis, Tennessee, USA
| | - Senaid Trnacevic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.,University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Enisa Mesic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.,University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Mirza Biscevic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.,General Hospital "Prim. Dr. Abdulah Nakas", Sarajevo, Bosnia and Herzegovina
| | - Mustafa Sefic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Vjekoslav Gerc
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Abdulah Kucukalic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Zlatko Hrgovic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Jacob Bergsland
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.,University Hospital Oslo, Oslo, Norway
| | - Mirko Grujic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
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