1
|
Ohmann C, Panagiotopoulou M, Canham S, Felder G, Verde PE. An assessment of the informative value of data sharing statements in clinical trial registries. BMC Med Res Methodol 2024; 24:61. [PMID: 38461273 PMCID: PMC10924983 DOI: 10.1186/s12874-024-02168-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 02/02/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND The provision of data sharing statements (DSS) for clinical trials has been made mandatory by different stakeholders. DSS are a device to clarify whether there is intention to share individual participant data (IPD). What is missing is a detailed assessment of whether DSS are providing clear and understandable information about the conditions for data sharing of IPD for secondary use. METHODS A random sample of 200 COVID-19 clinical trials with explicit DSS was drawn from the ECRIN clinical research metadata repository. The DSS were assessed and classified, by two experienced experts and one assessor with less experience in data sharing (DS), into different categories (unclear, no sharing, no plans, yes but vague, yes on request, yes with specified storage location, yes but with complex conditions). RESULTS Between the two experts the agreement was moderate to substantial (kappa=0.62, 95% CI [0.55, 0.70]). Agreement considerably decreased when these experts were compared with a third person who was less experienced and trained in data sharing ("assessor") (kappa=0.33, 95% CI [0.25, 0.41]; 0.35, 95% CI [0.27, 0.43]). Between the two experts and under supervision of an independent moderator, a consensus was achieved for those cases, where both experts had disagreed, and the result was used as "gold standard" for further analysis. At least some degree of willingness of DS (data sharing) was expressed in 63.5% (127/200) cases. Of these cases, around one quarter (31/127) were vague statements of support for data sharing but without useful detail. In around half of the cases (60/127) it was stated that IPD could be obtained by request. Only in in slightly more than 10% of the cases (15/127) it was stated that the IPD would be transferred to a specific data repository. In the remaining cases (21/127), a more complex regime was described or referenced, which could not be allocated to one of the three previous groups. As a result of the consensus meetings, the classification system was updated. CONCLUSION The study showed that the current DSS that imply possible data sharing are often not easy to interpret, even by relatively experienced staff. Machine based interpretation, which would be necessary for any practical application, is currently not possible. Machine learning and / or natural language processing techniques might improve machine actionability, but would represent a very substantial investment of research effort. The cheaper and easier option would be for data providers, data requestors, funders and platforms to adopt a clearer, more structured and more standardised approach to specifying, providing and collecting DSS. TRIAL REGISTRATION The protocol for the study was pre-registered on ZENODO ( https://zenodo.org/record/7064624#.Y4DIAHbMJD8 ).
Collapse
Affiliation(s)
- Christian Ohmann
- European Clinical Research Infrastructures Network (ECRIN), Kaiserswerther Strasse 70, 40477, Düsseldorf, Germany.
| | | | - Steve Canham
- European Clinical Research Infrastructure Network (ECRIN), 75014, Paris, France
| | - Gerd Felder
- European Clinical Research Infrastructure Network (ECRIN), 40764, Langenfeld, Germany
| | - Pablo Emilio Verde
- Coordination Centre for Clinical Trials, Heinrich Heine University Düsseldorf, 40225, Düsseldorf, Nordrhein-Westfalen, Germany
| |
Collapse
|
2
|
Borana R, Tyagi J, Di Tanna GL, Jha V, Bhaumik S. Intent to share individual participant data of Indian clinical trials. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 19:100318. [PMID: 38025657 PMCID: PMC10665899 DOI: 10.1016/j.lansea.2023.100318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023]
Affiliation(s)
- Ronak Borana
- Meta-research and Evidence Synthesis Unit, The George Institute for Global Health, India
| | - Jyoti Tyagi
- Meta-research and Evidence Synthesis Unit, The George Institute for Global Health, India
| | - Gian Luca Di Tanna
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Switzerland
| | - Vivekanand Jha
- The George Institute for Global Health, UNSW, India
- School of Public Health, Imperial College London, London, UK
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Soumyadeep Bhaumik
- Meta-research and Evidence Synthesis Unit, The George Institute for Global Health, India
- Meta-research and Evidence Synthesis Unit, The George Institute for Global Health, UNSW, Australia
| |
Collapse
|
3
|
Vieira M, Andia T, Karim O, Srishti SA, Pineda SA, Alonso Ruiz A, Large K, Liu Y, Moon S, Naher N, Siddiqui A, Ahmed SM. Rising pharmaceutical innovation in the Global South: a landscape study. J Pharm Policy Pract 2023; 16:155. [PMID: 38012700 PMCID: PMC10680326 DOI: 10.1186/s40545-023-00669-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND There is growing interest in pharmaceutical innovation in low- and middle-income countries (LMICs), but information on existing activities, capacities, and outcomes is scarce. We mapped available data at the global level, and studied the national pharmaceutical innovation systems of Bangladesh and Colombia to shed light on pharmaceutical research and development (R&D) in the Global South, including challenges and prospects, to help fill existing knowledge gaps. METHODS We gathered and analyzed data from three types of sources: literature, semi-structured interviews with key informants, and publicly available data on R&D funding, R&D scientific capacity measured by human resources, and clinical trial activities. RESULTS Pharmaceutical R&D activities are occurring in many LMICs, but 16 countries have emerged as frontrunners. Investment in R&D in LMICs has increased in the past decade, particularly from middle-income countries (MICs). Capacity is also growing, with an increase in the number of research organizations and the amount of funding available from external sources. The total number of clinical trials and the proportion of trials in LMICs increased markedly, and there is also growing activity in the earlier, more innovative and riskier Phase 1 and 2 trials. Non-commercial entities comprise the majority of clinical trial funders and sponsors in LMICs. Finally, investments have borne fruit, as indicated by a number of innovative medicines developed in LMICs. The Bangladesh and Colombia country studies showed that there is still a need for both targeted R&D policies to strengthen capacities in the pharmaceutical sector, and more government support to overcome the challenges of a lack of funding and coordination among different actors. CONCLUSIONS By triangulating between the data sources, it was possible to paint a broad picture of who was involved in pharmaceutical R&D in LMICs, in which particular countries, for which diseases, in which R&D phases, and with what results-as well as how these trends have changed over time. Prioritizing pharmaceutical R&D is an important strategy for better meeting health needs. The trendlines are promising, but focused attention is still needed to realize the potential for greater innovation in the Global South.
Collapse
Affiliation(s)
- Marcela Vieira
- Global Health Centre, Geneva Graduate Institute, Maison de La Paix, Chemin Eugène-Rigot 2, 1202, Geneva, Switzerland.
| | - Tatiana Andia
- Universidad de los Andes, Cra. 1 #18a-12, La Candelaria, Bogotá, Cundinamarca, Colombia
| | - Obaida Karim
- BRAC James P Grant School of Public Health, BRAC University, 7/8/10th Floor, Medona Tower, 28 Mohakhali Commercial Area, Bir Uttom A K Khandakar Road, Dhaka, 1213, Bangladesh
| | - Sanjida Ahmed Srishti
- BRAC James P Grant School of Public Health, BRAC University, 7/8/10th Floor, Medona Tower, 28 Mohakhali Commercial Area, Bir Uttom A K Khandakar Road, Dhaka, 1213, Bangladesh
| | | | - Adrian Alonso Ruiz
- Global Health Centre, Geneva Graduate Institute, Maison de La Paix, Chemin Eugène-Rigot 2, 1202, Geneva, Switzerland
| | - Kaitlin Large
- Global Health Centre, Geneva Graduate Institute, Maison de La Paix, Chemin Eugène-Rigot 2, 1202, Geneva, Switzerland
| | - Yiqi Liu
- Global Health Centre, Geneva Graduate Institute, Maison de La Paix, Chemin Eugène-Rigot 2, 1202, Geneva, Switzerland
| | - Suerie Moon
- Global Health Centre, Geneva Graduate Institute, Maison de La Paix, Chemin Eugène-Rigot 2, 1202, Geneva, Switzerland
| | - Nahitun Naher
- BRAC James P Grant School of Public Health, BRAC University, 7/8/10th Floor, Medona Tower, 28 Mohakhali Commercial Area, Bir Uttom A K Khandakar Road, Dhaka, 1213, Bangladesh
| | - Azizah Siddiqui
- Global Health Centre, Geneva Graduate Institute, Maison de La Paix, Chemin Eugène-Rigot 2, 1202, Geneva, Switzerland
| | - Syed Masud Ahmed
- BRAC James P Grant School of Public Health, BRAC University, 7/8/10th Floor, Medona Tower, 28 Mohakhali Commercial Area, Bir Uttom A K Khandakar Road, Dhaka, 1213, Bangladesh
| |
Collapse
|
4
|
Akl EA, Cuker A, Mustafa RA, Nieuwlaat R, Stevens A, Schünemann HJ. Prospective collaborative recommendation development: a novel model for more timely and trustworthy guidelines. J Clin Epidemiol 2023; 162:156-159. [PMID: 37648070 DOI: 10.1016/j.jclinepi.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 08/14/2023] [Accepted: 08/23/2023] [Indexed: 09/01/2023]
Affiliation(s)
- Elie A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
| | - Adam Cuker
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Outcomes and Implementation Research Unit, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Reem A Mustafa
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Robby Nieuwlaat
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Adrienne Stevens
- Centre for Immunization Readiness, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| |
Collapse
|
5
|
Seidler AL, Willson ML, Aberoumand M, Williams JG, Hunter KE, Barba A, Simes RJ, Webster A. The changing landscape of clinical trials in Australia. Med J Aust 2023; 219:192-196. [PMID: 37573518 PMCID: PMC10952960 DOI: 10.5694/mja2.52059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 08/15/2023]
Affiliation(s)
| | | | | | | | - Kylie E Hunter
- NHMRC Clinical Trials CentreUniversity of SydneySydneyNSW
| | - Angie Barba
- NHMRC Clinical Trials CentreUniversity of SydneySydneyNSW
| | - R John Simes
- NHMRC Clinical Trials CentreUniversity of SydneySydneyNSW
| | - Angela Webster
- NHMRC Clinical Trials CentreUniversity of SydneySydneyNSW
| |
Collapse
|
6
|
Kobold S, Bultjer N, Stacey G, Mueller SC, Kurtz A, Mah N. History and current status of clinical studies using human pluripotent stem cells. Stem Cell Reports 2023; 18:1592-1598. [PMID: 37028422 PMCID: PMC10444540 DOI: 10.1016/j.stemcr.2023.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 04/09/2023] Open
Abstract
The Human Pluripotent Stem Cell Registry established a database of clinical studies using human pluripotent stem cells (PSCs) as starting material for cell therapies. Since 2018, we have observed a switch toward human induced pluripotent stem cells (iPSCs) from human embryonic stem cells. However, rather than using iPSCs for personalized medicines, allogeneic approaches dominate. Most treatments target ophthalmopathies, and genetically modified iPSCs are used to generate tailored cells. We observe a lack of standardization and transparency about the PSCs lines used, characterization of the PSC-derived cells, and the preclinical models and assays applied to show efficacy and safety.
Collapse
Affiliation(s)
- Sabine Kobold
- Fraunhofer-Institut für Biomedizinische Technik (IBMT), Joseph-von-Fraunhofer Weg 1, 66280 Sulzbach, Germany
| | - Nils Bultjer
- Fraunhofer-Institut für Biomedizinische Technik (IBMT), Joseph-von-Fraunhofer Weg 1, 66280 Sulzbach, Germany
| | - Glyn Stacey
- International Stem Cell Banking Initiative, 2 High Street, Barley SG88HZ, UK
| | - Sabine C Mueller
- Fraunhofer-Institut für Biomedizinische Technik (IBMT), Joseph-von-Fraunhofer Weg 1, 66280 Sulzbach, Germany
| | - Andreas Kurtz
- Fraunhofer-Institut für Biomedizinische Technik (IBMT), Joseph-von-Fraunhofer Weg 1, 66280 Sulzbach, Germany; Berlin Institute of Health Center for Regenerative Therapies, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Nancy Mah
- Fraunhofer-Institut für Biomedizinische Technik (IBMT), Joseph-von-Fraunhofer Weg 1, 66280 Sulzbach, Germany.
| |
Collapse
|
7
|
Ramdjee B, Husson M, Hajage D, Tubach F, Estellat C, Dechartres A. COVID-19 trials were not more likely to report intent to share individual data than non-COVID-19 trials in ClinicalTrials.gov. J Clin Epidemiol 2023; 158:10-17. [PMID: 36965602 PMCID: PMC10036148 DOI: 10.1016/j.jclinepi.2023.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/30/2023] [Accepted: 03/21/2023] [Indexed: 03/27/2023]
Abstract
OBJECTIVES To compare intent to share individual participant data (IPD) between COVID-19 and non-COVID-19 trials registered at ClinicalTrials.gov between 01/09/2020, and 01/03/2021. We also evaluated factors independently associated with intent to share IPD and whether intent to share IPD has improved as compared with the prepandemic period. METHODS We searched ClinicalTrials.gov for all interventional phase 3 studies registered between 01/09/2020, and 01/03/2021. Then, we identified COVID-19 trials and selected a random sample of non-COVID-19 trials with a ratio 2:1. We compared the intent to share IPD between these trials and with 292 trials registered between 01/12/2019, and 01/03/2020 (prepandemic period). RESULTS We included 148 COVID-19 trials and 296 non-COVID-19 trials. Intent to share IPD did not significantly differ between COVID-19 and non-COVID-19 trials (22.3% vs. 27.0%, P = 0.3). Intent to share IPD was independently associated with industry-sponsorship (odds ratio [OR] = 2.92; 95% confidence interval [CI]: 1.65-5.27) and location in the United States (OR = 2.93; 95% CI: 1.64-5.41) or the European Union (OR = 2.06; 95% CI: 1.03-4.19). The intent to share IPD has not significantly improved compared with the prepandemic period (P = 0.16). CONCLUSION Data-sharing intent at registration does not seem better for COVID-19 trials.
Collapse
Affiliation(s)
- Bruno Ramdjee
- AP-HP, Hôpital Pitié Salpêtrière, Département de Santé Publique, F75013, Paris, France
| | - Mathilde Husson
- AP-HP, Hôpital Pitié Salpêtrière, Département de Santé Publique, F75013, Paris, France
| | - David Hajage
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Département de Santé Publique, CIC-1901, F75013, Paris, France
| | - Florence Tubach
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Département de Santé Publique, CIC-1901, F75013, Paris, France
| | - Candice Estellat
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Département de Santé Publique, CIC-1901, F75013, Paris, France
| | - Agnès Dechartres
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Département de Santé Publique, CIC-1901, F75013, Paris, France.
| |
Collapse
|
8
|
Dron L, Kalatharan V, Gupta A, Haggstrom J, Zariffa N, Morris AD, Arora P, Park J. Data capture and sharing in the COVID-19 pandemic: a cause for concern. Lancet Digit Health 2022; 4:e748-e756. [PMID: 36150783 PMCID: PMC9489064 DOI: 10.1016/s2589-7500(22)00147-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 12/25/2022]
Abstract
Routine health care and research have been profoundly influenced by digital-health technologies. These technologies range from primary data collection in electronic health records (EHRs) and administrative claims to web-based artificial-intelligence-driven analyses. There has been increased use of such health technologies during the COVID-19 pandemic, driven in part by the availability of these data. In some cases, this has resulted in profound and potentially long-lasting positive effects on medical research and routine health-care delivery. In other cases, high profile shortcomings have been evident, potentially attenuating the effect of-or representing a decreased appetite for-digital-health transformation. In this Series paper, we provide an overview of how facets of health technologies in routinely collected medical data (including EHRs and digital data sharing) have been used for COVID-19 research and tracking, and how these technologies might influence future pandemics and health-care research. We explore the strengths and weaknesses of digital-health research during the COVID-19 pandemic and discuss how learnings from COVID-19 might translate into new approaches in a post-pandemic era.
Collapse
Affiliation(s)
- Louis Dron
- Real World & Advanced Analytics, Cytel Health, Vancouver, BC, Canada,Correspondence to: Mr Louis Dron, Real World & Advanced Analytics, Cytel Health, Vancouver, BC V5Z 4J7, Canada
| | - Vinusha Kalatharan
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
| | - Alind Gupta
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jonas Haggstrom
- Real World & Advanced Analytics, Cytel Health, Vancouver, BC, Canada,The International COVID-19 Data Alliance (ICODA), Health Data Research UK, London, UK
| | - Nevine Zariffa
- The International COVID-19 Data Alliance (ICODA), Health Data Research UK, London, UK,NMD Group, LLC, Bala Cynwyd, PA, USA
| | - Andrew D Morris
- The International COVID-19 Data Alliance (ICODA), Health Data Research UK, London, UK
| | - Paul Arora
- Real World & Advanced Analytics, Cytel Health, Vancouver, BC, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jay Park
- Department of Experimental Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada,Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
9
|
Mathebula L, Runeyi S, Wiysonge C, Ndwandwe D. Clinical trial registration during COVID-19 and beyond in the African context: what have we learned? Trials 2022; 23:460. [PMID: 35668437 PMCID: PMC9167898 DOI: 10.1186/s13063-022-06412-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 05/18/2022] [Indexed: 11/28/2022] Open
Abstract
Since the outbreak of COVID-19, many lives have been impacted especially on the African continent which is already fighting the burden of multiple diseases of poverty. However, clinical research has offered hope for treatment and prevention options for this infectious disease. Despite many COVID-19 clinical trials conducted globally, three countries in Africa account for more than 80% of all trials from the continent registered trials in clinical trial registries. This indicates geographic disparity among COVID-19 research in Africa. From the perspective of clinical trial registration, transparency in clinical research and the availability of data became important for making informed decisions to manage the pandemic. Registries serve as a source of planned, ongoing, and completed trials while allowing efficient funding allocation for research that would not duplicate efforts. Additionally, research gaps can be identified, which provide opportunities for collaboration among researchers. Therefore, a critical lesson learnt during this pandemic is that clinical trial registration is important in facilitating the process of tracking changes made to protocols and minimizing publication bias, thereby promoting and advocating for clinical research transparency. Moreover, registration in a clinical trial registry is a condition for publication and allows for trial summary results to be publicly available. Adhering to the principle of results sharing is especially important for the rapidly growing clinical research activities racing to find evidence-based interventions to end the COVID-19 pandemic.
Collapse
Affiliation(s)
- Lindi Mathebula
- Cochrane South Africa, South African Medical Research Council, Tygerberg, 7505, South Africa.
| | - Sinazo Runeyi
- Cochrane South Africa, South African Medical Research Council, Tygerberg, 7505, South Africa
| | - Charles Wiysonge
- Cochrane South Africa, South African Medical Research Council, Tygerberg, 7505, South Africa.,HIV and other Infectious Diseases Research Unit, South African Medical Research Council, Tygerberg, 7505, South Africa.,Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, 7505, South Africa.,School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, 7925, South Africa
| | - Duduzile Ndwandwe
- Cochrane South Africa, South African Medical Research Council, Tygerberg, 7505, South Africa
| |
Collapse
|
10
|
Wiysonge CS, Ndwandwe D, Mathebula L, Goga A, Gray G. Randomised trials of COVID-19 vaccines in Africa – charting the path forward. S AFR J SCI 2022. [DOI: 10.17159/sajs.2022/13224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Vaccines have played a critical role in controlling disease outbreaks, hence the proliferation of the development and testing of multiple vaccine candidates during the COVID-19 pandemic. Randomised trials are gold standards for evaluating the safety and efficacy of pharmaceutical interventions such as COVID-19 vaccines. However, contextual differences may attenuate effects of COVID-19 vaccines. Thus, the need to conduct COVID-19 vaccine trials in all settings, including in Africa. We conducted a cross-sectional analysis of planned, ongoing, and completed COVID-19 vaccine trials in Africa. We searched the South African National Clinical Trials Register, Pan African Clinical Trials Registry, and International Clinical Trials Registry Platform (ICTRP) on 12 January and 30 April 2022; and complemented this with a search of ClinicalTrials.gov on 17 May 2022. We screened the search output and included randomised trials with at least one recruitment site in Africa. We identified only 108 eligible trials: 90 (83%) evaluating candidate COVID-19 vaccines, 11 (10%) assessing if existing vaccines could prevent SARS-CoV-2 infection, and 7 (7%) evaluating interventions for improving COVID-19 vaccination coverage. South Africa had the highest number of trials at 58 (54%). Beyond South Africa, countries with more than 10 trial sites include Kenya, Ghana, Egypt, Uganda, and Zimbabwe. Among the trials, 14 (13%) do not have principal investigators based in Africa, 39 (30%) are funded by industry, and 91 (84%) are funded by institutions based outside the host country. COVID-19 vaccine trials with recruitment sites in Africa represented only 7% of the 1453 COVID-19 vaccine trials in the ICTRP. The paucity of COVID-19 vaccine trials conducted on the African continent is a cause for concern. This has implications for the role that Africa may play in future pandemics.
Collapse
Affiliation(s)
- Charles S. Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Durban, South Africa
| | - Duduzile Ndwandwe
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Lindi Mathebula
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Ameena Goga
- HIV and other Infectious Diseases Research Unit, South African Medical Research Council, Durban, South Africa
- Department of Paediatrics and Child Health, University of Pretoria, Pretoria, South Africa
| | - Glenda Gray
- Office of the President and CEO, South African Medical Research Council, Cape Town, South Africa
| |
Collapse
|