General characteristics and reasons for the discontinuation of drug clinical trials in mainland China

Abstract Background Although discontinuation is common in clinical trials, no study has been conducted to analyse the current situation and reasons for the suspension or discontinuation of drug clinical trials in China. This study aims to analyse the general characteristics and reasons for the disco...

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Autores principales:	Ben-nian Huo, Mao-lin Ai, Yun-tao Jia, Yao Liu, Yang Wang, Nan-ge Yin, Lin Song
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Clinical trials Discontinuation Drug trial registration and information publication platform China Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/0e459245411d41149f1fd7261a0c486d
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spelling	oai:doaj.org-article:0e459245411d41149f1fd7261a0c486d2021-11-14T12:39:31ZGeneral characteristics and reasons for the discontinuation of drug clinical trials in mainland China10.1186/s12874-021-01443-21471-2288https://doaj.org/article/0e459245411d41149f1fd7261a0c486d2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12874-021-01443-2https://doaj.org/toc/1471-2288Abstract Background Although discontinuation is common in clinical trials, no study has been conducted to analyse the current situation and reasons for the suspension or discontinuation of drug clinical trials in China. This study aims to analyse the general characteristics and reasons for the discontinuation of registered clinical trials in mainland China and to identify the associated factors. Methods We conducted a cross-sectional observational study of discontinued trials registered in the Drug Trial Registration and Information Publication Platform before March 31, 2020. All trials with a status of terminated or stopped recorded in the platform were classified as discontinued trials and included in the analysis. The basic characteristics of the discontinued trials were recorded, reasons for trial discontinuation were recorded and divided into 4 categories as drug development strategy, trial planning, trial conduct and studied drug. Pearson’s chi-square test and fisher’s exact test were used to compare the differences in reasons for discontinuation between neoplasm trials and non-neoplasm trials, and to examine the associations of trial characteristics with different reasons related to trials discontinuation. Results Three hundred twelve discontinued trials were included in this study. The studied drugs were mainly chemical drugs [229 (73.4%)], and indications of the studied drugs were mainly neoplasms [77 (24.7%)]. Geographical location of the discontinued trials were mostly in northern [114 (36.5%)] and eastern [96 (30.8%)] China. Study type of the included trials was mainly bioequivalence studies [97 (31.1%)]. The most common reason for trial discontinuation was commercial or strategic decision [84 (26.9%)], followed by futility/lack of efficacy [70 (22.4%)]. The number of trial centers, sample size and whether participants had been enrolled were significantly associated with trial discontinuation (P < 0.05). Multiple center trials showed a higher rate of trial discontinuation due to trial conduct related reasons than single center trials (P < 0.05), trials with sample size > 500 showed a higher rate of trial discontinuation due to studied drug related reasons (P < 0.05), and trials enrolled participants showed a lower rate of trial discontinuation due to commercial or strategic decision and a higher rate of trial discontinuation due to studied drug related reasons than trials without enrolled participants (P < 0.05). Besides, neoplasm trials showed a higher rate of trial discontinuation due to poor recruitment and safety comparing with non-neoplasm trials (P < 0.05). Conclusions Trial discontinuation in China mainly occurred because of commercial or strategic decision and futility/lack of efficacy of the studied drug. Clinical trials with multiple centers and a large sample size may more likely be discontinued due to trial conduct related reasons such as good clinical practice. Discontinuation due to drug safety and lack of efficacy in multiple center trials with a large sample size deserves more attention to avoid resources wastes. Full communication with regulatory authorities such as Center for Drug Evaluation and research institutes to develop a feasible protocol is important for sponsors to avoid trial discontinuation due to protocol issues.Ben-nian HuoMao-lin AiYun-tao JiaYao LiuYang WangNan-ge YinLin SongBMCarticleClinical trialsDiscontinuationDrug trial registration and information publication platformChinaMedicine (General)R5-920ENBMC Medical Research Methodology, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Clinical trials Discontinuation Drug trial registration and information publication platform China Medicine (General) R5-920
spellingShingle	Clinical trials Discontinuation Drug trial registration and information publication platform China Medicine (General) R5-920 Ben-nian Huo Mao-lin Ai Yun-tao Jia Yao Liu Yang Wang Nan-ge Yin Lin Song General characteristics and reasons for the discontinuation of drug clinical trials in mainland China
description	Abstract Background Although discontinuation is common in clinical trials, no study has been conducted to analyse the current situation and reasons for the suspension or discontinuation of drug clinical trials in China. This study aims to analyse the general characteristics and reasons for the discontinuation of registered clinical trials in mainland China and to identify the associated factors. Methods We conducted a cross-sectional observational study of discontinued trials registered in the Drug Trial Registration and Information Publication Platform before March 31, 2020. All trials with a status of terminated or stopped recorded in the platform were classified as discontinued trials and included in the analysis. The basic characteristics of the discontinued trials were recorded, reasons for trial discontinuation were recorded and divided into 4 categories as drug development strategy, trial planning, trial conduct and studied drug. Pearson’s chi-square test and fisher’s exact test were used to compare the differences in reasons for discontinuation between neoplasm trials and non-neoplasm trials, and to examine the associations of trial characteristics with different reasons related to trials discontinuation. Results Three hundred twelve discontinued trials were included in this study. The studied drugs were mainly chemical drugs [229 (73.4%)], and indications of the studied drugs were mainly neoplasms [77 (24.7%)]. Geographical location of the discontinued trials were mostly in northern [114 (36.5%)] and eastern [96 (30.8%)] China. Study type of the included trials was mainly bioequivalence studies [97 (31.1%)]. The most common reason for trial discontinuation was commercial or strategic decision [84 (26.9%)], followed by futility/lack of efficacy [70 (22.4%)]. The number of trial centers, sample size and whether participants had been enrolled were significantly associated with trial discontinuation (P < 0.05). Multiple center trials showed a higher rate of trial discontinuation due to trial conduct related reasons than single center trials (P < 0.05), trials with sample size > 500 showed a higher rate of trial discontinuation due to studied drug related reasons (P < 0.05), and trials enrolled participants showed a lower rate of trial discontinuation due to commercial or strategic decision and a higher rate of trial discontinuation due to studied drug related reasons than trials without enrolled participants (P < 0.05). Besides, neoplasm trials showed a higher rate of trial discontinuation due to poor recruitment and safety comparing with non-neoplasm trials (P < 0.05). Conclusions Trial discontinuation in China mainly occurred because of commercial or strategic decision and futility/lack of efficacy of the studied drug. Clinical trials with multiple centers and a large sample size may more likely be discontinued due to trial conduct related reasons such as good clinical practice. Discontinuation due to drug safety and lack of efficacy in multiple center trials with a large sample size deserves more attention to avoid resources wastes. Full communication with regulatory authorities such as Center for Drug Evaluation and research institutes to develop a feasible protocol is important for sponsors to avoid trial discontinuation due to protocol issues.
format	article
author	Ben-nian Huo Mao-lin Ai Yun-tao Jia Yao Liu Yang Wang Nan-ge Yin Lin Song
author_facet	Ben-nian Huo Mao-lin Ai Yun-tao Jia Yao Liu Yang Wang Nan-ge Yin Lin Song
author_sort	Ben-nian Huo
title	General characteristics and reasons for the discontinuation of drug clinical trials in mainland China
title_short	General characteristics and reasons for the discontinuation of drug clinical trials in mainland China
title_full	General characteristics and reasons for the discontinuation of drug clinical trials in mainland China
title_fullStr	General characteristics and reasons for the discontinuation of drug clinical trials in mainland China
title_full_unstemmed	General characteristics and reasons for the discontinuation of drug clinical trials in mainland China
title_sort	general characteristics and reasons for the discontinuation of drug clinical trials in mainland china
publisher	BMC
publishDate	2021
url	https://doaj.org/article/0e459245411d41149f1fd7261a0c486d
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General characteristics and reasons for the discontinuation of drug clinical trials in mainland China

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