We worked on a Phase II study of a drug to treat Fragile X syndrome that, like most rare work we do, was a challenge from the start. Fragile X is a rare and not fully understood genetic disorder, typically resulting from an expansion of the CGG triplet repeat within the Fragile X mental retardation 1 (FMR1) gene...
Our seventh installment of The Placebo Problem continues our look at the increasingly high placebo response that is plaguing clinical trials in analgesia and psychiatry. Check out the other posts here. The placebo response is broad. It goes far beyond the effects of merely consuming a sugar pill; it is the patient’s response to the...
Before starting Phase 1 trials, an Investigational New Drug (IND) application must be approved by the FDA. This critical early step in clinical trial development grants an exemption to laws prohibiting the transportation of drugs across state lines prior to market approval. The three major required areas of information in an IND include: Animal pharmacology...
This is the next installment of our look at the increasingly high placebo response that is plaguing clinical trials in analgesia and psychiatry. Check out the other posts here. Over the past few weeks, we’ve discussed the psychological, neurobiological, and genetic mechanisms responsible for the placebo response. Today, we turn to the study designs used...
A trial’s success depends largely on the ability to recruit and retain an adequate number of participants. Recruitment can be especially difficult in opioid clinical trials, due to a variety of factors. Here are seven things you should know about the challenges associated with recruiting patients for opioid trials: 1. Certain necessary aspects of trial...
Opioid analgesics are essential to the management of pain in many patients, but they are also associated with potential risks for abuse, overdose, and diversion, concerns which must be considered in the planning and execution of clinical trials studying these controlled substances. In this paper, we discuss the challenges of conducting clinical trials of controlled...
This is the fifth installment of our look at placebo response issues in analgesia and psychiatry clinical trials. Read other posts in the series here. Studies examining genetic variants associated with high or low placebo responses – the “placebome” – are relatively recent, but represent an important line of research that can yield insights into...
This is the fourth in our series examining the increasingly high placebo response issues plaguing analgesia and psychiatry clinical trials. Additional posts in the series are located here. As with many other aspects of placebo research, the majority of research on underlying neurobiological mechanisms has focused on placebo analgesia. In fact, roughly 40 positron emission...
There are many pitfalls that come with preparing an Investigational New Drug application for FDA submission. Luckily, there are also plenty of ways to avoid them. But the most important strategy? It all comes down to one thing: Always remember to keep your audience (the FDA reviewers) in mind as you write. These five actionable...
This is the third installment of our look at the increasingly high placebo response that is plaguing clinical trials in analgesia and psychiatry. Additional posts in the series can be accessed here. Solutions to the placebo problem require an understanding of the underlying mechanisms. Broadly, research on contributors to the placebo response falls into two...