Clinical Trials Transformation Initiative Releases Recommendations to Enhance the Feasibility of Developing New Antibacterial Drugs

Today, CTTI released two new sets of recommendations designed to advance clinical trials for an important and particularly challenging area of antibacterial drug development: hospital-acquired and ventilator-associated bacterial pneumonia (HABP/VABP). This work is part of CTTI’s antibacterial drug development program, which includes a suite of projects tackling specific issues to improve clinical trials and bolster the pipeline for new antibacterial drugs.

CTTI’s new recommendations outline innovative approaches to designing clinical trials for HABP/VABP, including early enrollment strategies and the streamlined collection of safety data. CTTI convened multi-stakeholder teams to analyze the challenges associated with HABP/VABP trials and develop the proposed solutions. The feasibility of these new approaches will be tested in an upcoming pilot study, the findings of which are expected to help drive the adoption of streamlined practices for antibacterial drug development across the clinical trial enterprise.

“The CTTI project teams’ work is the type of science that can benefit the overall field of antibacterial drug development by advancing the science of clinical trials for hospital-acquired and ventilator acquired pneumonia,” said Edward M. Cox, M.D., M.P.H., Director of the Office of Antimicrobial Products from the U.S. Food and Drug Administration’s Center for Drug Evaluation and Research. “We look forward to continued progress of the CTTI effort and the results from additional studies that will evaluate proposed solutions to these challenges.”

CTTI’s latest recommendations appear as part of a peer-reviewed supplement in the journal Clinical Infectious Diseases that features collaborative and innovative approaches by CTTI and others to address this pressing public health concern and speed new treatments to patients.

“This supplement from Clinical Infectious Diseases is really impressive and broad, highlighting many of the problems within antimicrobial resistance, from how to improve the development of new drugs, to engaging with the private sector. I am delighted to see such a prestigious scientific journal engage with this issue in a holistic approach looking at policy as well as scientific actions that need to be taken” said Jim O’Neill, Chair of the AMR Review.

Antibacterial resistance is an international public health crisis, and new treatment options are urgently needed. HABP/VABP occurs in seriously ill patients and is associated with high rates of antibiotic resistance and mortality. Multiple comorbidities, the rapid time course of acute illness, and other factors make conducting clinical trials in this population especially complex. “As someone whose susceptibility to multiple infections and Pneumonias has plagued me for six decades, these recommendations signal a transformational breakthrough,” said Stephen Mikita, patient advocate.

On August 24, CTTI will host a public webinar on this topic: Antibacterial Drug Development in a Time of Great Need: Global Expert Panel.

CTTI Reveals Findings from Pediatric Antibiotic Trials Project at PAS 2016

Conducting antibacterial trials in pediatric populations has unique challenges, which have contributed to the overall complexity of antibacterial drug development. CTTI’s Pediatric Antibiotic Trials Project aims to identify barriers related to scientific and operational issues in the design and conduct of clinical trials of antibacterial drugs for children, as well as develop recommendations to address these challenges.

After conducting surveys with investigators of pediatric antibiotic clinical trials and community providers, conducting qualitative interviews with parents and industry representatives, and reviewing information in the ClinicalTrials.gov database, we now have a body of evidence to inform this discussion. Findings indicate a multiplicity of real and perceived modifiable barriers to participating in or conducting pediatric antibacterial clinical trials, the need for deeper engagement with parents, and the necessity of effective recommendations to improve the design and conduct of these trials. These findings will be presented at the Pediatric Academic Societies (PAS) 2016 Meeting in Baltimore, MD on April 30 – May 3, 2016.

Poster Topic: Pediatric Trials in Antibacterial Drug Development: Findings from the Clinical Trials Transformation Project
Location: Exhibit Hall F
Date & Time: Saturday, April 30, 2016, from 1:30 – 2:45 PM EST
Speaker: Brian Smith, Duke University School of Medicine

 

A Brave New World: Registry-Based Clinical Trials

MARCH 30, 2016

CTTI Project: Registry Trials

Meeting Objectives

  • Identify essential elements of registries needed to successfully embed and conduct registry-based clinical trials
  • Present findings from CTTI’s Registry Trials Project: Literature Review and Expert Interviews
  • Receive feedback on potential benefits of and existing barriers to the use of registries in clinical trials
  • Reach consensus on best practices to increase adoption of clinical trials within registries

Meeting Location:

DoubleTree Silver Spring Hotel by Hilton, 8727 Colesville Road, Silver Spring, MD 20910

The views and opinions expressed in this presentation are those of the individual presenter and should not be attributed to the Clinical Trials Transformation Initiative, or any organization with which the presenter is employed or affiliated.

CTTI’s Mobile Clinical Trials Program is Recognized as Advancing Clinical Trials in The Guardian

CTTI’s Mobile Clinical Trials (MCT) Program focuses on integrating new mobile technologies in the design and conduct of clinical trials. Although medical research steadily progresses, the clinical trial enterprise can be slow to adopt new approaches and tools. As noted by Janet Woodcock in a recent article published by The Guardian, both pharmaceutical companies and regulators desire more innovation in the clinical trial setting. Aligned with this goal, the article recognized CTTI efforts to help increase innovation through initiating the MCT program. Dr. Martin Landray, a MCT Program leader and medical expert, was also quoted in the article, acknowledging that many currently used tests or metrics are outdated and do not provide the best information to guide patient treatment. He points out that wearable technology can provide more comprehensive data on a patient’s activities and health measurements. Additionally, according to The Guardian article, Landray

“estimates that in some cases, shifting to a mobile-based trial may reduce costs by 10-fold. This cost cutting, coupled with the fact that mobile trials’ recruitment efforts are not limited by geography, has the potential to advance our scientific understanding of rare diseases.”

CTTI is committed to helping the clinical trial enterprise explore the benefits offered by technological advancements with remote capabilities. The MCT Program seeks to address important issues related to the successful integration of mobile technologies in clinical trial conduct, including receptivity within the current legal/regulatory frameworks, stakeholder perceptions regarding risks and benefits of its use, and technical aspects of practical application.

Now Available: Poster on Cost Drivers of HABP/VABP Phase 3 Clinical Trials

On October 9, 2015, results from CTTI’s Streamlining HABP/VABP Trials Project were presented in the poster session, Cost Drivers of Hospital Acquired Bacterial Pneumonia and Ventilator Associated Bacterial Pneumonia (HABP/VABP) Phase Three Clinical Trials, at ID Week 2015 in San Diego, CA. This poster explores the drivers of HABP/VABP direct and indirect clinical trial costs and identifies opportunities to lower these costs.

We are pleased to share this poster on our website.

The Possibilities of Conducting Randomized Clinical Trials using Electronic Data in the Mini-Sentinel Environment

On May 15th Richard Platt, MD, MS, of Harvard Pilgrim Healthcare, and Patrick Archdeacon, MD, of the FDA, spoke at a CTTI-hosted webinar titled Developing Approaches to Conducting Randomized Trials in the Mini-Sentinel Environment. During this teleconference, Platt and Archdeacon summarized the collaborative work of CTTI and Mini-Sentinel investigators exploring the potential for building on the Sentinel’s health-plan-based teams and data infrastructure to facilitate multi-center clinical trials. A recently released report, Developing Approaches to Conducting Randomized Trials Using the Mini-Sentinel Distributed Database, fully describes the project and results. Their talk concluded with an explanation of the follow-up phases of this work, which will likely include convening working groups to further advance the concepts put forth in this report and collaborating with other partners.

We are pleased to share the recording of this webinar with the public, and we encourage interested parties to learn more about the Mini-Sentinel.