Abstract:
:In the clinical development of some new infectious disease drugs, early clinical pharmacology trials may predict with high confidence that the efficacious doses are well below the range of the safety margin. In this case, a dose-ranging study may be unnecessary after a proof-of-concept (PoC) study testing the highest dose. A multi-stage adaptive design spanning both PoC and confirmatory stages is proposed in this context. The design incorporates two interim analyses allowing strategies for stopping, continuing, or expanding the study. A conditional power threshold for a binary endpoint is proposed to assess futility. Additional components of early efficacy and sample size adjustment are also included to enhance the design's flexibility and robustness. Design operating characteristics are evaluated by numerical calculation. We show that the proposed streamlined trial design has the same statistical rigor as a conventional phase 3 clinical trial with adequate power and a properly controlled type 1 error rate. Additional adaptive design options are also investigated and discussed.
journal_name
Stat Methods Med Resjournal_title
Statistical methods in medical researchauthors
Fan XF,Gallo P,Su G,Menton R,Segal Fdoi
10.1177/0962280218807950subject
Has Abstractpub_date
2019-12-01 00:00:00pages
3491-3501issue
12eissn
0962-2802issn
1477-0334journal_volume
28pub_type
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