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A response adaptive randomization platform trial for efficient evaluation of Ebola virus treatments: A model for pandemic response.

Publication ,  Journal Article
Berry, SM; Petzold, EA; Dull, P; Thielman, NM; Cunningham, CK; Corey, GR; McClain, MT; Hoover, DL; Russell, J; Griffiss, JM; Woods, CW
Published in: Clin Trials
February 2016

The outbreak of Ebola virus disease in West Africa is the largest ever recorded. Numerous treatment alternatives for Ebola have been considered, including widely available repurposed drugs, but initiation of enrollment into clinical trials has been limited. The proposed trial is an adaptive platform design. Multiple agents and combinations will be investigated simultaneously. Additionally, new agents may enter the trial as they become available, and failing agents may be removed. In order to accommodate the many possible agents and combinations, a critical feature of this design is the use of response adaptive randomization to assign treatment regimens. As the trial progresses, the randomization ratio evolves to favor the arms that are performing better, making the design also suitable for all-cause pandemic preparedness planning. The study was approved by US and Sierra Leone ethics committees, and reviewed by the US Food and Drug Administration. Additionally, data management, drug supply lines, and local sites were prepared. However, in response to the declining epidemic seen in February 2015, the trial was not initiated. Sierra Leone remains ready to rapidly activate the protocol as an emergency response trial in the event of a resurgence of Ebola. (ClinicalTrials.gov Identifier: NCT02380625.) In summary, we have designed a single controlled trial capable of efficiently identifying highly effective or failing regimens among a rapidly evolving list of proposed therapeutic alternatives for Ebola virus disease and to treat the patients within the trial effectively based on accruing data. Provision of these regimens, if found safe and effective, would have a major impact on future epidemics by providing effective treatment options.

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Published In

Clin Trials

DOI

EISSN

1740-7753

Publication Date

February 2016

Volume

13

Issue

1

Start / End Page

22 / 30

Location

England

Related Subject Headings

  • Statistics & Probability
  • Sierra Leone
  • Research Design
  • Randomized Controlled Trials as Topic
  • Pandemics
  • Humans
  • Hemorrhagic Fever, Ebola
  • Clinical Protocols
  • Antiviral Agents
  • 5203 Clinical and health psychology
 

Citation

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Berry, S. M., Petzold, E. A., Dull, P., Thielman, N. M., Cunningham, C. K., Corey, G. R., … Woods, C. W. (2016). A response adaptive randomization platform trial for efficient evaluation of Ebola virus treatments: A model for pandemic response. Clin Trials, 13(1), 22–30. https://doi.org/10.1177/1740774515621721
Berry, Scott M., Elizabeth A. Petzold, Peter Dull, Nathan M. Thielman, Coleen K. Cunningham, G Ralph Corey, Micah T. McClain, et al. “A response adaptive randomization platform trial for efficient evaluation of Ebola virus treatments: A model for pandemic response.Clin Trials 13, no. 1 (February 2016): 22–30. https://doi.org/10.1177/1740774515621721.
Berry SM, Petzold EA, Dull P, Thielman NM, Cunningham CK, Corey GR, et al. A response adaptive randomization platform trial for efficient evaluation of Ebola virus treatments: A model for pandemic response. Clin Trials. 2016 Feb;13(1):22–30.
Berry, Scott M., et al. “A response adaptive randomization platform trial for efficient evaluation of Ebola virus treatments: A model for pandemic response.Clin Trials, vol. 13, no. 1, Feb. 2016, pp. 22–30. Pubmed, doi:10.1177/1740774515621721.
Berry SM, Petzold EA, Dull P, Thielman NM, Cunningham CK, Corey GR, McClain MT, Hoover DL, Russell J, Griffiss JM, Woods CW. A response adaptive randomization platform trial for efficient evaluation of Ebola virus treatments: A model for pandemic response. Clin Trials. 2016 Feb;13(1):22–30.
Journal cover image

Published In

Clin Trials

DOI

EISSN

1740-7753

Publication Date

February 2016

Volume

13

Issue

1

Start / End Page

22 / 30

Location

England

Related Subject Headings

  • Statistics & Probability
  • Sierra Leone
  • Research Design
  • Randomized Controlled Trials as Topic
  • Pandemics
  • Humans
  • Hemorrhagic Fever, Ebola
  • Clinical Protocols
  • Antiviral Agents
  • 5203 Clinical and health psychology