Clinical Trial Evidence Supporting FDA Approval of Novel Therapeutic Agents, 2005-2012

JAMA: 1/22/14

Importance  Many patients and physicians assume that the safety and effectiveness of newly approved therapeutic agents is well understood; however, the strength of the clinical trial evidence supporting approval decisions by the US Food and Drug Administration (FDA) has not been evaluated.

Objectives  To characterize pivotal efficacy trials (clinical trials that serve as the basis of FDA approval) for newly approved novel therapeutic agents.

Design and Setting  Cross-sectional analysis using publicly available FDA documents for all novel therapeutic agents approved between 2005 and 2012.

Main Outcomes and Measures  Pivotal efficacy trials were classified according to the following design features: randomization, blinding, comparator, and trial end point. Surrogate outcomes were defined as any end point using a biomarker expected to predict clinical benefit. The number of patients, trial duration, and trial completion rates were also determined. Read more