06Jun

Since Pfizer launched the first randomized clinical trial to be conducted entirely remotely in 2011, virtual clinical trials have been a trend waiting to happen. Now, prompted by the COVID-19 pandemic, and given the blessing of the FDA, broad acceptance of decentralized trials is becoming a reality.

Writing in the May DIA Global Forum, Dr. Jonathan Cotliar, says that with the impact COVID-19 is having on traditional, face-to-face trials, “Those who were once skeptical of the virtual model are now compelled to embrace it out of necessity.”

As chief medical officer of the virtual clinical trial management company Science 37, Cotliar would be expected to say that. But he’s not alone. Since the beginning of the year, interest in virtual clinical trials has grown; dozens of articles extolling their benefits and predicting their broader adoption have been published.

After the Food and Drug Administration released its “Guidance on Conduct of Clinical Trials of Medical Products during COVID-19 Public Health Emergency” in March, interest in decentralized trials has soared.

The Guidance says that for trials already underway, “Sponsors should determine if in-person visits are necessary to fully assure the safety of trial participants.” The FDA says “sponsors should evaluate whether alternative methods” – among them, virtual visits and phone contact – would be adequate substitutes for in-person contact.

Discussing the FDA guidance, Clinical Leader chief editor Ed Miseta, wrote, “With patients concerned for their health and hesitant about leaving their homes or visiting clinics or hospitals, incorporating virtual aspects into trials may be the only way to ensure their continued participation.”

The clinical news and information portal HCPLive, published a perspective in April pointing out, “The ongoing advancements in cloud, mobile, and IoT, combined with video conferencing and wearables, are opening up unprecedented opportunities for pharma and healthcare, bringing about the evolution of clinical trial management.”

Those technologies writes Daniel Piekarz SVP of Life Sciences & Healthcare at the software development firm, DataArt, will make virtual clinical trials and digital healthcare the “new normal post-COVID-19.”

There are significant benefits to both patients and trial sponsors and managers of virtual trials versus conventional, centralized trials. As Piekarz explains, “Virtual visits and remote patient monitoring in place of mandated in-person site visits gives trial participants a choice as well as the added peace of mind that they won’t be exposed to unnecessary risks. Virtual visits allow sponsors to reach a larger population of participants improving subject recruitment, engagement, and retention.”

Indeed, last month, the managed care company UnitedHealth Group and Yale School of Medicine said they would be launching a virtual study examining the potential role of ACE inhibitors in preventing the severe consequences of COVID-19. The study “Will adopt an innovative, modern approach as one of the first virtual COVID-19 clinical trials to be launched at scale with a suite of digital tools.”

And just last week Reuters reported that LabCorp and software provider Medable will work together “to speed up the adoption of virtual clinical trials, as many participants are dropping out of ongoing studies due to the COVID-19 pandemic.”

Photo by Chris Montgomery on Unsplash

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Jun 6, 2023

Wide Scale Testing Beginning for COVID-19 Vaccines

Researchers are making so much progress in developing a vaccine against COVID-19 that the first wide-scale testing could begin in a matter of weeks.

The New York Times Coronavirus Vaccine Tracker says a vaccine developed by the 10-year-old biotech company Moderna expects to start wide-scale testing this month. If it does, it would mark an almost unprecedented acceleration of the clinical testing process.

Typically, testing and approving a new vaccine takes two or three years. Sometimes more. But under the federal government’s Operation Warp Speed, Modena received a fast-track designation from the Food and Drug Administration. It also got a $483 million award to further its Covid-19 vaccine.

Through its Coronavirus Vaccine Tracker The Times is updating the status of all the vaccines that have reached human testing, along with a selection of promising vaccines still being tested in cells or animals. Because of the number and especially speed at which bioscience and pharmaceutical firms are moving to develop a successful vaccine, the Tracker is being updated almost every day.

The World Health Organization lists 149 different vaccine projects underway worldwide. 17 are in clinical evaluation, meaning they are being tested in humans, either in small groups to ensure their safety and basic efficacy, or in hundreds to see the effect among different age groups.

The Vaccine Tracker lists five vaccine candidates that are in or about to launch Phase III testing, the broadest testing category where thousands of volunteers are enlisted to determine if the vaccine is widely effective and how well it protects people from becoming infected. That’s the test Moderna expects to begin soon.

A vaccine developed by AstraZeneca and the University of Oxford is already in Phase III testing in Brazil and South Africa and is in a simultaneous Phase II and III study in Europe. This program, like Moderna’s, is part of Operation Warp Speed.

The Vaccine Tracker lists two Chinese firms – Sinovac Biotech and Sinopharm – as ready to soon start broad testing of their respective vaccines. Sinopharm’s testing will be conducted in the United Arab Emirates. Sinovac plans to conduct its Phase III study in China and Brazil.

A fifth vaccine, which is not a vaccine specifically for COVID-19, but a sort of immune system booster, is being tested in Australia. Bacillus Calmette-Guerin, a vaccine originally developed for tuberculosis, has been found over its 100 year history to help fight off other types of infections and parasites. The Phase III testing will determine if it also helps protect against COVID-19.

Image by Angelo Esslinger

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