{"id":7745,"date":"2020-06-05T11:44:07","date_gmt":"2020-06-05T11:44:07","guid":{"rendered":"https:\/\/www.kolabtree.com\/blog\/?p=7745"},"modified":"2020-06-05T11:55:08","modified_gmt":"2020-06-05T11:55:08","slug":"the-difficulties-in-clinical-trials","status":"publish","type":"post","link":"https:\/\/www.kolabtree.com\/blog\/de\/the-difficulties-in-clinical-trials\/","title":{"rendered":"Die Schwierigkeiten bei klinischen Versuchen"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Wissenschaftliche Studien werden mit einer Reihe von Kontrollexperimenten und Wiederholungen so konzipiert, dass die Antwort auf die untersuchte Frage eindeutig ist. Bei komplexen Versuchsanordnungen wie klinischen Studien sind die Ergebnisse oft weniger eindeutig, was eine Extrapolation der Daten unm\u00f6glich macht [1]. Berichten zufolge sind viele klinische Studien unzureichend konzipiert, was zu unklaren oder nutzlosen Ergebnissen f\u00fchrt [1-3]. Andere Probleme wie die Rekrutierung einer ausreichenden Zahl von Patienten f\u00fcr die richtige Stichprobengr\u00f6\u00dfe [4], Voreingenommenheit und Wahrnehmungen w\u00e4hrend der Rekrutierung [2, 5], das Ausscheiden von Patienten aus einer Studie [5, 6], Intransparenz oder das Fehlen einer ausreichenden \u00dcberpr\u00fcfung durch Experten [1, 7] sind sehr reale Faktoren, die die Studie beeintr\u00e4chtigen k\u00f6nnen, so dass eindeutige Schlussfolgerungen schwer zu ziehen sind. Dar\u00fcber hinaus wird die Validierung von Arzneimitteln in der Regel auch nach der Marktzulassung fortgesetzt, und zwar auf Bev\u00f6lkerungsebene, wo seltene, unerw\u00fcnschte oder nicht zielgerichtete Wirkungen nur bei einer gro\u00dfen Stichprobengr\u00f6\u00dfe und \u00fcber l\u00e4ngere Zeitr\u00e4ume hinweg beobachtet werden [8].\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Der gesamte Prozess der Arzneimittelentwicklung ist langwierig und m\u00fchsam, da er strenge Tests zur Wirksamkeit und Sicherheit am Menschen beinhaltet. Dieser Prozess ist jedoch notwendig, um der \u00d6ffentlichkeit ein einigerma\u00dfen vollst\u00e4ndiges Profil des neuen Medikaments oder eines bestehenden Medikaments, das f\u00fcr eine neue Indikation verwendet wird, zu vermitteln. Die Strenge der klinischen Versuche ist auch notwendig, um Trag\u00f6dien wie die des <\/span><span style=\"font-weight: 400;\">BIA 10-2474 Verfahren [9, 10], das <\/span><span style=\"font-weight: 400;\">Theralizumab-Studie [11], <\/span><span style=\"font-weight: 400;\">die Gentherapie-Studie f\u00fcr Ornithin-Transcarbamylase (OTC)-Mangel [12], <\/span><span style=\"font-weight: 400;\">und die Contergan-Katastrophe in den 1950er und 60er Jahren [13].\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Jede dieser Trag\u00f6dien hat zu zahlreichen Bem\u00fchungen der wissenschaftlichen Gemeinschaft, medizinischer Einrichtungen und staatlicher Stellen gef\u00fchrt, die Kommunikation und Konsultation zu verbessern und Probleme fr\u00fchzeitig zu erkennen, um Schaden zu verhindern und die Anwendbarkeit k\u00fcnftiger Studien besser zu bewerten [14-17]. Dennoch ist der Prozess von der Arzneimittelentdeckung bis zur Markteinf\u00fchrung noch lange nicht perfekt. In den letzten Monaten wurde die Welt Zeuge der Komplexit\u00e4t und oft auch der Unschl\u00fcssigkeit wissenschaftlicher Studien. Angesichts der j\u00fcngsten Nachrichten \u00fcber die positiven Ergebnisse der Remdesivir-Studie bei schweren COVID-19-Patienten und der beschleunigten FDA-Zulassung des Medikaments [18, 19] m\u00fcssen wir uns vor Augen halten, dass noch mehr Arbeit zu leisten ist.\u00a0<\/span><\/p>\n<ol>\n<li><span style=\"font-weight: 400;\">Ioannidis, J.P., <\/span><i><span style=\"font-weight: 400;\">Why Most Clinical <a href=\"https:\/\/www.kolabtree.com\/blog\/de\/ensuring-reproducibility-in-ai-driven-research-how-freelance-experts-can-help-in-biotech-and-healthcare\/\">Forschung<\/a> Is Not Useful.<\/span><\/i><span style=\"font-weight: 400;\"> PLoS Med, 2016. 13(6): p. e1002049.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Treweek, S. und M. Zwarenstein, <\/span><i><span style=\"font-weight: 400;\">Die Bedeutung von Studien: pragmatische und erkl\u00e4rende Studien und das Problem der Anwendbarkeit.<\/span><\/i><span style=\"font-weight: 400;\"> Versuche, 2009. 10: p. 37.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Slattery, P., A.K. Saeri, und P. Bragge, <\/span><i><span style=\"font-weight: 400;\">Forschungsmitgestaltung im Gesundheitswesen: ein schneller \u00dcberblick \u00fcber die \u00dcberpr\u00fcfungen.<\/span><\/i><span style=\"font-weight: 400;\"> Health Res Policy Syst, 2020. 18(1): p. 17.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Reynolds, T., <\/span><i><span style=\"font-weight: 400;\">Klinische Studien: Kann die Technologie das Problem der geringen Rekrutierung l\u00f6sen?<\/span><\/i><span style=\"font-weight: 400;\"> BMJ, 2011. 342: p. d3662.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Lehmann, B.A., et al., <\/span><i><span style=\"font-weight: 400;\">\"Und dann kam er in die falsche Gruppe\": Eine qualitative Studie zur Untersuchung der Auswirkungen der Randomisierung bei der Rekrutierung f\u00fcr eine randomisierte kontrollierte Studie.<\/span><\/i><span style=\"font-weight: 400;\"> Int J Environ Res Public Health, 2020. 17(6).<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Cleland , J.G.F., et al., <\/span><i><span style=\"font-weight: 400;\">Eine Methode zur Verringerung des Verlustes von Folgeuntersuchungen in klinischen Studien: informierte R\u00fccknahme der Zustimmung.<\/span><\/i><span style=\"font-weight: 400;\"> Europ\u00e4ische Zeitschrift f\u00fcr Herzinsuffizienz 2004. 6<\/span><\/li>\n<\/ol>\n<p><b>\u00a0<\/b><span style=\"font-weight: 400;\">(1).<\/span><\/p>\n<ol start=\"7\">\n<li><span style=\"font-weight: 400;\">Miyakawa, T., <\/span><i><span style=\"font-weight: 400;\">Keine Rohdaten, keine Wissenschaft: eine weitere m\u00f6gliche Ursache f\u00fcr die Krise der Reproduzierbarkeit.<\/span><\/i><span style=\"font-weight: 400;\"> Mol Brain, 2020. <\/span><b>13<\/b><span style=\"font-weight: 400;\">(1): p. 24.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Raj, N., et al., <\/span><i><span style=\"font-weight: 400;\">\u00dcberwachung nach dem Inverkehrbringen: ein \u00dcberblick \u00fcber die wichtigsten Aspekte und Ma\u00dfnahmen f\u00fcr ein wirksames Funktionieren im Vereinigten K\u00f6nigreich und in Kanada.<\/span><\/i><span style=\"font-weight: 400;\"> Ther Adv Drug Saf, 2019. <\/span><b>10<\/b><span style=\"font-weight: 400;\">: p. 2042098619865413.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Randerson, J., <\/span><i><span style=\"font-weight: 400;\">In der t\u00f6dlichen franz\u00f6sischen klinischen Studie wurden die Daten vor der Erh\u00f6hung der Medikamentendosis nicht \u00fcberpr\u00fcft.<\/span><\/i><span style=\"font-weight: 400;\"> Nature News, 2016.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Kaur, R., P. Sidhu, und S. Singh, <\/span><i><span style=\"font-weight: 400;\">Woran ist die klinische Phase-I-Studie mit BIA 10-2474 gescheitert? Globale Spekulationen und Empfehlungen f\u00fcr k\u00fcnftige Phase-I-Studien.<\/span><\/i><span style=\"font-weight: 400;\"> J Pharmacol Pharmacother, 2016. <\/span><b>7<\/b><span style=\"font-weight: 400;\">(3): p. 120-6.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Attarwala, H., <\/span><i><span style=\"font-weight: 400;\">TGN1412: Von der Entdeckung zur Katastrophe.<\/span><\/i><span style=\"font-weight: 400;\"> J Young Pharm, 2010. <\/span><b>2<\/b><span style=\"font-weight: 400;\">(3): p. 332-6.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Rinde, M., <\/span><i><span style=\"font-weight: 400;\">Der Tod von Jesse Gelsinger, 20 Jahre sp\u00e4ter<\/span><\/i><span style=\"font-weight: 400;\">, in <\/span><i><span style=\"font-weight: 400;\">Wissenschaftshistorisches Institut - Destillationen<\/span><\/i><span style=\"font-weight: 400;\">. 2019.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Vargesson, N., <\/span><i><span style=\"font-weight: 400;\">Thalidomid-induzierte Teratogenese: Geschichte und Mechanismen.<\/span><\/i><span style=\"font-weight: 400;\"> Birth Defects Res C Embryo Today, 2015. <\/span><b>105<\/b><span style=\"font-weight: 400;\">(2): p. 140-56.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Lipman, P.D., L. Dluzak, und C.M. Stoney, <\/span><i><span style=\"font-weight: 400;\">Ist diese Studie durchf\u00fchrbar? Erleichterung der Verwaltung von Meilensteinen der pragmatischen Studienplanung im Rahmen eines gestaffelten Finanzierungsmechanismus.<\/span><\/i><span style=\"font-weight: 400;\"> Versuche, 2019. <\/span><b>20<\/b><span style=\"font-weight: 400;\">(1): p. 307.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Dal-R\u00e9, R., P. Janiaud, und J.P.A. Ioannidis, <\/span><i><span style=\"font-weight: 400;\">Beweise aus der realen Welt: Wie pragmatisch sind randomisierte kontrollierte Studien, die als pragmatisch bezeichnet werden?<\/span><\/i><span style=\"font-weight: 400;\"> BMC Med, 2018. <\/span><b>16<\/b><span style=\"font-weight: 400;\">(1): p. 49.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Reijers, J.A.A., et al., <\/span><i><span style=\"font-weight: 400;\">Unerw\u00fcnschte Immunstimulation durch Verunreinigungen: Die dunkle Seite der Biopharmazeutika.<\/span><\/i><span style=\"font-weight: 400;\"> Br J Clin Pharmacol, 2019. <\/span><b>85<\/b><span style=\"font-weight: 400;\">(7): p. 1418-1426.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Van Norman, G.A., <\/span><i><span style=\"font-weight: 400;\">Die Grenzen von Tierversuchen zur Vorhersage der Toxizit\u00e4t in klinischen Studien: Ist es an der Zeit, unseren derzeitigen Ansatz zu \u00fcberdenken?<\/span><\/i><span style=\"font-weight: 400;\"> JACC Basic Transl Sci, 2019. <\/span><b>4<\/b><span style=\"font-weight: 400;\">(7): p. 845-854.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Krankheiten, N.I.o.A.a.I., <\/span><i><span style=\"font-weight: 400;\">Klinische NIH-Studie zeigt, dass Remdesivir die Genesung von fortgeschrittenem COVID-19 beschleunigt<\/span><\/i><span style=\"font-weight: 400;\">N.I.o. Health, Herausgeber. 2020.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Gilead, <\/span><i><span style=\"font-weight: 400;\">Gilead gibt Ergebnisse der Phase-3-Studie mit dem antiviralen Pr\u00fcfpr\u00e4parat Remdesivir bei Patienten mit schwerem COVID-19 bekannt<\/span><\/i><span style=\"font-weight: 400;\">Gilead, Herausgeber. 2020.<\/span><\/li>\n<\/ol>","protected":false},"excerpt":{"rendered":"<p>Scientific studies are designed with a number of control experiments and replications such that the answer to the question being investigated is clear. In complex experimental set-ups like clinical trials, results are often less clear making extrapolation of data impossible [1]. In fact, reports have indicated that many clinical trials are insufficiently designed, yielding ambiguous<\/p>\n<div class=\"read-more\"><a href=\"https:\/\/www.kolabtree.com\/blog\/de\/the-difficulties-in-clinical-trials\/\" title=\"Mehr lesen\">Mehr lesen<\/a><\/div>","protected":false},"author":12,"featured_media":7750,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[435],"tags":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v20.1 (Yoast SEO v20.1) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>The Difficulties in Clinical Trials - The Kolabtree Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.kolabtree.com\/blog\/de\/the-difficulties-in-clinical-trials\/\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Difficulties in Clinical Trials\" \/>\n<meta property=\"og:description\" content=\"Scientific studies are designed with a number of control experiments and replications such that the answer to the question being investigated is clear. 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In complex experimental set-ups like clinical trials, results are often less clear making extrapolation of data impossible [1]. 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