Pharmacogenetics and biomarkers are becoming normalised as important technologies to improve drug efficacy rates, reduce the incidence of adverse drug reactions, and make informed choices for targeted therapies. However, their wider clinical implementation has been limited by a lack of robust evidence. Suitable evidence is required before a biomarker's clinical use, and also before its use in a clinical trial. We have undertaken a review of five pharmacogenetic biomarker-guided randomised controlled trials (RCTs) and evaluated the evidence used by these trials to justify biomarker inclusion. We assessed and quantified the evidence cited in published rationale papers, or where these were not available, obtained protocols from trial authors. Very different levels of evidence were provided by the trials. We used these observations to write recommendations for future justifications of biomarker use in RCTs and encourage regulatory authorities to write clear guidelines.
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http://dx.doi.org/10.3390/jpm9030042 | DOI Listing |
Cardiol Rev
October 2024
Department of Cardiology, Royal Devon University Healthcare National Health Service Foundation Trust, Exeter, United Kingdom.
Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disorder characterized by structural and functional abnormalities. Current management strategies, such as medications and septal reduction therapies, have significant limitations and risks. Recently, cardiac myosin inhibitors (CMIs) like mavacamten and aficamten have shown promise as noninvasive treatment options.
View Article and Find Full Text PDFHum Reprod
December 2024
Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China.
Study Question: Are live birth rates (LBRs) per woman following flexible progestin-primed ovarian stimulation (fPPOS) treatment non-inferior to LBRs per woman following the conventional GnRH-antagonist protocol in expected suboptimal responders undergoing freeze-all cycles in assisted reproduction treatment?
Summary Answer: In women expected to have a suboptimal response, the 12-month likelihood of live birth with the fPPOS treatment did not achieve the non-inferiority criteria when compared to the standard GnRH antagonist protocol for IVF/ICSI treatment with a freeze-all strategy.
What Is Known Already: The standard PPOS protocol is effective for ovarian stimulation, where medroxyprogesterone acetate (MPA) is conventionally administered in the early follicular phase for ovulatory suppression. Recent retrospective cohort studies on donor cycles have shown the potential to prevent premature ovulation and maintain oocyte yields by delaying the administration of MPA until the midcycle (referred to as fPPOS), similar to GnRH antagonist injections.
Am J Phys Med Rehabil
September 2024
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
This review systematically examined the reporting of sex and female participation in post-stroke lower extremity (LE) motor rehabilitation randomized controlled trials (RCTs) over time and identified differences in female participation across RCTs conducted in low-and-middle-income countries (LMICs), high-income-countries (HICs), and HIC-regions. Systematic searches were conducted of MEDLINE, Embase, CINAHL and PsycINFO from 1970 to May 2022. RCTs in English were included if they examined post-stroke LE motor rehabilitation interventions in adults diagnosed with stroke.
View Article and Find Full Text PDFFam Pract
December 2024
Department of Medicine, Larner College of Medicine, University of Vermont, 89 Beaumont Ave, Burlington, VT 05405, United States.
Background: During coronavirus disease 2019 (COVID-19), people managing multiple chronic conditions (MCCs) experienced barriers to obtaining needed medications. The purposes of this paper are to (i) determine risk factors for difficulty obtaining medications during COVID-19, (ii) document reasons for the difficulty, and (iii) evaluate the impact on later physical and mental health outcomes.
Method: In a randomized controlled trial conducted in 2016-2021, 1969 adult primary care patients were surveyed about physical and mental health both before and during COVID-19.
PLoS One
December 2024
Machine Learning Department, Carnegie Mellon University, Pittsburgh, Pennsylvania, United States of America.
Many peer-review processes involve reviewers submitting their independent reviews, followed by a discussion between the reviewers of each paper. A common question among policymakers is whether the reviewers of a paper should be anonymous to each other during the discussion. We shed light on this question by conducting a randomized controlled trial at the Conference on Uncertainty in Artificial Intelligence (UAI) 2022 conference where reviewer discussions were conducted over a typed forum.
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