Department of Psychology and Behavioural Sciences

Historical Controls in Randomized Clinical Trials: Opportunities and Challenges

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DOI

  • Kathryn T Hall, Brigham and Women’s Hospital, Boston, MA , United States
  • Lene Vase
  • Deidre K. Tobias, Brigham and Women’s Hospital, Boston, MA
  • ,
  • Hesam T. Dashti, Brigham and Women’s Hospital, Boston, MA
  • ,
  • Jan Vollert, Imperial College London, Heidelberg University , Unknown
  • Ted J Kaptchuk, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
  • Nancy R. Cook, Brigham and Women’s Hospital, Boston, MA

Randomized control trials (RCTs) with placebo are the gold standard for determining efficacy of novel pharmaceutical treatments. Since their inception, over 75 years ago, researchers have amassed a large body of underutilized data on outcomes in the placebo control arms of these trials. Although rare disease indications have used these historical placebo data as synthetic controls to reduce burden on patients and accelerate drug discovery, broad use of historical controls is in its infancy. Large-scale historical placebo data could be leveraged to benefit both drug developers and patients if warehoused and made more available to guide trial design and analysis. Here, we examine challenges in utilizing historical controls related to heterogeneity in trial design, outcome ascertainment, patient characteristics, and unmeasured pharmacogenomic effects. We then discuss the advantages and disadvantages of current approaches and propose a path forward to broader use of historical controls in RCTs.

Original languageEnglish
JournalClinical Pharmacology and Therapeutics
Volume109
Issue2
Pages (from-to)343-351
Number of pages9
ISSN0009-9236
DOIs
Publication statusPublished - Feb 2021

    Research areas

  • ANALGESIA, ASSAY SENSITIVITY, CHRONIC PAIN, DRUG, EXPECTATION, HEART-FAILURE, METAANALYSIS, PLACEBO-RESPONSE, PREDICTORS, SYSTEMS

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