How representative are insomnia clinical trials?

Autor: Joris C. Verster, Timothy Roehrs, D Withrow, Gail Koshorek, Thomas Roth
Rok vydání: 2018
Předmět:
drug safety
insomnia
Hypnotic
0302 clinical medicine
Sleep Initiation and Maintenance Disorders
Taverne
Insomnia
Hypnotics and Sedatives
food and drug administration
drug abuse
Netherlands
Clinical Trials as Topic
education.field_of_study
adult
drug effect
clinical trial (topic)
General Medicine
Middle Aged
driving ability
Test (assessment)
Clinical trial
aged
female
priority journal
medicine.symptom
driver licence
mental health
Automobile Driving
medicine.medical_specialty
medicine.drug_class
Population
telephone interview
Placebo
Article
03 medical and health sciences
Bias
male
Zopiclone
medicine
Humans
human
normal human
education
DSM-IV-TR
drug use
treatment duration
business.industry
screening
Mental health
United States
030227 psychiatry
Zolpidem
drug efficacy
age
Telephone interview
Sleep Aids
Pharmaceutical

Family medicine
Remelteon
placebo
business
030217 neurology & neurosurgery
patient selection
Zdroj: Sleep Medicine, 51, 118. Elsevier bedrijfsinformatie b.v.
ISSN: 1389-9457
DOI: 10.1016/j.sleep.2018.06.003
Popis: Objectives To address the question of how representative subjects studied in hypnotic clinical trials are of the broader insomnia population, this study assessed initial contact rates and reasons for inclusion and exclusion during recruitment to an efficacy trial and to a safety trial of Food & Drug Administration (FDA) approved hypnotics. Methods Otherwise heathy persons meeting Diagnostic Statistical Manual, Fourth Edition, Revised (DSM-IVR) criteria for insomnia were recruited. In one study, persons 32–65 yrs, were invited to a 12 month trial of nightly use of zolpidem or placebo. In the other, persons 21–64 yrs with driver's licenses were recruited to test the effects of a hypnotic on live on-the-road driving ability. In both studies screening was conducted through an initial telephone interview followed by a clinic visit. Results In the United States (US) study 13% (n = 410) of 3180 initial contacts and in the Netherlands (NL) study 67% (n = 53) of the 79 initial contacts proceeded to the clinic visit. Of those at clinic 25% of US and 37% of NL participants failed to meet additional insomnia criteria. Mental health exclusions accounted for 24% of US and 23% of NL participants and medical problems accounted for 23% of US and 9% NL exclusions. Finally 20% of US and 26% of NL participants were excluded for drug use/abuse histories. After all screening 4% of the initial US contacts and 0% of the NL contacts entered the study. Conclusions These data suggest persons entering insomnia hypnotic clinical trials are a highly selected sample that is unlikely to be representative of the broad insomnia population or the population of potential medication users.
Databáze: OpenAIRE