Sharing Clinical Trial Data: Maximizing Benefits, Minimizing Risk
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Original Articles International Patterns of Tuberculosis and the Prevalence of Symptoms of Asthma, Rhinitis, and Eczema
Thorax 2000;55:449–453 449 Original articles Thorax: first published as 10.1136/thorax.55.6.449 on 1 June 2000. Downloaded from International patterns of tuberculosis and the prevalence of symptoms of asthma, rhinitis, and eczema Erika von Mutius, Neil Pearce, Richard Beasley, Soo Cheng, Ondine von Ehrenstein, Bengt Björkstén, Stephan Weiland, on behalf of the ISAAC Steering Committee Abstract national patterns of the prevalence of these Background—An ecological analysis was diseases2 are largely unknown. In particular, conducted of the relationship between they cannot be explained by the established tuberculosis notification rates and the putative risk factors such as allergen exposure prevalence of symptoms of asthma, aller- and air pollution which do not appear to be gic rhinoconjunctivitis, and atopic eczema strongly related to the underlying population in 85 centres from 23 countries in which prevalence.2–5 This has led to consideration of standardised data are available. These factors that may programme the initial suscep- essentially comprised countries in Europe tibility to asthma and/or atopy which have as well as the USA, Canada, Australia, and changed in temporal association with the New Zealand. increasing trends in prevalence worldwide, are Methods—Tuberculosis notification rates consistent with international prevalence pat- were obtained from the World Health terns, and for which biological plausibility exists Organization. Data on the prevalence of with respect to an underlying mechanism. symptoms of asthma, rhinitis, and eczema One such hypothesis is that the lack of expo- in 235 477 children aged 13–14 years were sure in early childhood to infections such as University Children’s based on the responses to the written and tuberculosis, measles, and diphtheria may Hospital, Klinikum video questionnaires from the Inter- increase the risk of developing atopic disorders http://thorax.bmj.com/ Innenstadt, Munich, national Study of Asthma and Allergies in 67 Germany such as asthma. -
Coronavirus: Covid-19 Has Killed More People Than SARS and MERS Combined, Despite Lower Case Fatality Rate
BMJ 2020;368:m641 doi: 10.1136/bmj.m641 (Published 18 February 2020) Page 1 of 1 News BMJ: first published as 10.1136/bmj.m641 on 18 February 2020. Downloaded from NEWS Coronavirus: covid-19 has killed more people than SARS and MERS combined, despite lower case fatality rate Elisabeth Mahase The BMJ The novel coronavirus that has so far spread from China to 26 This comment came after the first case of covid-19 was countries around the world does not seem to be as “deadly as confirmed in Africa (in Egypt). Commenting on this milestone other coronaviruses including SARS and MERS,” the World in the outbreak, Trudie Lang, director of the Global Health Health Organization has said. Network at the University of Oxford, said it was “important but At a briefing on 17 February WHO’s director general, Tedros not unexpected.” She highlighted the fact that WHO had Adhanom Ghebreyesus, said that more than 80% of patients declared the outbreak a “public health emergency” to “support with covid-19 have a “mild disease and will recover” and that less well resourced nations in responding and preparing for it is fatal in 2% of reported cases. In comparison, the 2003 cases.” outbreak of severe acute respiratory syndrome (SARS) had a Lang praised the response of the Africa Centres for Disease case fatality rate of around 10% (8098 cases and 774 deaths), Control and Prevention, which is based in Ethiopia and supports http://www.bmj.com/ while Middle East respiratory syndrome (MERS) killed 34% countries with surveillance, emergency responses, and of people with the illness between 2012 and 2019 (2494 cases prevention of infectious disease. -
Annual Meeting
Volume 97 | Number 5 Volume VOLUME 97 NOVEMBER 2017 NUMBER 5 SUPPLEMENT SIXTY-SIXTH ANNUAL MEETING November 5–9, 2017 The Baltimore Convention Center | Baltimore, Maryland USA The American Journal of Tropical Medicine and Hygiene The American Journal of Tropical astmh.org ajtmh.org #TropMed17 Supplement to The American Journal of Tropical Medicine and Hygiene ASTMH FP Cover 17.indd 1-3 10/11/17 1:48 PM Welcome to TropMed17, our yearly assembly for stimulating research, clinical advances, special lectures, guests and bonus events. Our keynote speaker this year is Dr. Paul Farmer, Co-founder and Chief Strategist of Partners In Health (PIH). In addition, Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, will deliver a plenary session Thursday, November 9. Other highlighted speakers include Dr. Scott O’Neill, who will deliver the Fred L. Soper Lecture; Dr. Claudio F. Lanata, the Vincenzo Marcolongo Memorial Lecture; and Dr. Jane Cardosa, the Commemorative Fund Lecture. We are pleased to announce that this year’s offerings extend beyond communicating top-rated science to direct service to the global community and a number of novel events: • Get a Shot. Give a Shot.® Through Walgreens’ Get a Shot. Give a Shot.® campaign, you can not only receive your free flu shot, but also provide a lifesaving vaccine to a child in need via the UN Foundation’s Shot@Life campaign. • Under the Net. Walk in the shoes of a young girl living in a refugee camp through the virtual reality experience presented by UN Foundation’s Nothing But Nets campaign. -
Gene-Environment Interactions in Chronic Inflammatory Disease
commentarY Gene-environment interactions in chronic inflammatory disease Harald Renz, Erika von Mutius, Per Brandtzaeg, William O Cookson, Ingo B Autenrieth & Dirk Haller Chronic inflammatory diseases represent a major challenge for both clinical research and patient care, and evidence indicates that these disorders develop as a result of complex gene-environment interactions. Better understanding of their cause-and-effect relationship is the basis for emerging proposals for therapy and prevention. ince the end of World War II there has been The European Science Foundation brought polymorphisms, which has shown that there Sa substantial increase in the incidence of together an international group of experts on are overlapping susceptibility genes in these chronic inflammatory disease that seems to fol- subjects ranging from epidemiology to epigenet- inflammatory disorders3. A prototypic example low a geographical pattern of industrialization ics for a 5-day meeting (19–22 October 2010) in is the discovery of polymorphisms in ORMDL3 and urban living1. This includes allergic condi- Barcelona, Spain2, intended to help define stra- in both asthma and IBD4,5. tions (asthma, allergic rhinoconjunctivitis, food tegic directions for research into this increasing Despite the identification of many potential allergies and eczema), as well as autoimmune public health concern. In this first meeting of the susceptibility genes6,7, their individual effects disorders such as type 1 diabetes, chronic inflam- Forward Look initiative of the European Science seem to be quite modest. Thus, for many dis- matory bowl disease (IBD) and neurodegenera- Foundation, discussions focused on the grand eases, the alleles that have been identified by tive disease. Genetics cannot account for the challenges that face research into gene-envi- genome-wide association studies explain only increase in prevalence over time (Fig. -
Joint Statement on Public Disclosure of Results from Clinical Trials
Joint statement on public disclosure of results from clinical trials Signatories on 18 May 2017 Indian Council of Medical Research Research Council of Norway UK Medical Research Council Médecins Sans Frontières Epicentre CEPI PATH Institut Pasteur Bill and Melinda Gates Foundation Wellcome Trust Introduction The current 2013 Declaration of Helsinki states that “Every research study involving human subjects must be registered in a publicly accessible database before recruitment of the first subject.” and that “Researchers have a duty to make publicly available the results of their research .... Negative and inconclusive as well as positive results must be published or otherwise made publicly available”. In addition to the ethical imperative, poor allocation of resources for product development and financing of available interventions, and suboptimal regulatory and public health recommendations may occur where decisions are based on only a subset of all completed clinical trials. The signatories of this joint statement affirm that the prospective registration and timely public disclosure of results from all clinical trials is of critical scientific and ethical importance. Furthermore timely results disclosure reduces waste in research, increases value and efficiency in use of funds and reduces reporting bias, which should lead to better decision-making in health. Within 12 months of becoming a signatory of this statement, we each pledge to develop and implement a policy with mandated timeframes for prospective registration and public disclosure of the results of clinical trials that we fund, co-fund, sponsor or support. We each agree to monitor registration and endorse the development of systems to monitor results reporting on an ongoing basis. -
Childhood Allergies and Asthma: New Insights
Available online at www.sciencedirect.com ScienceDirect Childhood allergies and asthma: New insights on environmental exposures and local immunity at the lung barrier 1 1,2 Hermelijn H Smits , Lucie¨ n EPM van der Vlugt , 3,4 2 Erika von Mutius and Pieter S Hiemstra While certain bacteria and respiratory viruses promote local mucus-producing goblet cells and club cells. It not only inflammation and disease onset, a more diverse colonization of acts as a selective physical barrier against inhaled com- the different species in the (gut) microbiome may be linked to ponents, but is also actively involved in host defense, more regulatory responses and protection against asthma and inflammation and immunity [1]. This is illustrated by the allergies. These processes are also influenced in part by food ability of airway epithelial cells to mount robust antimi- intake, both targeting the composition of the gut microbiome crobial responses, produce pro-inflammatory mediators and influencing the immune system via metabolites. Early life and contribute to resolving inflammation. Airway epithe- environmental microbial exposure also contributes to lial cells are also actively involved in regulation of adap- protection against asthma and allergy and is linked with an tive immunity, and may orchestrate Th2 immunity and early activation of the innate immune system and the tolerance in allergy and asthma by for example recruiting development of regulatory immune responses. Although and activating dendritic cells (DC) and type 2 innate greater mechanistic insight is needed, it is tempting to lymphoid cells (ILC2) [2]. Recent studies have highlight- speculate that part of the environmental effect can be ed a role for the epithelial barrier and its interaction with explained by modulation of the microbiome composition at the innate immune system in preventing or reducing mucosal surfaces, epithelial barrier function and/or local allergic and/or asthmatic symptoms [3,4]. -
Factors Influencing Clinical Trial Site Selection in Europe
BMJ Open: first published as 10.1136/bmjopen-2013-002957 on 15 November 2013. Downloaded from Open Access Research Factors influencing clinical trial site selection in Europe: the Survey of Attitudes towards Trial sites in Europe (the SAT-EU Study) Marta Gehring,1 Rod S Taylor,2 Marie Mellody,3 Brigitte Casteels,4 Angela Piazzi,3 Gianfranco Gensini,5 Giuseppe Ambrosio6 To cite: Gehring M, ABSTRACT et al Strengths and limitations of this study Taylor RS, Mellody M, . Objectives: Applications to run clinical trials in Factors influencing clinical Europe fell 25% between 2007 and 2011. Costs, speed ▪ trial site selection in Europe: We provide systematic evidence across a large of approvals and shortcomings of European Clinical the Survey of Attitudes sample of expert professionals indicating that towards Trial sites in Europe Trial Directive are commonly invoked to explain this fostering competitiveness of European clinical (the SAT-EU Study). BMJ unsatisfactory performance. However, no hard evidence research may not require additional government Open 2013;3:e002957. is available on the actual weight of these factors or has spending/incentives. Carefully crafted harmonisa- doi:10.1136/bmjopen-2013- it been previously investigated whether other criteria tion of approvals, greater visibility of centres of 002957 may also impact clinical trial site selection. excellence via disease networks/the web, and Design: The Survey of Attitudes towards Trial sites in reduction of ‘hidden’ costs are more likely to ▸ Prepublication history for Europe (SAT-EU Study) was an anonymous, cross- boost competitiveness of European clinical this paper is available online. sectional web-based survey that systematically research. -
Written Evidence Submitted by the BBC
Written evidence submitted by the BBC The DCMS Sub-committee on Online Harms and Disinformation Covid-19 Inquiry April 2020 Executive summary 1. The BBC is the leading public service broadcaster in the UK, with a mission to inform, educate and entertain. Our first public purpose is to provide impartial news and information to help people understand and engage with the world around them, and we deliver this across national, local and global news services.1 2. The Editorial Guidelines are the standards that underpin all our journalism, at all times, including during the Covid-19 pandemic. They apply to all our content, wherever and however it is received. Producing and upholding these Editorial Guidelines is an obligation across the BBC and all output made in accordance with these Editorial Guidelines fulfills our public purposes and meets and goes beyond the requirements of our regulator, Ofcom. 3. Coverage of Covid-19 is dominating the UK news across all platforms. And with a plethora of cross platform content, people are most likely to turn to the BBC’s TV, radio and online services for the latest news on the pandemic (82%)2, significantly more than any other source. 4. BBC News has attracted record audiences across platforms with our nations and regions, UK wide and international coverage highlighting the importance of impartial and accurate news at this time. 5. The BBC remains the UK’s primary source for news. In a world of fake news and disinformation online, audiences said they turn to the BBC for a reliable take on events and this reputation for accuracy and trust sends audiences to the BBC during breaking news and to verify facts.3 During the Covid-19 pandemic 83% of people trust coverage on BBC TV4; and audiences from the UK and around the world have come to BBC News in their millions to stay informed and seek trusted advice on how they can protect themselves and those most at risk. -
Transparency in the Time of Constant Change
PhUSE 2014 Paper RG02 Transparency in the Time of Constant Change Todd Case, Biogen Idec, Cambridge MA, USA ABSTRACT The time has come, after years of hard work, to submit your application to the regulatory agency for review and possible approval! What a relief to be able to finally hand off all of your hard work and, wait a minute, ensure that all data can be reproducible?!? While CDISC has been widely adopted and its SDTM and AdAM models widely implemented, there is still the need to understand the process of ensuring that all the data is a reflection of how it was originally collected, which in some cases can be very challenging. This paper will discuss some more trending ways of both creating and presenting data in ways that ensure it is consumable and can be understood not only for analysis/submission purposes but also that post-approval it is transparent and that everyone who has a vested stake can review the data in an appropriate way. INTRODUCTION With the publication of Bad Pharma: How Medicine is Broken , and How We Can Fix it, by Dr. Ben Goldacre in 2013 a bright spotlight was shone on the data behind/supporting clinical trials. A large part of his thesis is that pharmaceutical companies exaggerate the efficacy of successful trials and that, in addition to drug companies, regulators , physicians (who are educated by the drug companies) and even patient groups have failed to protect us. Another rather striking revelation was that a clinical trial with positive results is twice more likely to be published than one with negative results (although it should be noted that this specifically is related to results – the protocol is always provided). -
Series Asthma 2020 1 Primary Prevention of Asthma: from Risk and Protective Factors to Targeted Strategies for Prevention Rachel
20TL11343 THELANCET-D-20-11343R1 Series [PII_REPLACE] Rachel B Embargo: September 7, 2020—23:30 (BST) This version saved: 11:07, 04-Sep-20 Doctopic: Review and Opinion Asthma 2020 1 Primary prevention of asthma: from risk and protective factors to targeted strategies for prevention Erika von Mutius, Hermelijn H Smits Asthma is a complex disease that often starts in childhood. Genomic and environmental factors as well as aberrant Published Online immune maturation early in life can contribute to the onset of disease, with great disparity over time and geographical September 7, 2020 https://doi.org/10.1016/ regions. Epidemiological studies have scrutinised environmental exposures and attempted to translate these PII exposures into prevention strategies. Some approaches for patients with asthma have been successful (eg, smoking See Comment Lancet Respir Med ban, the Finnish Asthma Programme), and primary prevention of wheeze in pre-school children (age 0–5 years) by 2020; published online Sept 7. the supplementation of vitamin D or fish oil, or both, to pregnant women seems promising. Several recent prevention http://dx.doi.org/10.1016/ initiatives are based on strong asthma-protective environmental microbial exposures associated with traditional rural S2213-2600(20)30400-8 lifestyles. Preclinical studies with various bacterial lysates, bacterial and dietary metabolites, or helminthic compounds This is the first in a Series of have yielded promising results that await translation into clinical practice. Given the immense societal and individual three papers about reducing the burden of asthma burden of asthma, there is an urgent need to further develop novel strategies to eradicate the disease. -
Patents, Partnerships, and the Pre-Competitive Collaboration Myth in Pharmaceutical Innovation
Patents, Partnerships, and the Pre-Competitive Collaboration Myth in Pharmaceutical Innovation Liza S. Vertinsky* Public-private partnerships offer a promising alternative paradigm for pharmaceutical innovation in complex disease areas where there are both strong commercial interests and significant public need. They have the potential to reduce the tremendous waste associated with duplicative unsuccessful drug development efforts and to encourage the sharing of knowledge essential to accelerate pharmaceutical innovation. Patents threaten the potential of partnership strategies, however, by making it harder to sustain robust systems of knowledge sharing. Policymakers have tried to avoid this problem by focusing partnership strategies on areas deemed to be pre-competitive — areas of collaboration without competition and typically also without patents. This Article suggests that the current pre-competitive approach to partnership strategies in pharmaceutical innovation is fundamentally flawed for two reasons. First, it ignores the competitive market pressures that both shape what is deemed to be pre-competitive and fuel tensions * Copyright © 2015 Liza S. Vertinsky. Associate Professor of Law, Emory University School of Law. Many thanks to Timothy Holbrook, Timothy Terrell, Yaniv Heled, Cynthia Ho, Kevin Outterson, and Michael Carroll, as well as Sean O’Connor, Roger Ford, Dan Burk, Mark McKenna, and other participants of the Yale Innovation Beyond IP conference 2014; Arti Rai, Jerome Reichman, Katherine Strandburg, Brett Frischmann, Michael Madison, Peter Lee, Margaret Chon, Sonali Shah, and the other participants in the Medical Commons Workshop at NYU in May 2014 and the 2nd Thematic Conference on the Knowledge Commons at NYU in September 2014; participants in the summer workshop at Georgia State College of Law in July 2014; participants of the Emory Faculty Colloquium; Simon Stern, Abraham Drassinower, Margaret J. -
Agenda, WHO Ebola Research and Development Summit
WHO Ebola Research and Development Summit Geneva, 11 – 12 May 2015 WHO Executive Board Room Agenda Rapporteur: Elisabeth Heseltine Monday 11 May 2015 8:00-9:00 Registration Session 1: Introduction Chair: John Mackenzie (Curtin University, Australia) 9:00-9:15 Welcome: Margaret Chan, Director-General, World Health Organization (WHO) and Objectives of meeting, expected outcomes: Marie-Paule Kieny, Assistant-Director General, Health Systems and Innovation (WHO) 9:15-9:35 Keynote lecture: The Ebola response/getting to zero (20 min), Bruce Aylward (WHO) 9:35-10:15 Country perspectives on R&D during the Ebola epidemic (10 min each) • Wiltshire Johnson (Pharmacy Board, Sierra Leone) • Stephen Kennedy (Ministry of Health, Liberia) • Mandy Kader Konde (CEFORPAG, Guinea) Discussion (10 min) 10:15-10:45 Coffee break SESSION 2: Main lessons learnt on R&D in the 2014-15 EVD outbreak in West Africa. Main challenges, and factors that facilitated implementation of research activities in the affected countries Chair: Nicole Lurie (HHS/ASPR, USA) 10:45-11:30 What were the known facts, pipelines and major challenges to Ebola R&D when the international emergency was declared in August 2014, and what has been achieved since then? This presentation and discussion will identify crucial knowledge gaps at the start of the outbreak, e.g., in immunopathogenesis, appropriate animal models, use of in vitro data, natural history of disease ; and map out the current (May 2015) achievements in filling these gaps. Peter Jahrling (NIH/NIAID, USA): Addressing knowledge