Evidence mapPaperPMID 31989328Full record

ArticleThe AAPS journal2020

Demonstrating Contribution of Components of Fixed-Dose Drug Combinations Through Longitudinal Exposure-Response Analysis.

Asbjørn Nøhr-Nielsen, Theis Lange, Julie Lyng Forman, Theodoros Papathanasiou, David J R Foster, Richard N Upton, Ole Jannik Bjerrum, Trine Meldgaard Lund

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Article in The AAPS journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Asbjørn Nøhr-NielsenDepartment of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
Theis LangeDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark.
Julie Lyng FormanDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark.
Theodoros PapathanasiouDepartment of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
David J R FosterSchool of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
Richard N UptonSchool of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
Ole Jannik BjerrumDepartment of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
Trine Meldgaard LundDepartment of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark. trine.lund@sund.ku.dk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Exposure-response (ER) modeling for fixed-dose combinations (FDC) has previously been found to have an inflated false positive rate (FP), i.e., observing a significant effect of FDC components when no true effect exists. Longitudinal exposure-response (LER) analysis utilizes the time course of the data and is valid for several clinical endpoints for FDCs. The aim of the study was to investigate if LER is applicable for the validation of FDCs by demonstrating the contribution of each component to the overall effect without inflation of FP rates. FP and FN rates associated with ER and LER analysis were investigated using stochastic simulation and estimation. Four hundred thirty-two scenarios with varying numbers of patients, duration, sampling frequency, dose distribution, design, and drug activity were analyzed using a range of linear, log-linear, and non-linear models to asses FP and FN rates. Lastly, the impact of the clinical trial parameters was investigated. LER analyses provided well-controlled FP rates of the expected 5% or less; however, in low information clinical trials consisting of 30 patients, 4 samples, and 20 days, LER analyses lead to inflated FN rates. Parameter investigation showed that when the clinical trial includes sufficient patients, duration, samples, and an appropriate trial design, the FN rates are in general below the expected 5% for LER analysis. Based on the results, LER analysis can be used for the validation of FDCs and fixed ratio drug combinations. The method constitutes a new avenue for providing evidence that demonstrates the contribution of each component to the overall clinical effect.

Indexed as

Drug CombinationsModels, BiologicalPharmacokineticsDose-Response Relationship, DrugDrug Administration ScheduleHumansLinear ModelsLongitudinal StudiesNonlinear DynamicsReproducibility of ResultsDrug Combinationsclinical developmentfixed-dose combinationsPK-PD modelingregulatory sciencestatistics

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.