(Another!) FDA trial design workshop: Complex innovative designs

Dear All:

Adding to the 19 Mar 2018 (Designs for Rare Diseases) and 16 Apr 2018 (Inclusion/Exclusion criteria) workshops already announced (see list below), FDA has now announced a 20 Mar 2018 workshop on complex innovative designs (CID) in clinical drug trials. From the Federal Register notice, we are told that the workshop seeks to (1) facilitate discussion and information sharing about the use of CID in drug development and regulatory decision making and (2) obtain input from stakeholders about a CID pilot program. Ideas to be discussed include complex adaptive designs, use of external/historical control subjects, Bayesian designs, master protocols, clinical trial simulations, and the proposed CID pilot program.

Why is this relevant to those of us working on new approaches to antimicrobial resistance (AMR)? Although AMR does not appear in the titles of any of these workshops, some of the ideas could be (or could become) very relevant for the AMR community.

In particular, the mathematics of rare events make it hard to develop narrow-spectrum agents outside of a few special situations. As non-traditional alternative therapies are often narrow-spectrum (e.g., most monoclonal antibody approaches), we simply must find ways forward lest we never develop such products. 

We’ve had several public discussions on this problem (see this note for further details) and we’re definitely not done with the conversation. As the ideas to be discussed in the upcoming workshops might help us with trial designs for narrow-spectrum products, I’m delighted to see them on the calendar! Also, the mention of a pilot program for complex innovative designs is new and of interest. 

All best wishes, –jr

John H. Rex, MD | Chief Medical Officer, F2G Ltd. | Expert-in-Residence, Wellcome Trust. Follow me on Twitter: @JohnRex_NewAbx. See past newsletters and subscribe for the future: https://13.43.35.2/blog/

Upcoming meetings of interest to the AMR community:

Share

Conflict-Borne XDR Superbugs: It’s Time for the PASTEUR Act!

Dear All: The recent publication of an exceptionally good plain-language summary of the AMR problem in Rolling Stone (yes, you read that correctly!) prompts today’s 3-part journey into the way(s) that war contributes to the threat of resistant superbugs. We’ve summarized the story in outline form — please explore the references for further details. And

ENABLE-2 funding now includes Hit Identification & Validation

23 July 2024 addenda x 2:  Mark Blaskovich let me know that the CO-ADD project is still offering a free in vitro screening service. See https://www.co-add.org/ to submit compounds for free testing vs 5 bacteria and 2 fungi; see https://db.co-add.org/ for structures and screening data on >100K compounds. The GHIT Fund has announced its 21st Request for Proposals for its Hit-to-Lead Platform to

NIAID/DMID thinking for FY2026: Antibacterials, Phage, and Antifungals

Dear All, NIAID’s DMID (Division of Microbiology and Infectious Diseases) recently held a council meeting during which they proposed program concepts that encompassed both antibacterial therapies (including phage) as well as antifungal therapies for funding in FY 2026 (the year that would run from 1 Oct 2025 to 30 Sep 2026). There is no guarantee that

WHO Antibacterial Pipeline Review: Update thru 31 Dec 2023

Dear All, WHO have released an update through 31 Dec 2023 of their ongoing series of antibacterial pipeline reviews! Here are the links you need: The report: 2023 Antibacterial agents in clinical and preclinical development: an overview and analysis and a press release about the report. Infographics: Key facts and recommendations from the 2023 antibacterial agents in clinical

Scroll to Top