Neuroendovascular clinical trials disruptions due to COVID-19. Potential future challenges and opportunities.


Journal

Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079

Informations de publication

Date de publication:
Sep 2020
Historique:
received: 11 06 2020
revised: 17 06 2020
accepted: 20 06 2020
pubmed: 2 7 2020
medline: 25 8 2020
entrez: 2 7 2020
Statut: ppublish

Résumé

To assess the impact of COVID-19 on neurovascular research and deal with the challenges imposed by the pandemic. A survey-based study focused on randomized controlled trials (RCTs) and single-arm studies for acute ischemic stroke and cerebral aneurysms was developed by a group of senior neurointerventionalists and sent to sites identified through the clinical trials website (https://clinicaltrials.gov/), study sponsors, and physician investigators. The survey was sent to 101 institutions, with 65 responding (64%). Stroke RCTs were being conducted at 40 (62%) sites, aneurysm RCTs at 22 (34%) sites, stroke single-arm studies at 37 (57%) sites, and aneurysm single-arm studies at 43 (66%) sites. Following COVID-19, enrollment was suspended at 51 (78%) sites-completely at 21 (32%) and partially at 30 (46%) sites. Missed trial-related clinics and imaging follow-ups and protocol deviations were reported by 27 (42%), 24 (37%), and 27 (42%) sites, respectively. Negative reimbursements were reported at 17 (26%) sites. The majority of sites, 49 (75%), had put new trials on hold. Of the coordinators, 41 (63%) worked from home and 20 (31%) reported a personal financial impact. Remote consent was possible for some studies at 34 (52%) sites and for all studies at 5 (8%) sites. At sites with suspended trials (n=51), endovascular treatment without enrollment occurred at 31 (61%) sites for stroke and 23 (45%) sites for aneurysms. A total of 277 patients with acute ischemic stroke and 184 with cerebral aneurysms were treated without consideration for trial enrollment. Widespread disruption of neuroendovascular trials occurred because of COVID-19. As sites resume clinical research, steps to mitigate similar challenges in the future should be considered.

Identifiants

pubmed: 32606103
pii: neurintsurg-2020-016502
doi: 10.1136/neurintsurg-2020-016502
pmc: PMC7371488
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

831-835

Informations de copyright

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Ansaar T Rai (AT)

Interventional Neuroradiology, West Virginia University Rockefeller Neuroscience Institute, Morgantown, West Virginia, USA ansaar.rai@gmail.com.

Thabele M Leslie-Mazwi (TM)

Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA.

Kyle M Fargen (KM)

Department of Neurological Surgery and Radiology, Wake Forest University, Winston-Salem, North Carolina, USA.

Aditya S Pandey (AS)

Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.

Guilherme Dabus (G)

Department of Interventional Neuroradiology and Neuroendovascular Surgery, Miami Neuroscience Institute and Miami Cardiac & Vascular Institute - Baptist Hospital, Miami, Florida, USA.

Ameer E Hassan (AE)

Department of Neurology, University of Texas Rio Grande Valley School of Medicine, Edinburg, Texas, USA.

Justin F Fraser (JF)

Department of Neurological Surgery, University of Kentucky, Lexington, Kentucky, USA.

Joshua A Hirsch (JA)

NeuroEndovascular Program, Massachusetts General Hospital, Boston, Massachusetts, USA.

Rishi Gupta (R)

Department of Neurosurgery, WellStar Health System, Marietta, Georgia, USA.

Ricardo Hanel (R)

Stroke and Cerebrovascular Center, Baptist Medical Center Jacksonville, Jacksonville, Florida, USA.

Albert J Yoo (AJ)

Department of Neurointervention, Texas Stroke Institute, Plano, Texas, USA.

Hormozd Bozorgchami (H)

Oregon Health and Science University, Portland, Oregon, USA.

David Fiorella (D)

Department of Neurosurgery, Stony Brook University, Stony Brook, New York, USA.

J Mocco (J)

The Mount Sinai Health System, New York, New York, USA.

Adam S Arthur (AS)

Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA.
Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Osama Zaidat (O)

Department of Neuroscience, St Vincent Mercy Hospital, Toledo, Ohio, USA.

Adnan H Siddiqui (AH)

Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA.

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