Side Effects in Clinical Trials (2024)

There is a special vocabulary for talking about side effects in clinical trials. The side effect of a treatment during clinical trials is called an Adverse Event (AE). The National Cancer Institute (NCI) has established a standardized way to measure the seriousness of an adverse event. This is called the Common Toxicity Criteria for Adverse Events (CTCAE). The complete CTCAE can be found at the NCI website: http://ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm.

Adverse events are graded on a scale from 1 to 5. (Grade 0 refers to not having a symptom or problem, so someone with grade 0 pain has no pain at all.) Grade 1 adverse events are mild and generally not bothersome. Grade 2 events are bothersome and may interfere with doing some activities but are not dangerous. Grade 3 events are serious and interfere with a person’s ability to do basic things like eat or get dressed. Grade 3 events may also require medical intervention. Grade 4 events are usually severe enough to require hospitalization. Grade 5 events are fatal.

Most clinical trials and doctors focus on grade 3 or higher events, because those are the most dangerous. Grade 2 events however, can significantly impact the patient’s quality of life, even if they are not medically dangerous. For example, a grade 1 headache is mild. A grade 2 headache keeps the patient from doing things like shopping or cooking. A grade 3 headache keeps the patient from getting out of bed even to go to the bathroom.

Side Effects in Clinical Trials (2024)

FAQs

Side Effects in Clinical Trials? ›

The most common adverse events generally reported include symptoms such as localized pain, fatigue, headache, and other typical ailments, with a large portion considered preventable by some meta-studies.

What are the risks of clinical trials? ›

Possible risks

Clinical trials do come with some risks. Most clinical trials pose the risk of minor discomfort, which often lasts only a short time. However, some study participants experience complications that require medical attention.

What are the negatives of clinical trials? ›

Clinical trials and studies do come with some possible risks, including: The research may involve tests that pose a risk to participants. For example, certain physical tests may increase the chance of falling, and X-rays may cause a small increase in the risk of developing cancer.

What are the grades of side effects in clinical trials? ›

How side effects are graded
  • In research studies, side effects are graded from 1 to 4. Grade 1 is very mild and grade 4 is very serious.
  • GRADE 1 (Mild) ...
  • GRADE 2 (Moderate) ...
  • GRADE 3 (Severe) ...
  • GRADE 4 (Potentially life threatening)

What is an AE in clinical trials? ›

• An adverse event is any untoward or unfavorable medical occurrence in a human. subject, including any abnormal sign (for example, abnormal physical exam or. laboratory finding), symptom, or disease, temporally associated with the subject's.

What are side effects and adverse reactions in clinical trials? ›

An adverse drug reaction (ADR) can be defined as 'an appreciably harmful or unpleasant reaction resulting from an intervention related to the use of a medicinal product; adverse effects usually predict hazard from future administration and warrant prevention, or specific treatment, or alteration of the dosage regimen, ...

How often do clinical trials go wrong? ›

Why does 90% of clinical drug development fail? Only 1 out of 10 drug candidates successfully passes clinical trial testing and regulatory approval.

Why do 90% of clinical trials fail? ›

“Most drugs will fail in a Phase 2b trial because of lack of efficacy, and part of it is because maybe we didn't choose the right target for the disease, or perhaps we didn't have the right biomarker [measureable substance] to be able to determine whether the drug worked, or maybe we didn't select the right patients.”

Why do patients decline clinical trials? ›

Reasons for declining include fear of side effects, concerns about costs, and logistical barriers to participation such as time burden and lack of transportation.

Is it a good idea to participate in clinical trials? ›

Whether they are healthy or have been diagnosed with a medical condition, people should take part in clinical research only if they feel informed about and comfortable with the entire process.

What is considered a severe side effect? ›

Serious adverse event report ― These reports meet the definition of “serious” specified by the Code of Federal Regulations because one of the following is reported: death, life-threatening illness, hospitalization or prolongation of hospitalization, permanent disability, congenital anomaly, or birth defect.

What is the failure rate of clinical trials? ›

It takes 10 to 15 years and around US$1 billion to develop one successful drug. Despite these significant investments in time and money, 90% of drug candidates in clinical trials fail.

What is considered a serious adverse event? ›

A serious adverse event (SAE) refers to any expected or unexpected adverse event, related or unrelated to the therapy being studied, occurring at any agent dose, any phase of product, or procedure testing, that results in any of the following outcomes: death, a life-threatening adverse event, requires inpatient ...

What is a Grade 5 serious adverse event? ›

Grades 5 are fatal adverse event resulting in death. Clarification should be made between a serious AE (SAE) and an AE that is considered severe in intensity (Grade 3 or 4), because the terms serious and severe are NOT synonymous.

What is EC in clinical trials? ›

For the purpose of the Rule 122DD, an Ethics Committee is a committee comprising of medical, scientific, non-medical and nonscientific members, whose responsibility is to ensure the protection of the rights, safety and well-being of human subjects involved in a clinical trial and it shall be responsible for reviewing ...

How do you report death in clinical trials? ›

All deaths require expedited reporting (usually within 24 hours of study's knowledge of death). The report of death should be submitted to NIA Program Officer and to the DSMB Chair (or a Safety Officer, for studies without the DSMB) or to the designated DSMB member if a DSMB is established.

What are the ethical issues in clinical trials? ›

A major ethical concern related to clinical trials is whether participants are fully informed about the risks entailed in the trials and the likelihood that they will not personally benefit from the research.

How risky are Phase 1 clinical trials? ›

Phase I studies may involve risks even though an investigational drug has passed the Preclinical phase of testing. Phase I studies typically offer little or no benefit to the volunteer subjects; therefore they typically are compensated for their time and effort.

How are clinical trials unethical? ›

Clinical trials may be unethical because participants in the clinical trials assume equipoise i.e. that the chance of finding a benefit or a harm are equal and written signed consents are required.

What is the biggest barrier to clinical trials? ›

Recruiting study participants is one of the most challenging tasks in the clinical trial process, and arguably one of the biggest barriers to success in clinical research.

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