External Controls: FDA Guidance Provides Clarity But Does Little To Remove Hurdles

Agency discourages use of externally controlled trials in all but a very limited number of situations truly ripe for such an approach; new draft guidance discusses at length the various confounding factors that can introduce bias into a comparison between an investigational treatment and an external control using either real-world data or data from another clinical trial.

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The road to use of external controls will be blocked for most drug development programs. • Source: Shutterstock

The US Food and Drug Administration’s draft guidance on design and conduct of externally controlled trials may give sponsors more clarity on use of such approaches, but considerable obstacles remain to demonstrating drug efficacy or safety to the agency’s satisfaction.

Through the guidance, the FDA seeks to discourage use of externally controlled trials in all but a very limited...

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