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Dementia disease burden outstrips trial activity

A review has found there is far less clinical trial activity related to dementia than researchers expected, given the condition’s growing prevalence and national disease burden.

The analysis, carried out by researchers at the National Health and Medical Research Council Trials Centre, examined 5143 trials with Australians sites that were registered with either the Australian New Zealand Clinical Trials Registry or the website ClinicalTrials.gov between January 2008 and December 2012.

Based on modelling related to the nine National Health Priority Areas (NHPAs) – as designated by Australian governments – researchers set out to determine how closely clinical trial activity paralleled the overall health burden posed by conditions such as dementia, cardiovascular disease, cancer, mental health, obesity and diabetes.

Researchers concluded that the level of planned recruitment into dementia-related trials was equal to or less than half of what they had predicted based on the national disease burden dementia posed, measured in terms of disability adjusted life years. The number of trials relating to dementia was also lower than researchers anticipated.

Other conditions found to have a less-than-anticipated level of clinical trial activity were asthma and obesity. In comparison, researchers found that trial activity for NHPAs such as cancer, mental health and cardiovascular disease were far more closely aligned with the disease burden each posed.

The paper’s authors conceded that the analysis did not allow them to determine an optimal level of trial activity for each condition and that not all research relating to NHPAs was necessarily best carried out using clinical trials. In addition, unlike conditions such as cancer and cardiovascular disease that were made NHPAs in the mid-1990s, dementia was added to the list only in 2012.

They concluded, however, that their findings “suggest there is a need to further examine research activity for obesity, dementia and asthma to determine if and how clinical trials research in these areas should be increased”.

The paper was published this week in the Medical Journal of Australia online.

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