Clinical trials are how we test promising new drugs and therapies to determine if they are safe and effective. Though all trials are different and have their own set of qualifications, time commitments, and treatment regimen, among others, it’s important to be familiar with the general process, terminology, and requirements.
That’s why we’ve compiled a list of frequently asked questions about clinical trials – to help you prepare better understand and prepare for a clinical trial.
You can find a comprehensive list of epilepsy clinical trials at CenterWatch I Connect Clinical Trials Listing for Epilepsy. This list is a subset of available epilepsy clinical trials that can be found on ClinicalTrials.gov.
The length of a clinical trial can vary depending on the study protocol, the treatment that is being tested, the specific disorder or syndrome being evaluated, the number of people affected by the disorder, and the ability to recruit people interested in participating in the trial. Some trials last a short period of time, such as 12 weeks, while others can last several years.
Well-designed and well-executed clinical trials offer a lot of benefits, including:
Clinical trials also pose potential risks, including:
Clinical trials require the participation of both healthy volunteers and volunteers with the illness that the drug will treat. Researchers choose clinical trial participants based on eligibility requirements which vary by trial. Researchers design these criteria to help identify the most appropriate volunteers, or “subjects”, for the trial and to keep volunteers safe. Eligibility requirements may include age, gender, type and stage of a disease, previous treatment history, and other medical conditions.
As a study participant, you will have a direct line of contact to healthcare providers who assure your safety and monitor your health. If at any point you wish to withdraw your participation for any reason, let a healthcare provider know that you wish to leave the study. They will work with you to determine the next steps and ensure the transition of your care outside the trial.
To determine whether an investigational treatment is effective in treating a condition or disease, clinical trials can be designed so that some people receive the treatment being studied, and other people in the trial do not. The set of people in the trial who do NOT receive the treatment being studied is called the control group.
A control group is a standard against which effects of the investigational therapy are evaluated. The control group is usually given either a currently approved treatment for the disease or a placebo. The researchers can then compare the effect that the investigational treatment had on the study group (also referred to as the experimental group) compared to the effect that the placebo or standard treatment had on the control group.
Usually, the trial’s protocol will dictate that participants are randomly assigned to be part of either the study group or the control group. Participants cannot select the group they are in because that would introduce bias into the study results. This type of study design is referred to as a randomized controlled trial.
A study protocol is a document approved by the FDA that outlines the design for how the clinical trial will be carried out. It is carefully designed to safeguard the participant’s health and to answer specific medical questions. The protocol will detail the trial objectives, trial design, who can participate in the trial, the schedule of tests, procedures, medications and dosages, and the trial length.
The clinical trial will follow a study protocol that outlines the strict scientific standards to protect patients and produce results that help us understand if the treatment is safe and effective. The healthcare team administering the clinical trial may include doctors, nurses, social workers, and other healthcare providers who will monitor your health and give you specific instructions about the study. During a clinical trial, you may have periodic tests or treatments in a hospital, clinic, or doctor’s office. The study protocol will describe all the specific details of the trial such as where, when, and how you will be monitored, as well as the type of health information collected to evaluate the efficiency of the treatment and your overall health while participating.
Side effects are unwanted or undesirable effects that occur as a result of taking the a drug, device, or treatment. Side effects can range from very minor problems such as drowsiness or dry mouth to serious consequences such as pancreatitis or heart issues.
On the other hand, an adverse reaction is an unforeseen effect that occurs when a medication is administered correctly and can generally be addressed by either lowering the dose or stopping the medication. The terms adverse reactions and side effects are often used interchangeably, but technically they have different meanings.
Before a participant can begin a clinical trial, the people conducting the study must get their informed consent. According to the FDA, informed consent is the process by which a prospective participant learns, “adequate information to allow for an informed decision about” participating in a clinical trial. This process is in place to ensure you understand all the information they provide, including the potential benefits and risks of participating in the study. This is an important time for you to ask any questions that you may have.
The investigator or their staff will explain the details of the study, including its purpose, duration, required procedures, key contacts, and the potential benefits and risks of participating. They will then provide you with an informed consent document to review and sign, documenting that you have been fully informed and agree to participate in the study. They must also give you sufficient time to consider whether you want to participate. During that time, you may find it beneficial to talk to family, friends, or your healthcare provider about whether you should participate.
Informed consent is not a contract, and the participant may withdraw from the clinical trial at any time.
Drugs, devices, or treatments that have not yet been approved by the FDA for public use, but are being studied, are often referred to as “investigational” or “experimental.”
A placebo is a substance with no active medication in it. It is often referred to as a “sugar pill.” In some clinical trials, a portion of the study participants are given a placebo instead of the investigational treatment to compare and evaluate the treatment’s effectiveness. Patients in the study will not know if they are receiving the investigational treatment or the placebo.
A single-masked study, also known as a single-blinded study, is a clinical trial design where only the research team, not the participants, know whether they are receiving the placebo or the real treatment.
A double-masked study, also known as a double-blinded study, is a clinical trial design where neither the participants nor the study researchers know who receives the placebo or the study medication. Only a select group of people who do not interact with participants (usually a pharmacist or other medical provider) know who is getting the drug or placebo.
The Data and Safety Monitoring Board (DSMB) is an independent group of experts that oversees the clinical trial’s conduct and ensures that study participants are safe. The primary responsibilities of the DSMB are to 1) periodically review and evaluate the accumulated study data for participant safety, study conduct, progress, and efficacy; and 2) make recommendations concerning the continuation, modification, or termination of the trial.
While CURE Epilepsy currently does not fund the type of clinical trials required for FDA approval of a new drug, device, or treatment, we do fund basic (foundational) research and translational research to find cures for epilepsy. These two types of research are critical steps in developing a new therapy and provide initial data that it will be safe and effective in human trials. After these two steps are completed, an investigational treatment can move forward into clinical trials.
Every patient and every clinical trial is different. Each clinical trial has its own set of qualifications, time commitments, treatment regimen, and more. To determine if a particular trial is right for you, do as much research as you can. Meet with the research coordinator and ask them questions relevant to your health, the study, the requirements, and the time commitment. Questions such as those below can help you with your decision. You may have more or different questions, but these serve as a good starting point.
Here are some other tips and tools to consider as you decide on whether participating in a clinical trial is right for you.
Kim Nye, a mother of two children with epilepsy, shares her advice on participating in clinical trials.
Dr. Darcy Krueger outlines what patients should ask prior to participating in a clinical trial.