Statistical design of noninferiority multiple region clinical trials to assess global and consistent treatment effects. Issue 6 (2nd November 2017)

• Record Type: Journal Article
• Authors: Diao, Guoqing; Zeng, Donglin; Ibrahim, Joseph G.; Rong, Alan; Lee, Oliver; Zhang, Kathy; Chen, Qingxia
• Is Part Of: Journal of biopharmaceutical statistics. Volume 27:Issue 6(2017)
• Page Start: 933
• Page End: 944
• Publication Date: 2017-11-02
• Subjects: Consistency of treatment effects -- global treatment effect -- multiregional clinical trial -- noninferiority clinical trial -- random effects model -- signed likelihood ratio test; Pharmacy -- Statistical methods -- Periodicals; Drugs -- Testing -- Statistical methods -- Periodicals; Biometry -- Periodicals; Biopharmaceutics -- Periodicals; Pharmacokinetics -- Periodicals; 615.19
• DOI: 10.1080/10543406.2017.1293075
• Languages: English
• ISSNs: 1054-3406

Abstract

ABSTRACT: Noninferiority multiregional clinical trials (MRCTs) have recently received increasing attention in drug development. While a major goal in an MRCT is to estimate the global treatment effect, it is also important to assess the consistency of treatment effects across multiple regions. In this paper, we propose an intuitive definition of consistency of noninferior treatment effects across regions under the random-effects modeling framework. Specifically, we quantify the consistency of treatment effects by the percentage of regions that meet a predefined treatment margin. This new approach enables us to achieve both goals in one modeling framework. We propose to use a signed likelihood ratio test for testing the global treatment effect and the consistency of noninferior treatment effects. In addition, we provide guidelines for the allocation rule to achieve optimal power for testing consistency among multiple regions. Extensive simulation studies are conducted to examine the performance of the proposed methodology. An application to a real data example is provided.