The IDeAl project is strongly represented to discuss multiplicity issues related to rare diseases at the 9th International Conference on Multiple Comparison Procedures MCP2015, September 2nd – 5th, in Hyderabad, India (http://www.mcp-conference.org/). This conference promotes research and applications of Multiple Comparison Procedures and provides a forum for interactions among industry practitioners, regulators, research scientists from subject matter areas and statisticians.
The IDeAl project co-organized an invited panel discussion on “Frontiers of confirmatory inference in small populations” chaired by F. König and M. Posch.
Generating clinical evidence for small populations is extremely challenging, e.g., in the development of orphan drugs, personalized medicines or drug development for children. The ability of conventional statistical methods to evaluate new therapeutic approaches for any given rare diseases is limited due to the small number of patients concerned. This means that established statistical approaches to demonstrate the efficacy and safety of therapies may fail in this situation.
The number of rare diseases is also increasing simply due to the fact that what was considered as a single indication in the past is nowadays understood as multiple different diseases that may require different treatments. Furthermore, when conducting clinical trials in smaller and smaller study populations, we land in multiplicity territory in ways that traditional development programs and trials in “common” diseases do not. For example some diseases may have numerous symptoms. A treatment that benefited any of the symptoms might be considered as useful. Which level of evidence is needed? Should a drug be disregarded because the primary endpoint chosen turned out not to be the one the drug impacted on? What if the treatment effect was diluted due to a too broad study population? Single arm versus parallel group designs?
In addition, IDeAl presentations by RD Hilgers, N. Heusen, CF Burman and F König are included in the regular program with several presentations.