A Systematic Evaluation of Effect of Adherence Patterns on the Sample Size and Power of a Clinical Study

Surulivelrajan Mallayasamy, Ayyappa Chaturvedula, Terrence Blaschke, Michael J. Fossler

Research output: Contribution to journalArticle

Abstract

The objective of our study was to evaluate the effect of adherence patterns on the sample size and power of a clinical trial. Simulations from a population pharmacokinetic/pharmacodynamic (PK/PD) model linked to an adherence model were used. Four types of drug characteristics, such as long (~35 hours) and short (~12 hours) half-life in combination with earlier or delayed time to reach steady-state PD end points were studied. Adherence patterns were simulated using Markov chains. Our results clearly demonstrate the significant impact of varying levels and patterns of nonadherence on the sample size and power of a study. For drugs with short half-lives the evidence to support efficacy could be diluted by various patterns of nonadherence that would make its efficacy indistinguishable from the response to placebo. Prospectively utilizing clinical trial simulations with thorough incorporation of various adherence patterns would provide valuable information when designing a trial.

Original languageEnglish
Pages (from-to)818-828
Number of pages11
JournalCPT: Pharmacometrics and Systems Pharmacology
Volume7
Issue number12
DOIs
Publication statusPublished - 01-12-2018

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Sample Size
Clinical Trials
Pharmacodynamics
Markov Chains
Pharmacokinetics
Evaluation
Pharmaceutical Preparations
Markov processes
Half-Life
Placebos
Efficacy
Drugs
Population
End point
Markov chain
Simulation
Clinical Studies
Evaluate
Model
Demonstrate

All Science Journal Classification (ASJC) codes

  • Modelling and Simulation
  • Pharmacology (medical)

Cite this

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A Systematic Evaluation of Effect of Adherence Patterns on the Sample Size and Power of a Clinical Study. / Mallayasamy, Surulivelrajan; Chaturvedula, Ayyappa; Blaschke, Terrence; Fossler, Michael J.

In: CPT: Pharmacometrics and Systems Pharmacology, Vol. 7, No. 12, 01.12.2018, p. 818-828.

Research output: Contribution to journalArticle

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