How to avoid risks for patients in minimal-access trials: Avoiding complications in clinical first-in-human studies by example of the ADBEE study

Best Pract Res Clin Obstet Gynaecol. 2016 Aug:35:84-96. doi: 10.1016/j.bpobgyn.2015.11.004. Epub 2015 Nov 14.

Abstract

A clinical trial is a prospective study designed to establish the safety and efficacy of investigational devices in humans, in accordance with the strict guidelines of the Food and Drug Administration (FDA; USA) or European Medicines Agency (EMA; Europe). Before a clinical first-in-human study is initiated, preclinical studies of the investigational product are mandatory, and the results should be sufficient to indicate that the investigational device is acceptably safe for the proposed evaluation in human subjects. The present paper describes an experience of clinical trials, highlighting ways of avoiding possible complications in clinical first-in-human studies. For a better approach to our aim, we exemplified a prospective, randomized, single-blind study, ADBEE. The primary objective was to assess the safety of the ADBLOCK system when used as an adjunct to laparoscopic primary removal of myomas in women wishing to improve pregnancy outcomes.

Keywords: ADBLOCK system; adhesions; clinical trials; complications; safety and efficacy.

Publication types

  • Clinical Trial, Phase I
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Dextrins / adverse effects
  • Dextrins / therapeutic use*
  • Female
  • Gels
  • Humans
  • Infertility, Female / etiology
  • Infertility, Female / surgery
  • Laparoscopy / adverse effects*
  • Leiomyoma / complications
  • Leiomyoma / surgery*
  • Polymers / adverse effects
  • Polymers / therapeutic use*
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control*
  • Prospective Studies
  • Risk Factors
  • Single-Blind Method
  • Tissue Adhesions / etiology
  • Tissue Adhesions / prevention & control*
  • Uterine Neoplasms / complications
  • Uterine Neoplasms / surgery*

Substances

  • Dextrins
  • Gels
  • Polymers