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Grand Rounds January 20, 2023: Collaborative Pragmatic Trials in Action: EVOLVE-MI (Mikhail Kosiborod, MD)

Rethinking Clinical Trials

Discussion Themes – Is the trial being done under an IND or is it under label? The treatment is on-label because anyone with an acute coronary has at risk cardiovascular disease so technically it is on-label. The recruitment rate is higher than what you would expect in a normal ACS trial. Can it be done under an IND.

Trials 130
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Grand Rounds February 3, 2023: Pragmatic Trials For Children With Congenital Heart Disease – Insights From The NITRIC Trial (Luregn Schlapbach, PhD, FCICM)

Rethinking Clinical Trials

This was not a dose finding trial and no nitrosothiol compounds were measured; the perfusionists in the study were not blinded; we allowed open label iNO; the choice of ventilator-free days as a primary endpoint can be criticized. There were a number of limitations.

Trials 130
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Grand Rounds June 2, 2023: PROACT Xa and The Wizard of Oz: Behind the Curtain of a Pragmatic Decentralized Clinical Trial (John Alexander, MD, MHS)

Rethinking Clinical Trials

The drugs were administered open label and all patients were given a low dose of aspirin. The primary endpoint was composite of valve thrombosis or valve-related thromboembolism, and the primary safety endpoint was major bleeding. The trial took place at 64 sites, and randomized 863 patients.