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Optimal dose-finding for efficacy-safety-models with placebo effects
Stockholm University, Faculty of Social Sciences, Department of Statistics.ORCID iD: 0000-0002-2629-5033
Stockholm University, Faculty of Social Sciences, Department of Statistics.ORCID iD: 0000-0003-4161-7851
(English)Manuscript (preprint) (Other academic)
Abstract [en]

The knowledge of how good or optimal designs look like is essential for dose-finding trials. In many cases, dose-finding trials consider both efficacy and safety. We analyse, therefore, a bivariate model for these two outcomes. In contrast to earlier research, we consider a model also having placebo effects to see the impact on the optimal design. We calculate D-optimal designs algebraically and numerically. We see that one more design point is necessary, but that otherwise, the optimal design has a similar structure compared to the model without placebo effects. We confirm that the drug's therapeutic index has a significant impact on the shape of the optimal design.

Keywords [en]
Bivariate model, Dose-finding, Fedorov Algorithm, Optimal design, Placebo Effect
National Category
Probability Theory and Statistics Pharmaceutical Sciences
Research subject
Statistics
Identifiers
URN: urn:nbn:se:su:diva-198268OAI: oai:DiVA.org:su-198268DiVA, id: diva2:1607772
Available from: 2021-11-02 Created: 2021-11-02 Last updated: 2022-02-25
In thesis
1. Optimal design for dose-finding studies
Open this publication in new window or tab >>Optimal design for dose-finding studies
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

One of the most complex tasks during the clinical development of a new drug is to find a correct dose. Optimal experimental design has as a goal to find the best ways to perform an experiment considering the available resources and the statistical model. Optimal designs have already been used to determine the design of dose-finding studies. In this thesis, optimal designs are considered for the simultaneous response of efficacy and safety in a bivariate model, for the drug combination trials, and for general regression problems, including but not limited to dose-finding analysis.

The thesis consists of four papers: In Paper I, the dose that maximizes the clinical utility index based on an efficacy-safety Emax model gives us the desirable balance between effects and side effects. In order to make use of a symmetry property, we use a log-transformed dose scale. The geometric characterization of the multivariate Elfving method is used to derive c-optimal points and weights for arbitrary c-vectors. The second paper is an extension of the first one. We still use the log-transformed dose scale bivariate model and consider now also the placebo effect and side-effect. Fedorov’s exchange algorithm is applied in order to derive locally D-optimal designs numerically. 

Optimal experimental design for dose-finding studies often focuses on one drug only. Paper III calculates D-optimal designs for the efficacy Emax model of two drugs that might interact. Three conditions can occur in drug combination trials. When there is a positive interaction, we deal with synergy; when it is negative, we have antagonism; and when the interaction is zero, it is called additivity.

Finally, in Paper IV, we present a low dimensional regression model with a distortion term. The distortion term, which in our case is a stochastic process, contributes to the regression. Thus, we estimate the combined model, which is a mixed effect model. Optimal designs for this model are derived by applying the Fedorov Algorithm.

Place, publisher, year, edition, pages
Stockholm: Department of Statistics, Stockholm University, 2021. p. 34
Keywords
bivariate model, distortion, drug combination, Elfving set, Emax model, Fedorov algorithm, mixed effects models, optimal experimental design
National Category
Probability Theory and Statistics Pharmaceutical Sciences
Research subject
Statistics
Identifiers
urn:nbn:se:su:diva-198271 (URN)978-91-7911-686-6 (ISBN)978-91-7911-687-3 (ISBN)
Public defence
2021-12-17, hörsal 11, hus F, Universitetsvägen 10 F, Stockholm, 13:00 (English)
Opponent
Supervisors
Available from: 2021-11-24 Created: 2021-11-02 Last updated: 2022-02-25Bibliographically approved

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Tsirpitzi, Renata EiriniMiller, Frank

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