Clinical pharmacologists in research
It is now clear that the systems we have in place, both in academic
research and in the industry, are not well suited for emergencies when
immediate answers are required by our colleagues standing bed side and
by those in charge of making policy decisions. The academic world is
used to grant applications, reviews, publications and more reviews. The
system emphasises quality over speed, proper methodology over quick
answers. Can clinical pharmacology contribute to development of
procedures for future emergencies? Can we perhaps make do with
non-blinded studies? What randomisation is good enough? Are we happy
with surrogate outcomes? Clinicaltrials.gov returns 262 studies on the
role of hydroxychloroquine and/or chloroquine in COVID-19 (3). Most of
them are single centre, of questionable methodological quality. At a
time when there were already millions of confirmed cases with tens of
thousands recovered, many of whom were treated, we were still struggling
to find answers. It wasn’t until the results of the RECOVERY trial that
we got high quality data (4). Clinical pharmacologists could play a key
role in coming up with a framework for rapid ”real world” trials that
could provide us with answers in future emergencies.