Extension of three-arm non-inferiority studies to trials with multiple new treatments

Non‐inferiority (NI) trials are becoming increasingly popular. The main purpose of NI trials is to assert the efficacy of a new treatment compared with an active control by demonstrating that the new treatment maintains a substantial fraction of the treatment effect of the control. Most of the stati...

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Bibliographic Details
Published in:Statistics in medicine 2012-10, Vol.31 (24), p.2833-2843
Main Authors: Kwong, Koon Shing, Cheung, Siu Hung, Hayter, Anthony J., Wen, Miin-Jye
Format: Article
Language:English
Subjects:
Algorithms
assay sensitivity
Bronchodilator Agents - therapeutic use
Clinical trials
Clinical Trials as Topic - methods
control treatment
Drugs
familywise error rate
Humans
Indans - therapeutic use
Medical statistics
Medical treatment
non-inferiority trial
placebo
pre-specified non-inferiority margin
Pulmonary Disease, Chronic Obstructive - drug therapy
Quinolones - therapeutic use
Sample Size
Scopolamine Derivatives - therapeutic use
Spirometry
three-arm design
Tiotropium Bromide
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Summary:Non‐inferiority (NI) trials are becoming increasingly popular. The main purpose of NI trials is to assert the efficacy of a new treatment compared with an active control by demonstrating that the new treatment maintains a substantial fraction of the treatment effect of the control. Most of the statistical testing procedures in this area have been developed for three‐arm NI trials in which a new treatment is compared with an active control in the presence of a placebo. However, NI trials frequently involve comparisons of several new treatments with a control, such as in studies involving different doses of a new drug or different combinations of several new drugs. In seeking an adequate testing procedure for such cases, we use a new approach that modifies existing testing procedures to cover circumstances in which several new treatments are present. We also give methods and algorithms to produce the optimal sample size configuration. In addition, we also discuss the advantages of using different margins for the assay sensitivity test between the active control and the placebo and the NI test between the new treatments and the active control. We illustrate the new approach by using data from a clinical trial. Copyright © 2012 John Wiley & Sons, Ltd.
ISSN:0277-6715
1097-0258
DOI:10.1002/sim.5467