Researchers from MRC CTU at UCL have called for a move away from traditional ‘two-arm' trials towards a ‘multi-arm’ approach that could speed up the process of getting effective new treatments to patients. This call comes in a commentary piece published in The Lancet on 25 July 2014.
Randomised controlled trials are the best way of finding out if new treatments are better than the current standard treatment. But trials take a long time to set-up and run, and can be expensive.
The usual design for a randomised controlled trial is to randomly allocate volunteer patients to receive either the new treatment or the current standard one. The trial doctors and nurses closely monitor both groups (or arms). At the end of the trial, all the data is analysed to see if the new treatment works better than the old one.
Multi-arm trials test several new treatments against the existing one at the same time. This offers several advantages over two arm trials:
- It saves time compared to testing all the treatments sequentially in a series of two-arm trials
- It increases the chances that one of the new treatments in the trial will be better than the existing one, compared to if you were only testing one new treatment
- It allows you to test more treatments than would ever be done in two-arm trials
- It is much cheaper to test a new treatment as part of a multi-arm trial than in a separate two-arm trial – about half the cost
- Our experience so far is that our multi-arm trials have recruited participants faster than comparable two-arm trials
In the commentary the authors urge research funders, drug companies, researchers and doctors to move away from two-arm trials being the norm, to adopt more efficient designs such as multi-arm trials. This will speed up the rate at which patients can benefit from new treatments.