Review

Registration of intervention trials of Traditional Chinese Medicine for four neurological diseases on Chinese Clinical Trial Registry and ClinicalTrials.gov: a narrative review

  • Jingjing WEI ,
  • Rongjuan GUO ,
  • Guojing FU ,
  • Xiao LIANG ,
  • Zhenmin XU ,
  • Min JIA ,
  • Zixiu ZENG ,
  • Wanqing DU ,
  • Weiwei JIAO ,
  • Linjuan SUN ,
  • Hongmei LIU ,
  • Chunli GUO ,
  • Chenguang TONG ,
  • Yunling ZHANG ,
  • Xing LIAO
Expand
  • 1 Graduate school, Beijing University of Chinese Medicine, Beijing 10029, China
    2 Center for Evidence Based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
    3 Department of Neurology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
    4 Department of Neurology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
Prof. LIAO Xing, Center for Evidence Based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China. Email: okfrom2008@hotmail.com.
Prof. ZHANG Yunling, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China. yunlingzhang2004@126.com;

Received date: 2021-02-12

  Accepted date: 2021-05-13

  Online published: 2022-01-25

Supported by

NATCM TCM Inheritance and Innovation Hundred-Thousand-Ten Thousand “Talents Project QiHuang Scholar) – National TCM Leading Personnel Support Program (NATCM Personnel and Education Department [2018] No. 12)”;Research on optimizing construction of evidence-based ability of traditional Chinese medicine encephalopathy, Special fund for basic scientific research business expenses of central public welfare scientific research institutes(ZZ13-024-3)

Abstract

OBJECTIVE: To analyze the current status of clinical trial registration of Traditional Chinese Medicine (TCM) for the treatment of neurological diseases.

METHODS: Interventional clinical trials of TCM treatment for ischemic stroke, hemorrhagic stroke, vascular cognitive impairment, tension-type headache before September 22, 2020 on the platform of Chinese Clinical Trial Registry (ChiCTR), and ClinicalTrials.gov were searched. Two researchers independently selected the literature and extracted data.

RESULTS: A total of 180 interventional clinical trials were included for analysis. Out of 180 trials, 127 were from ChiCTR and 53 from ClinicalTrials.gov. The countries primary sponsoring the included trials were China (176, 97.8%), and the common categories of primary sponsors were hospital (131, 72.8%). Among the study design, the largest proportion of allocation was randomized (172, 95.6%), interventional model assignment was parallel (163, 90.6%), masking was double blind 49 (27.2%), and the sample size was ≤ 400 (144, 80.0%). The trials were most carried out at a single center (102, 56.7%). Among the included studies, 112 (62.2%) registered on ChiCTR attached the ethical approval documents. In terms of trial stages, 50 (27.7%) studies were in phase Ⅳ. The mostly used intervention was Chinese herbal medicines (99, 55%), acupuncture (68, 37.8%) was the second. By searching the registration number on China National Knowledge Infrastructure Database and PubMed, 38 (21.1%) registered trials were published, including 25 protocol studies and 14 research results with one (NCT02275949) published both the protocol and the results.

CONCLUSIONS: Irregular and inadequate reporting, untimely update and publication, insufficient information on traditional medicine unique characteristics, and lack of international collaborations are the problems existing in the interventional clinical registration trials of traditional medicine treatment on neurological diseases. More efforts need to be made from the above aspects to standardize and improve the registration of traditional medicine trials.

Cite this article

Jingjing WEI , Rongjuan GUO , Guojing FU , Xiao LIANG , Zhenmin XU , Min JIA , Zixiu ZENG , Wanqing DU , Weiwei JIAO , Linjuan SUN , Hongmei LIU , Chunli GUO , Chenguang TONG , Yunling ZHANG , Xing LIAO . Registration of intervention trials of Traditional Chinese Medicine for four neurological diseases on Chinese Clinical Trial Registry and ClinicalTrials.gov: a narrative review[J]. Journal of Traditional Chinese Medicine, 2022 , 42(1) : 148 -153 . DOI: 10.19852/j.cnki.jtcm.2022.01.010

References

[1] Feigin VL, Nichols E, Alam T, et al. Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the global burden of disease study 2016. Lancet Neurol 2019;18:459-80.
[2] Wu SM, Wu B, Liu M, et al. Stroke in China: advances and challenges in epidemiology, prevention, and management. Lancet Neurol 2019;18:394-405.
[3] Wang LD, Liu JM, Yang Y, et al. The prevention and treatment of stroke still face huge challenges — brief report on stroke prevention and treatment in China, 2018. Zhong Guo Xun Huan Za Zhi 2019;34:105-19.
[4] Czakó C, Kovács T, Ungvari Z, et al. Retinal biomarkers for Alzheimer's disease and vascular cognitive impairment and dementia (VCID): implication for early diagnosis and prognosis. GeroScience 2020;42:1499-525.
[5] O'Brien JT, Thomas A. Vascular dementia. Lancet 2015;386:1698-706.
[6] Jia LF, Du YF, Chu L, et al. Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: a cross-sectional study. Lancet Public Health 2020;5:e661-71.
[7] Stovner LJ, Nichols e, Steiner TJ, et al. Global, regional, and national burden of migraine and tension-type headache, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2018;17:954-76.
[8] James SL, Abate D, Abate AH, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden Disease Study 2017. Lancet 2018;392:1789-858.
[9] W?ber-Bing?l ?, W?ber C, Uluduz D, et al. The global burden of headache in children and adolescents-developing a questionnaire and methodology for a global study. J Headache Pain 2014;15:86.
[10] Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd ed. Cephalalgia 2018;38:1-211.
[11] Ni XJ, Lin H, Li H, et al. Evidence‐based practice guideline on integrative medicine for stroke 2019. J Evid Based Med 2020;13:137-52.
[12] Zhou XX, Huang JS, Xie M, Wu CH. Expert consensus for TCM preventive treatment of diseases: vascular mild cognitive impairment. Zhong Guo Zhong Yi Yao Xin Xi Za Zhi 2020;27:1-5.
[13] Yu SY, Zhang MJ, Zhou JY, Liu RZ, Wan Q, Li YS. Headache care in China. Headache 2014;54:601-9.
[14] Wang B, Chen D, Zhou HE, Shi HX, Xie Q. Influence of clinical pathways used the hospitals of Traditional Chinese Medicine on patients hospitalized with stroke: a systematic review and Meta-analysis. J Tradit Chin Med 2017;37:159-64.
[15] Cai YY, Jiang WM. Research progress of Traditional Chinese Medicine intervention vascular cognitive impairment. Zhong Guo Zhong Yao Za Zhi 2017;42:1837-41.
[16] Hu WY, Han ZY, Ma HP, Lin JF, Chang Z. Systematic evaluation and Meta-analysis of efficacy and safety of Tianzhi granules in treatment of vascular cognitive impairment. Zhong Guo Zhong Yao Za Zhi 2020;45:4766-75.
[17] Gou J, Yang HX, Yu Y, Guo RJ. Systematic review and Meta-analysis of efficacy and safety of compound Congrong Yizhi capsules on vascular cognitive impairment. Zhong Guo Zhong Yao Za Zhi 2020;45:1924-32.
[18] Coeytaux RR, Befus D. Role of acupuncture in the treatment or prevention of migraine, tension-type headache, or chronic headache disorders. Headache 2016;56:1-3.
[19] Bendtsen L, Evers S, Linde M, Mitsikostas DD, Sandrini G, Schoenen J. EFNS guideline on the treatment of tension-type headache — report of an EFNS task force. Eur J Neurol 2010;17:1318-25.
[20] Wu TX, Li YP, Li J, Zhong ZH, Jia WN. Chinese clinical trial registration and publishing system, and explanation. Zhong Guo Xun Zheng Yi Xue Za Zhi 2006;6:395-6.
[21] WHO. WHO. International Clinical Trials Registry Platform (ICTRP), Trial registration. https://www.who.int/clinical-trials-registry-platform/network/trial-registration. (Accessed 20th January 2021).
[22] Zhang X, Tian R, Yang Z, et al. Quality assessment of clinical trial registration with Traditional Chinese Medicine in WHO registries. BMJ Open 2019;9:e025218.
[23] The Central People’s Government of the People’s Republic of China, China and India join the WHO international clinical trial registration platform. http://www.gov.cn/jrzg/2007-07/25/content_697236.htm (2007, accessed 7th October 2020).
[24] National Administration of Traditional Chinese Medicine of China, Notice on the issuance of TCM diagnosis and treatment plans for 8 diseases of encephalopathy and psychiatry. http://yzs.satcm.gov.cn/zhengcewenjian/2018-03-24/3203.html. (21st January 2011, accessed 7th October 2020).
[25] Wu TX, Li YP, Yao X, Li J. Clinical trial registration: to improve the quality of clinical research in China. Zhong Guo Xun Zheng Yi Xue Za Zhi 2006;3:153-6.
[26] WHO. WHO International Clinical Trials Registry Platform (ICTRP), About ICTRP. https://www.who.int/ictrp/about/en/. (Accessed 7th October 2020).
[27] Wang YY, Huang LQ. Taking a broad and long-term view to establish China Center for Evidence Based Traditional Chinese Medicine (CCEBTCM). Zhong Guo Xun Zheng Yi Xue Za Zhi 2019;19:1131-7.
[28] Li YP, Wu TX, Li J, Zhong ZH, Jia WN. Joint statement of establishing Chinese clinical trial registration and publishing system. Zhong Xi Yi Jie He Xue Bao 2006;4:331-2.
[29] Ross JS, Gross CP, Krumholz HM. Promoting transparency in pharmaceutical industry-sponsored research. Am J Public Health 2012;102:72-80.
[30] Pearn J. Publication: an ethical imperative. BMJ 1995;310:1313-5.
[31] Breil T, Boettcher M, Hoffmann G F, Ries M. Publication status of completed registered studies in pediatric appendicitis: a cross-sectional analysis. BMJ Open 2018;8:e021684.
[32] Li J, Jin X, He YY, Fang YX, Wei JM. Practical explorations of multi-center clinical research organized by medical scientific periodicals. Bian Ji Xue Bao 2015;1:47-9.
[33] Fisher M, Amarenco P, Aronowski J, et al. International collaborations are essential for stroke. Stroke 2019;50:2993-4.
[34] Webster TJ. Think international collaborations are safe? Think again. Int J Nanomedicine 2019;14:6933-5.
[35] Cheng CW, Wu TX, Shang HC, et al. CONSORT extension for Chinese herbal medicine formulas 2017: recommendations, explanation, and elaboration. Ann Intern Med 2017;167:112-21.
Outlines

/