Designing Clinical Trials for Dystonia

Wendy R. Galpern, Christopher S. Coffey, Alberto Albanese, Ken Cheung, Cynthia L. Comella, Dixie J. Ecklund, Stanley Fahn, Joseph Jankovic, Karl Kieburtz, Anthony E. Lang, Michael P. McDermott, Jeremy M. Shefner, Jan K. Teller, John L P Thompson, Sharon D. Yeatts, H. A. Jinnah

Research output: Contribution to journalArticlepeer-review


With advances in the understanding of the pathophysiology of dystonia, novel therapeutics are being developed. Such therapies will require clinical investigation ranging from exploratory studies to examine safety, tolerability, dosage selection, and preliminary efficacy to confirmatory studies to evaluate efficacy definitively. As dystonia is a rare and complex disorder with clinical and etiological heterogeneity, clinical trials will require careful consideration of the trial design, including enrollment criteria, concomitant medication use, and outcome measures. Given the complexities of designing and implementing efficient clinical trials, it is important for clinicians and statisticians to collaborate closely throughout the clinical development process and that each has a basic understanding of both the clinical and statistical issues that must be addressed. To facilitate designing appropriate clinical trials in this field, we review important general clinical trial and regulatory principles, and discuss the critical components of trials with an emphasis on considerations specific to dystonia. Additionally, we discuss designs used in early exploratory, late exploratory, and confirmatory phases, including adaptive designs.

Original languageEnglish
Pages (from-to)117-127
Number of pages11
Issue number1
Publication statusPublished - Jan 2014


  • Adaptive designs
  • Clinical trials
  • Confirmatory trials
  • Dystonia
  • Exploratory trials

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Clinical Neurology
  • Pharmacology


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