Despite the pandemic, clinical trial activity remained historically high in 2020, especially in oncology, according to a new report by IQVIA. Clinical trial starts increased 8 percent in 2020, an annual growth rate on par with those observed since 2017.

A surge in clinical trials focused on COVID-19 vaccines and therapies resulted in 866 industry-sponsored interventional studies, yielding 12 vaccines and four novel therapeutics to date, as well as a robust pipeline for additional ongoing studies, IQVIA said.

The annual growth rate includes a recovery that began in mid-2020 to levels higher than the corresponding period in 2019 — even excluding new COVID-19 trials. Of those 866 trials, 51 were subsequently terminated; the remaining 815 trials account for 61 percent of infectious disease trials started from 2020 through early April 2021. Overall, 49 percent of COVID-19 trials remain active, 15 percent are planned but not active and 30 percent are either closed or completed.

There were a total of 4,686 clinical trials started in 2020 — including 1,821 phase 1 studies, 1,880 phase 2 studies and 985 phase 3 studies. By comparison, there were 4,325 studies started in 2019 — including 1,856 phase 1 studies, 1,590 phase 2 studies and 879 phase 3 studies. IQVIA said oncology and rare disease studies were less impacted by disruptions caused by the pandemic.

Although subsequent waves of COVID-19 cases have persisted, the clinical trial industry has not seen parallel disruptions to trial starts, compared to the first wave. IQVIA said adaptations and adjustments made by hospitals, investigators and sponsors helped shield the industry from more devastating disruption.

“While there has been a rebound in trial starts, the overall capacity of sponsors and investigators to conduct trials, along with continued reduced patient volumes in health systems, may be contributing to lower numbers of trial starts,” IQVIA said.

Oncology trial starts reached historically high levels in 2020, hitting a mark more than 60 percent higher than studies started in 2015, IQVIA said, reflecting “strong momentum in this area and especially in rare oncology indications.” There was also significant overlap between oncology and rare diseases, with rare oncology trials representing 63 percent of oncology trials overall and 64 percent of rare disease trials overall — signaling a trend toward precision medicine.

Clinical trial starts in eight other therapy areas — specifically, dermatology, neurology, endocrinology, immunology, cardiovascular disease, women’s and sexual health, respiratory disease and ophthalmology — declined slightly in 2020 but remained high in most cases and were only temporarily disrupted, IQVIA said. More of the declines were in phase 1 trials, as the pandemic hampered sponsors and investigators from initiating new trials.

IQVIA also found that clinical trial complexity continued a two-year decline in 2020, a consequence of the reduced number of sites and countries performing research due to the pandemic, and slight decreases in endpoints and eligibility criteria in trials.

The length of trials has been increasing across all phases and now averages 1.5 years for phase 1, almost three years for phase 2 and 2.5 years for phase 3, as measured from trial start to primary completion.

Read the report here: https://bit.ly/3ftwQ9n.