In this issue of the Journal, Gallin and colleagues1 reportthe results of a clinical trial of itraconazole for the preventionof severe fungal infection in children and adults with chronicgranulomatous disease. This trial required 10 years to enrolljust 39 patients. The study illustrates some of the problemsand options that arise in the design of clinical trials of newtherapies for rare diseases.
When patients are scarce, one option is to design the studyso that patients serve as their own controls. For example, ina two-group crossover study,2 each patient receives the twostudy treatments sequentially . . . [Full Text of this Article]
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