The US Food and Drug Administration (FDA) has published draft guidance designed to facilitate the use of Bayesian methodologies in clinical trials of drugs and biologics, helping drug developers make better use of available data, conduct more efficient clinical trials and deliver safe and effective treatments to patients sooner.

"Bayesian methodologies help address two of the biggest problems of drug development: high costs and long timelines. Providing clarity around modern statistical methods will help sponsors bring more cures and meaningful treatments to patients faster and more affordably,” said Marty Makary, MD, MPH, Commissioner, FDA.

Bayesian approaches use a different framework from traditional statistical approaches. In a Bayesian analysis, data from a study are combined with relevant prior information to form a new distribution that can be used for inference and to draw conclusions about safety and efficacy.

Examples of Bayesian calculations used in various ways in clinical trials can include determining futility or success earlier in adaptive trials; informing design elements like dose selection in subsequent trials; incorporating information from other sources, such as previous clinical study data, real-world evidence and external or non-concurrent controls; facilitating subgroup analyses and supporting primary inference in a trial.

The guidance provides recommendations on the appropriate use of Bayesian methods, with an emphasis on the use of these methods to support primary inference. Bayesian methods may be especially valuable for sponsors targeting rare or paediatric indications, where patient populations are smaller.

The publication of this guidance—Use of Bayesian Methodology in Clinical Trials of Drugs and Biologics Guidance for Industry—is intended to satisfy the FDA’s commitment in the Prescription Drug User Fee Act (PDUFA) VII. As part of the sixth reauthorisation of the PDUFA, the FDA and industry agreed to performance goals around enhancing the capacity to review complex innovative trial designs, including a commitment to publish draft guidance on the use of Bayesian methodology in clinical trials of drugs and biological products.

The FDA is seeking public comment on the draft guidance, titled Use of Bayesian Methodology in Clinical Trials of Drugs and Biologics; Draft Guidance for Industry.