title: Clinical trials: curing a critical deficiency in metabolic medicine.
abstract: The treatment of rare disorders is often driven by experience and expert opinion rather than formal clinical trials because of the significant barriers in place to conducting traditional random, placebo controlled, national studies. Dr. Doug Kerr graphically illustrates these problems in the treatment of inborn errors of mitochondrial oxidative phosphorylation as reviewed elsewhere in this issue. New models and additional funding for studying the ultra rare diseases that are the purview of metabolic medicine are desperately needed to move the field forward in an evidence-based fashion. In this commentary, the challenges associated with conducting clinical trials in ultra-rare disorders are discussed and potential solutions suggested.
authors.affiliation: University of Pittsburgh, Children's Hospital of Pittsburgh of UPMC, One Children's Hospital Drive, 4401 Penn Avenue, Pittsburgh, PA 15224, USA.
authors.forename: Jerry
authors.initials: J
authors.lastname: Vockley
authors.forename: Catherine M Walsh
authors.initials: CM
authors.lastname: Vockley
mesh_terms: D002986:Clinical Trials as Topic; D004579:Electron Transport; D019317:Evidence-Based Medicine / Q000379:methods*; D006801:Humans; D008661:Metabolism, Inborn Errors / Q000188:drug therapy / Q000628:therapy*; D028361:Mitochondrial Diseases / Q000188:drug therapy / Q000628:therapy*