Two hundred sixty-eight years ago, the sailors aboard the HMS Salisbury were facing a very real fear: scurvy, a disease that had claimed the lives of more than a million sailors, had appeared on their ship. It was thought that perhaps drinking orange and lemon juice might prevent the disease, but no one knew for sure how to stop the life-threatening illness.
Enter James Lind, a surgeon in Britain’s Royal Navy who is known today as the first to run a clinical trial. Lind, “acting on a hunch that scurvy was caused by putrefaction of the body that could be cured through the introduction of acids,” recruited twelve sailors to participate in what is widely believed to be the first “like versus like” comparison test of treatment options. Lind gave two men each a different treatment regimen every day for two weeks, and in the end, those given citrus fruits had the best response. The key to curing scurvy was discovered – and the clinical trial as we know it was born.
Centuries later, we’ve come a long way. Today, the US government website clinicaltrials.gov lists 35,373 clinical trials actively recruiting patients. In the years since Lind’s time, clinical trial protocol and drug approval practices have become heavily regulated, and hundreds of thousands of clinical trials have yielded some 1,505 FDA drug approvals to date. These drugs provide relief from symptoms and – in some cases – save lives.
Today, we are celebrating International Clinical Trials Day. If you are a patient who has participated in a trial, or a researcher who has conducted one, thank you. Your involvement in clinical trials is crucial to providing hope for the future of medicine.
But, we know that there is still work to be done. Just 3% of American cancer patients participate in clinical trials, and only 15% are even aware that clinical trials are an option. This may be one reason that up to 40% of oncology trial sites fail to enroll the minimum number of patients needed to conduct the trial. Time is wasted, money is wasted, and patients continue to suffer through illnesses without knowing all of their options.
We can do better. James Lind got the ball rolling. Let’s keep it going.