Determine Patients’ Needs

Patient Registries

In the context of therapy development, a patient registry (also called a disease registry) is a database that collects and stores information about patients diagnosed with a specific disease, genetic disorder, or medical condition.

  • Registry types: There are 2 general categories of registries.
    • A Contact registry can help connect patients to clinical trials and researchers to patients interested in furthering research.
    • A Natural History Study registry collects information about a disease from a patient and clinical perspective that can inform every stage of the therapy development process. 
  • Registry vs. clinical trial: A patient registry can be listed in ClinicalTrials.gov , but these registries differ from treatment-based clinical trials  in several important ways:
    • A registry does not investigate a new therapy.
      • Registries are based on the patient’s actual experience and their current medical care.
      • A treatment clinical trial has certain requirements, for example it will require a volunteer to take a certain treatment or use a specific medical device and follow a specific protocol to track the safety and effectiveness of the therapy.
      • Registries are observational.
      • Clinical trials are experimental.
    • In almost every case, there is no cost to join a registry and medical insurance providers are not involved. 
      • Depending on the clinical trial, a participant’s medical insurance and, ultimately, the participant may be responsible for certain portions or all of the expenses related to the treatment clinical trial protocol. 
  • Founders of a registry: A patient or disease registry can be set up by different stakeholders, however, forming a collaboration among several of the key stakeholders can increase the value of the data collected in the registry. Collaborators can include:
    • Patient groups (including their Medical or Scientific Advisors)
    • Clinicians
    • Academic researchers
    • Pharmaceutical companies
    • Biotechnology companies
  • Rare and genetic disease registries: A registry is important to a rare disease community and is especially valuable in certain situations. For example, when:
    • Small patient populations make it difficult to attract enough patients to run a clinical trial.
    • The disease is not well characterized, leading to delayed and missed diagnosis.
    • Poor understanding of the natural history of the disease and its progression without treatment makes it difficult to evaluate the effectiveness of a new therapy.
    • No biomarkers have been validated. 
    • Clinical endpoints are unclear.
    • Clinical trial designs do not include the patient perspective, making retention in a clinical trial a challenge. 
  • International registries: If a disease is relatively common, registries may only include people from a specific country . However, rare diseases benefit greatly from a global approach for a number of reasons. For example, an international registry:
  • Importance of registry: Registries benefit a number of populations, including patients and their caregivers, clinicians, researchers, industry partners, and regulatory agencies.
    • For patients and their caregivers, registries can:
      • Allow their voice to be heard. 
      • Capture the knowledge gained from living with the disease.
      • Increase the probability that a treatment or cure may be developed.
      • Provide valuable information to support accommodations and services that may  be needed at school, places of employment, or home.
      •  Empower and unite the community.
    • Registries can allow clinicians to: 
      • Better understand how the disease progresses over time.
      • Discover the signs and symptoms that are most responsible for decreasing a  patient’s quality of life. 
      • Explore the heterogeneity of signs, symptoms, and progression within the patient population.
      • Develop diagnostic criteria to decrease time to diagnosis.
      • Publish treatment and management guidelines.
    • For medical researchers, registries:
      • Validate animal models.
      • Establish patient-reported outcome and other clinical outcome measures.
      • Identify biomarkers.
      • Determine disease incidence.
      • Uncover common traits, behaviors, or symptoms not previously realized that may provide a better understanding of the pathology of the disease or new targets for treatment.  
      • Identify unmet medical needs to guide focus of treatment research.
    • Industry partners can gain insight on:
      • The established course of disease, biomarkers, and patient-reported outcome and other clinical outcome measures to increase the ability of a treatment to be evaluated for safety and effectiveness in clinical trials.
      • Improved clinical trials design based on knowledge from the patient perspective which can increase enrollment and retention. 
    • For regulators: 
      • An active, engaged patient community is one of the key components to  a successful therapy development and regulatory review process, especially for rare and genetic diseases.
      • Safety and efficacy of a newly approved treatment or medical device can be tracked accurately in an established natural history registry.
  • Learn more:

Resources

Building a Registry