From several articles read, does not appear that a dsmc ‘s role is to recommend chg in end points.
There is seperate IRB cydy had to employ for that.
Other than that it appears the efficacy recommedations are stop of the trial (for good and futile reason) Or continue the trial. Continuing itself means they expect us to hit our end points. Otherwise we would be asked to stop due to the futile clause. Secondly, dsmc may have recommended this but fda could revisit this. See below how even stopping a trial recommended by dsmc is recommended to
Be reviewed by the fda before doing so.So we could be in this bucket too. Thats why no PR until FDA and cydy discuss about the implications of stopping the trial:
7.2.1. DMC Recommendations to Terminate the Study
In almost all cases, a DMC is advisory to the sponsor; the sponsor decides whether to accept recommendations to discontinue a trial. FDA will rarely, if ever, tell a sponsor which decision to make. For trials that may be terminated early because a substantial benefit has been observed, however, consideration may still need to be given to the adequacy of data with regard to other issues such as safety, duration of benefit, outcomes in important subgroups and important secondary endpoints. We recommend that sponsors of trials that could potentially be terminated early for efficacy reasons discuss these issues with FDA prior to implementing the trial, when the statistical monitoring plan and early stopping boundaries are being developed. In these settings, consultation with FDA may provide the sponsor with important information regarding the regulatory and scientific implications of a decision and may lead to better decisions. Sponsors are encouraged to revisit these issues with FDA when considering DMC recommendations for early termination if new issues have arisen and/or if the regulatory implications of early termination were not adequately clarified at the outset of the trial.
