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Fewer than half of all clinical trials recently published in journals with high impact factors are adequately registered, and about a third of those that are registered properly show discrepancies between the registered primary outcome and the one that actually gets reported.

The fact that an increasing number of medications are unable to beat sugar pills has thrown the industry into crisis. It's not that the old meds are getting weaker, drug developers say. It's as if the placebo effect is somehow getting stronger. Why are inert pills suddenly overwhelming promising new drugs and established medicines alike? Pharma doesn't know, and drugmakers are realizing they need to fully understand the mechanisms behind it so they can design trials that differentiate more clearly between the beneficial effects of their products and the body's innate ability to heal itself. special task force of the Foundation for the National Institutes of Health is seeking to stem the crisis by quietly undertaking one of the most ambitious data-sharing efforts in the history of the drug industry.

Ethical Considerations in the Interpretation and Communication of Clinical Trial Results -- Coultas 4 (2): 194 -- Proceedings of the American Thoracic Society

We found that 5% imiquimod cream is an effective treatment option for superficial and nodular basal cell carcinomas, giving a clearance rate of 89.5% at an average of 39 months of follow up.

Raasch B. Clinical, Cosmetic and Investigational Dermatology. 9 June 2009.  There is reasonable evidence that the use of imiquimod for small (<2 cm) superficial BCC that occur other than on the face provides  outcomes only marginally less satisfactory t

For patients without comorbidities, our study revealed good cure rates for superficial BCC and superficial/nodular BCC (88% and 85%, respectively). Nodular and aggressive BCC and Bowen's disease exhibited lower cure rates (50%, 50%, and 57%, respectively). I

There is reasonable evidence that the use of imiquimod for small (<2 cm) superficial BCC that occur other than on the face provides outcomes only marginally less satisfactory than surgery. There would be a place for imiquimod in treating patients with frequent multiple primary lesions when access to surgery is difficult or where clinical judgment may be influenced by patient factors as reported in some of the studies, eg, where patients may have contraindications to surgery.  It was noted that if recurrences occurred in this study they mostly occurred during the first 9 months after the end of treatment. The initial response was therefore predictive of long-term outcome so these authors recommend and encourage continued monitoring of skin lesions.

To date one long-term study indicates a treatment success rate of 78%-81% and that initial response is a predictor of long-term outcome. Recurrences tend to occur within the first year after treatment. Future research will compare this preparation to the gold standard treatment for superficial BCC - surgical excision.

The initial sBCC clearance rate was 90% (12-week post treatment), whereas the proportion of subjects who were clinically clear at 2 years (current time point) was estimated to be 79.4%. 

Composite clearance rates (combined clinical and histological assessments) for the 5 and 7x/week imiquimod groups were 75% and 73%, respectively. Histological clearance rates for the 5 and 7x/week imiquimod groups were 82% and 79%, respectively. Increasing severity of erythema, erosion, and scabbing/crusting was associated with higher clearance rates. CONCLUSION: Imiquimod appears to be safe and effective for the treatment of sBCC when compared with vehicle cream. The difference in clearance rates between the two imiquimod dosing groups was not significant. The 5x/week regimen is recommended.

The initial sBCC clearance rate was 90% (12-week post treatment), whereas the proportion of subjects who were clinically clear at 2 years (current time point) was estimated to be 79.4%.

Clinical clearance rate at 1 and 2 years were 89% and 85%, respectively.

Clinical clearance rate at 1, 2 and 3 years were 94, 76 and 70%, respectively. We conclude that imiquimod seems to be an appropriate therapeutic alternative for the treatment of recurrent BCC in patients with associated co-morbidities.