Cited by 732Animal testing and alternativesImmunotoxicology and immune responsesVeterinary Pharmacology and Anesthesia

The DOI matches its Crossref record; 110 of the 118 references it cites were found in a registry or an index; 23 of the 67 sources its claims cite were checked for support.

Limitations of Animal Studies for Predicting Toxicity in Clinical Trials

Open access
Van Norman, Gail A.·2019·JACC: Basic to Translational Science

Abstract

Animal testing is used in pharmaceutical and industrial research to predict human toxicity, and yet analysis suggests that animal models are poor predictors of drug safety in humans. The cost of animal research is high-in dollars, delays in drug approval, and in the loss of potentially beneficial drugs for human use. Human subjects have been harmed in the clinical testing of drugs that were deemed safe by animal studies. Increasingly, investigators are questioning the scientific merit of animal research. This review discusses issues in using animals to predict human toxicity in pharmaceutical development. Part 1 focuses on scientific concerns over the validity of animal research. Part 2 will discuss alternatives to animal research and their validation and use in production of human pharmaceuticals.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review argues that animal toxicity testing is a poor predictor of human drug safety, citing low animal-human concordance, high clinical trial failure rates, and cases of severe human harm after animal tests deemed drugs safe. It concludes that animal testing should be abandoned or significantly curtailed in favor of more reliable alternatives, with alternatives to be discussed in Part 2.

Key findings

  • Concordance between animal and human results is low: a 2006 review of 76 animal studies found ~20% were contradicted in humans and only 37% were ever replicated in humans; a review of 221 animal experiments found agreement with human studies just 50% of the time. In 37 chemicals from the U.S. National Toxicology Program, average positive predictive value from mouse to rat was 55.3% for long-term and 44.8% for short-term studies, hovering around 50%—no greater than random chance.
  • Drug development failure rates raise doubts about animal predictivity: about 12% of pharmaceuticals pass preclinical testing to enter clinical trials, only 60% of those complete phase I, and approximately 89% of novel drugs fail human clinical trials, with about one-half of those failures due to unanticipated human toxicity. An analysis of 2,366 drugs concluded animal tests are highly inconsistent predictors of human toxic responses and “little better than what would result merely by chance—or tossing a coin.”
  • Post-approval toxicity is common: of 578 discontinued and withdrawn drugs in Europe and the United States, almost one-half were withdrawn or discontinued in post-approval actions due to toxicity; of 93 post-marketing serious adverse outcomes, only 19% were identified in preclinical animal studies. The most common toxicity types associated with U.S. and European drug withdrawals are hepatic (21%), cardiovascular (16%), hematological (11%), neurological (9%), and carcinogenicity (8%).
  • Costs and delays are substantial: rodent testing in cancer therapeutics adds an estimated 4 to 5 years and $2 to $4 million; registering a single pesticide takes about 10 years and $3 million in required animal studies; animal tests range from 1.5× to >30× as expensive as in vitro testing. A single 2-generation reproductive animal toxicity study averages €318,295 worldwide and €285,842 in Europe (roughly $349,890 and $314,215).

Methods

  • Design: narrative review focused on scientific concerns over the validity of animal research for predicting human toxicity in pharmaceutical development; Part 2 is stated to discuss alternatives.
  • Data: published analyses and reviews of animal-to-human toxicity concordance, drug failure and withdrawal statistics, regulatory and historical examples, and cost estimates; no new primary data are collected.
  • Analysis: narrative synthesis, including use of positive predictive value, negative predictive value, and likelihood ratios to assess the evidentiary value of animal toxicity tests for human outcomes.

Limitations

  • Stated in the paper: no comprehensive reviews of the total overall cost of animal testing in pharmaceutical development appear to exist; even the total number of animals or studies is unknown. The paper also states that a comprehensive study of the accuracy, likelihood ratios, and costs of alternative testing methods compared with animal toxicity testing has not been published, and that the prevalence of human toxicity is unknown once a drug tests positive in animals.
  • Stated in the paper: in some analyses, likelihood ratios could not be determined due to a lack of specificity reporting on the tests.
  • Evident from the text: this is a narrative review rather than a systematic review, it presents no new primary data, and it includes selected historical and contemporary examples; the second part on alternatives is not included in this paper.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.jacbts.2019.10.008

Cites

110 of 110 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

Graphical abstract
Graphical abstract CC BY-NC-ND · PubMed Central
Figure 1 Failures in Translational Research: Preclinical and Clinical Trials Percentages of drugs that fail in preclinical trials (due to drug toxicity or failure of efficacy in animal testing) and in clinical trials (due drug toxicity or failure of efficacy in human testing) are shown in columns 1 and 2. The third column demonstrates what would happen if animal and human toxicity were closely correlated and therefore drugs with human toxicity were eliminated at the preclinical testing stage by animal toxicity testing (one-half of all drug failures in clinical trials are due to toxicity issues despite safety in animals). Success rates of clinical trials increase from 11.7% overall to approximately 56%.
Figure 1 Failures in Translational Research: Preclinical and Clinical Trials Percentages of drugs that fail in preclinical trials (due to drug toxicity or failure of efficacy in animal testing) and in clinical trials (due drug toxicity or failure of efficacy in human testing) are shown in columns 1 and 2. The third column demonstrates what would happen if animal and human toxicity were closely correlated and therefore drugs with human toxicity were eliminated at the preclinical testing stage by animal toxicity testing (one-half of all drug failures in clinical trials are due to toxicity issues despite safety in animals). Success rates of clinical trials increase from 11.7% overall to approximately 56%.CC BY-NC-ND · PubMed Central
Figure 2 Toxicity Failures in Pharmaceutical Development
Figure 2 Toxicity Failures in Pharmaceutical DevelopmentCC BY-NC-ND · PubMed Central
Figure 3 Calculating LR The likelihood that a test showing toxicity in a mouse predicts toxicity in the rat (positive likelihood ratio [PLR]) or that a test showing no toxicity in a mouse predicts nontoxicity in a rat (negative likelihood ratio [NLR]). M+R+ = toxicity present in both mouse and rat; M+R− = toxicity present in mouse but not in rat; M−R+ = toxicity not present in mouse, but present in rat; and M−R− = toxicity not present in mouse and also not present in rat.
Figure 3 Calculating LR The likelihood that a test showing toxicity in a mouse predicts toxicity in the rat (positive likelihood ratio [PLR]) or that a test showing no toxicity in a mouse predicts nontoxicity in a rat (negative likelihood ratio [NLR]). M+R+ = toxicity present in both mouse and rat; M+R− = toxicity present in mouse but not in rat; M−R+ = toxicity not present in mouse, but present in rat; and M−R− = toxicity not present in mouse and also not present in rat.CC BY-NC-ND · PubMed Central

Verification

Claims the paper makes

20 No full text of the sources · 14 Own interpretation · 12 Partly supported · 8 Sources not found · 6 Couldn’t confirm · 4 No basis given · 2 Not checked yet · 1 Supported · 1 Supported so far · 1 Not supported · accuracy not yet measured

Show all 36 claims

  • It may state two separate claims as one. 25
  • Probably not a substantial claim. 13
33 of 33
  • The paper relies on this without support.

    Animal testing is used in pharmaceutical and industrial research to predict human toxicity.

    “Animal testing is used in pharmaceutical and industrial research to predict human toxicity”
  • The paper relies on this without support.

    Animal toxicity testing has been the stalwart basis of “ensuring” safety of in-human clinical testing and use.

    “Although animal toxicity testing has been the stalwart basis of “ensuring” safety of in-human clinical testing and use”
  • The paper relies on this without support.

    The published data on animal toxicity testing are sufficient to assess its reliability.

    “examination of the published data raises significant questions about whether it is reliable”
  • The paper relies on this without support.

    Animal models are used to predict human toxicity.

    “reliability of animal models in predicting human toxicity”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

3 of 3

Cited works that were retracted

Works this paper cites that were later retracted, from the retraction notices publishers deposit. Major when the notice came out before this paper was published.

1 of 1

Citations

Cites

1 retracted

Show all 118 references

Research works printed but not linked: 2

  1. Schardein, 1976, 5, 49
  2. Sankar, 2005, The delicate toxicity balance in drug discovery, Scientist, 19, 32

Cited by

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Metadata

Authors
Van Norman, G. A.
Venue
JACC: Basic to Translational Science
Publisher
Elsevier BV
Published
2019-11
Volume
4
Issue
7
Pages
845-854
ISSN
2452-302X (ISSN-L)
OpenAlex
W2990376563
Cited by
732
References
118
Citations by year
2026: 128 · 2025: 149 · 2024: 159 · 2023: 110 · 2022: 104 · 2021: 59 · 2020: 21
FWCI
68.93
Type
journal article
Language
en
Open access
Locations
  • JACC Basic to Translational Science (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Veterinary › Small Animals › Animal testing and alternatives
  • Life Sciences › Immunology and Microbiology › Immunology › Immunotoxicology and immune responses
  • Health Sciences › Veterinary › Small Animals › Veterinary Pharmacology and Anesthesia
Keywords
animal experimentation, animal models, drug safety, translational research, alternatives to animal testing, clinical trials, drug development, drug approval delays

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