Development of interim patient-reported outcome measures for the assessment of ulcerative colitis disease activity in clinical trials

Autor:	Margaret K. Vandervoort, Guangyong Zou, Geert D'Haens, Reena Khanna, W J Sandborn, Larry Stitt, Brian G. Feagan, Barrett G. Levesque, Mahmoud Mosli, Vipul Jairath
Přispěvatelé:	AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology
Rok vydání:	2015
Předmět:	Adult Male medicine.medical_specialty Placebo Inflammatory bowel disease law.invention chemistry.chemical_compound Double-Blind Method Mesalazine Randomized controlled trial law Internal medicine Outcome Assessment Health Care Humans Medicine Pharmacology (medical) Colitis Mesalamine Hepatology business.industry Gastroenterology Endoscopy Middle Aged medicine.disease Ulcerative colitis United States Surgery Patient Outcome Assessment Clinical trial chemistry Colitis Ulcerative Female Patient-reported outcome Gastrointestinal Hemorrhage business
Zdroj:	Alimentary pharmacology & therapeutics, 42(10), 1200-1210. Wiley-Blackwell
ISSN:	0269-2813
Popis:	SummaryBackground Patient-reported outcomes (PROs) have an increasingly important role in the evaluation of new therapies for inflammatory bowel disease. The US Food and Drug Administration has issued formal guidance to describe the role of PRO instruments in evaluation of claims for product labelling. However, no validated PRO exists for ulcerative colitis. Aim To investigate whether the PROs from the Mayo Clinic Score (MCS) for UC can be modified, to develop an interim PRO for use in clinical trials, alone or in combination with endoscopy. Methods Data from an induction trial of a mesalazine (mesalamine) formulation were used to compare effect sizes between mesalazine and placebo for PRO items (stool frequency and rectal bleeding) alone and in combination with endoscopy. The operating properties of the PRO were validated using data from a phase 2 trial of MLN02, a humanised antibody to the α4β7 integrin in patients with UC. Results A two-item PRO (PRO2) consisting of rectal bleeding = 0 and stool frequency ≤1 or ≤2, combined with an endoscopy subscore ≤1 yielded statistically significant differences between active drug and placebo. This combination yielded the most similar effect sizes and placebo rates for remission, compared to the primary trials. Use of PRO items alone yielded high placebo remission rates in both data sets, although rates were lower when the items were combined and remission defined as PRO2 = 0. Conclusion Patient-reported outcomes items derived from the Mayo Clinic Score combined with endoscopy as a co-primary endpoint may be an appropriate interim outcome measure for ulcerative colitis trials.
Databáze:	OpenAIRE
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