Wyeth Research, Discovery Translational Medicine, Collegeville, PA 19426, USA.
Arthritis Res Ther. 2009;11(6):255. doi: 10.1186/ar2834. Epub 2009 Nov 19.
One of the major challenges in rheumatology is to overcome the classification criteria that previously defined systemic lupus erythematosis, since the heterogeneity of the disease(s) appears to represent a complexity that probably substantially contributed to the failure of a number of recent trials. For those engaged in clinical trials, validated disease activity biomarkers that respond rapidly to treatment and are predictive of clinical response would greatly facilitate early decision-making around futility and dose selection. Likewise, use of validated patient stratification biomarkers possibly in conjunction with autoantibody profiles and disease manifestations will result in the recruitment of more homogeneous patient populations during later stage clinical studies, thereby decreasing size, costs, and risks in pivotal studies.
风湿学面临的主要挑战之一是克服之前定义系统性红斑狼疮的分类标准,因为疾病的异质性似乎代表了一种复杂性,这可能在很大程度上导致了最近多项试验的失败。对于那些参与临床试验的人来说,能够快速响应治疗并预测临床反应的经过验证的疾病活动生物标志物将极大地促进无效性和剂量选择方面的早期决策。同样,使用经过验证的患者分层生物标志物,可能与自身抗体谱和疾病表现相结合,将导致在后期临床研究中招募更同质的患者人群,从而降低关键研究的规模、成本和风险。