Section of Rheumatology and the Clinical Epidemiology Unit, Boston University School of Medicine, Boston, MA, USA.
J Rheumatol. 2011 Jul;38(7):1480-6. doi: 10.3899/jrheum.110276.
There has been a marked increase in the past 15 years in the number and quality of clinical trials in the idiopathic inflammatory vasculitides, especially the small-vessel vasculitides known as antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis [AAV; granulomatosis, with polyangiitis (Wegener's)]. These trials have been conducted by multicenter, international groups in Europe and the United States with financial support provided by government agencies and biopharmaceutical companies. This increased clinical trial activity in vasculitis has been accompanied by the development and validation of new outcome measures--a challenging process for these complex, multiorgan system diseases. The international OMERACT Vasculitis Working Group has developed and implemented an iterative research agenda that has utilized accumulated experience and datasets from several multicenter clinical trials and large cohort studies. This work has led to the development, evaluation, validation, and endorsement, through the OMERACT consensus and validation processes, of a "core set" of outcome measurements for use in clinical trials of AAV. The core set includes domains of disease activity, damage assessment, patient-reported outcomes, and mortality; there is at least one validated outcome measurement instrument available for each domain. This report reviews the domains of illness in AAV included in the OMERACT core set, describes the instruments validated to measure these domains, and presents the approved core set.
在过去的 15 年中,特发性炎症性血管炎的临床试验数量和质量显著增加,尤其是小血管血管炎,称为抗中性粒细胞胞质自身抗体(ANCA)相关性血管炎[AAV;肉芽肿伴多血管炎(韦格纳氏)]。这些试验是由欧洲和美国的多中心国际小组进行的,得到了政府机构和生物制药公司的财政支持。血管炎临床试验活动的增加伴随着新的疗效指标的发展和验证——这对于这些复杂的多器官系统疾病来说是一个具有挑战性的过程。国际 OMERACT 血管炎工作组制定并实施了一个迭代研究议程,该议程利用了来自多个多中心临床试验和大型队列研究的积累经验和数据集。这项工作导致了 AAV 临床试验中使用的“核心指标集”的开发、评估、验证和认可,通过 OMERACT 共识和验证过程。核心集包括疾病活动、损伤评估、患者报告结果和死亡率等领域;每个领域都至少有一个经过验证的疗效评估工具。本报告回顾了 OMERACT 核心集中包含的 AAV 疾病领域,描述了用于测量这些领域的验证工具,并介绍了已批准的核心集。