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MACUSTAR:中年相关性黄斑变性功能性、结构性及患者报告终点的开发与临床验证

MACUSTAR: Development and Clinical Validation of Functional, Structural, and Patient-Reported Endpoints in Intermediate Age-Related Macular Degeneration.

作者信息

Finger Robert P, Schmitz-Valckenberg Steffen, Schmid Matthias, Rubin Gary S, Dunbar Hannah, Tufail Adnan, Crabb David P, Binns Alison, Sánchez Clara I, Margaron Philippe, Normand Guillaume, Durbin Mary K, Luhmann Ulrich F O, Zamiri Parisa, Cunha-Vaz José, Asmus Friedrich, Holz Frank G

机构信息

Department of Ophthalmology, University of Bonn, Bonn,

Department of Ophthalmology, University of Bonn, Bonn, Germany.

出版信息

Ophthalmologica. 2019;241(2):61-72. doi: 10.1159/000491402. Epub 2018 Aug 28.

Abstract

PURPOSE

Currently, no outcome measures are clinically validated and accepted as clinical endpoints by regulatory agencies for drug development in intermediate age-related macular degeneration (iAMD). The MACUSTAR Consortium, a public-private research group funded by the European Innovative Medicines Initiative intends to close this gap.

PROCEDURES

Development of study protocol and statistical analysis plan including predictive modelling of multimodal endpoints based on a review of the literature and expert consensus.

RESULTS

This observational study consists of a cross-sectional and a longitudinal part. Functional outcome measures assessed under low contrast and low luminance have the potential to detect progression of visual deficit within iAMD and to late AMD. Structural outcome measures will be multimodal and investigate topographical relationships with function. Current patient-reported outcome measures (PROMs) are not acceptable to regulators and may not capture the functional deficit specific to iAMD with needed precision, justifying development of novel PROMs for iAMD. The total sample size will be n = 750, consisting mainly of subjects with iAMD (n = 600).

CONCLUSIONS

As clinical endpoints currently accepted by regulators cannot detect functional loss or patient-relevant impact in iAMD, we will clinically validate novel candidate endpoints for iAMD.

摘要

目的

目前,在中度年龄相关性黄斑变性(iAMD)的药物研发中,尚无临床验证且被监管机构认可为临床终点的疗效指标。由欧洲创新药物计划资助的公私合营研究团队MACUSTAR联盟旨在填补这一空白。

程序

制定研究方案和统计分析计划,包括基于文献综述和专家共识对多模态终点进行预测建模。

结果

这项观察性研究包括横断面和纵向两部分。在低对比度和低亮度条件下评估的功能疗效指标有可能检测出iAMD患者以及晚期AMD患者视觉功能缺损的进展情况。结构疗效指标将采用多模态,并研究与功能的地形关系。目前患者报告的疗效指标(PROMs)不被监管机构接受,可能无法以所需的精度捕捉iAMD特有的功能缺损,因此有必要开发针对iAMD的新型PROMs。总样本量将为n = 750,主要包括iAMD患者(n = 600)。

结论

由于监管机构目前认可的临床终点无法检测出iAMD患者的功能丧失或与患者相关的影响,我们将对iAMD的新型候选终点进行临床验证。

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