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一项评估 Bacopa 对海湾战争相关认知功能障碍的随机 II 期远程研究:一项全国性研究的设计和方法。

A randomized phase II remote study to assess Bacopa for Gulf War Illness associated cognitive dysfunction: Design and methods of a national study.

机构信息

Institute for Neuro Immune Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States; Department of Nutrition, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States; Halmos College of Natural Sciences and Oceanography, Nova Southeastern University, Fort Lauderdale, FL, United States.

RTI International, Research Triangle Park, NC, United States.

出版信息

Life Sci. 2021 Oct 1;282:119819. doi: 10.1016/j.lfs.2021.119819. Epub 2021 Jul 10.

Abstract

AIMS

Gulf War Illness (GWI) is a chronic, debilitating, multi-symptom condition affecting as many as one-third of the nearly 700,000 U.S. troops deployed to the Middle East during the 1990-1991 Gulf War (GW). The treatment of GWI relies on symptom management. A common challenge in studying the efficacy of interventions for symptom management is participant recruitment related to factors such as the burden of travelling to study sites and the widespread dispersion of Veterans with GWI. The goal of this study is to assess the efficacy of a novel low-risk therapeutic agent, Bacopa monnieri, for cognitive function in Veterans with GWI and to evaluate the utility of a remote patient-centric study design developed to promote recruitment and minimize participant burden.

MAIN METHODS

To promote effective participant recruitment, we developed a remote patient-centric study design. Participants will be recruited online through social media and through a web-based research volunteer list of GW Veterans. An online assessment platform will be used, and laboratory blood draws will be performed at clinical laboratory sites that are local to participants. Furthermore, the assigned intervention will be mailed to each participant.

SIGNIFICANCE

These study design adaptations will open participation to Veterans nearly nationwide and reduce administrative costs while maintaining methodologic rigor and participant safety in a randomized, placebo-controlled phase II clinical trial.

摘要

目的

海湾战争病(Gulf War Illness,GWI)是一种慢性、衰弱性的多症状疾病,影响了 1990-1991 年海湾战争(Gulf War,GW)期间部署到中东的近 70 万美军中的三分之一以上。GWI 的治疗依赖于症状管理。在研究症状管理干预措施的疗效时,一个常见的挑战是与旅行到研究地点的负担以及 GWI 退伍军人的广泛分散等因素相关的参与者招募。本研究的目的是评估新型低风险治疗剂 Bacopa monnieri 对 GWI 退伍军人认知功能的疗效,并评估一种远程以患者为中心的研究设计的实用性,该设计旨在促进招募并最大限度地减少参与者负担。

主要方法

为了促进有效的参与者招募,我们开发了一种远程以患者为中心的研究设计。参与者将通过社交媒体和 GW 退伍军人的基于网络的研究志愿者名单在线招募。将使用在线评估平台进行评估,并在靠近参与者的临床实验室地点进行实验室血液采集。此外,将向每位参与者邮寄指定的干预措施。

意义

这些研究设计的调整将使几乎全国的退伍军人都有机会参与,并在随机、安慰剂对照的 II 期临床试验中降低管理成本,同时保持方法学严谨性和参与者安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2602/9189930/9c9375ebe537/nihms-1812036-f0001.jpg

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1
Brainstem atrophy in Gulf War Illness.海湾战争病中的脑干萎缩。
Neurotoxicology. 2020 May;78:71-79. doi: 10.1016/j.neuro.2020.02.006. Epub 2020 Feb 17.
3
Neuropsychological Findings in Gulf War Illness: A Review.海湾战争综合征的神经心理学研究结果:综述
Front Psychol. 2019 Sep 26;10:2088. doi: 10.3389/fpsyg.2019.02088. eCollection 2019.

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