Department of Neurology, McKnight Brain Institute, University of Florida College of Medicine, Gainesville.
Department of Neurology, University of Pennsylvania, Philadelphia, PA.
Alzheimer Dis Assoc Disord. 2022;36(1):64-72. doi: 10.1097/WAD.0000000000000473.
Dementia with Lewy bodies (DLB) is one of the most common degenerative dementias. Clinical trials for individuals with DLB are increasing. We aimed to identify commonly used outcome measures for trials in DLB.
A pragmatic literature search of PubMed and clinicaltrials.gov identified interventional studies including populations with DLB. Studies were included if they enrolled participants with DLB and met the National Institutes of Health criteria for a clinical trial. Data were collected using standardized forms. Outcome measures were categorized according to core and supportive features of DLB.
After de-duplication, 58 trials were identified. The most common cognitive outcome measures were the Mini Mental State Examination (n=24) and Cognitive Drug Research computerized Assessment System (n=5). The Clinician's Assessment of Fluctuations was the most commonly used measure for fluctuations (n=4). Over half of studies used the Neuropsychiatric Inventory to assess behavioral symptoms (n=31). The Unified Parkinson's Disease Rating Scale was frequently used for motor assessment (n=23).
Clinical trial outcomes used in DLB are rarely validated in this population and some lack face validity. There is a need to validate existing scales in DLB and develop DLB-specific outcome measures.
路易体痴呆(DLB)是最常见的退行性痴呆之一。针对 DLB 患者的临床试验正在增加。我们旨在确定用于 DLB 试验的常用结局指标。
在 PubMed 和 clinicaltrials.gov 上进行了一项实用的文献检索,以确定包括 DLB 人群的干预性研究。如果研究纳入了 DLB 患者并符合国家卫生研究院临床试验标准,则将其纳入。使用标准化表格收集数据。根据 DLB 的核心和支持特征对结局指标进行分类。
去重后,共确定了 58 项试验。最常用的认知结局指标是简易精神状态检查(Mini Mental State Examination,MMSE,n=24)和认知药物研究计算机化评估系统(Cognitive Drug Research computerized Assessment System,n=5)。临床波动评估量表(Clinician's Assessment of Fluctuations,CAF,n=4)是最常用的波动评估指标。超过一半的研究使用神经精神疾病问卷(Neuropsychiatric Inventory,NPI,n=31)评估行为症状。统一帕金森病评定量表(Unified Parkinson's Disease Rating Scale,UPDRS,n=23)常用于评估运动。
DLB 中使用的临床试验结局指标很少在该人群中得到验证,有些缺乏表面效度。有必要在 DLB 中验证现有的量表,并开发 DLB 特异性结局指标。