Division of Nephrology, Columbia University Irving Medical Center, New York.
Division of Nephrology, New York University Langone Health, New York.
Am J Kidney Dis. 2022 Apr;79(4):570-581. doi: 10.1053/j.ajkd.2021.07.025. Epub 2021 Sep 24.
Blocking the complement system as a therapeutic strategy has been proposed for numerous glomerular diseases but presents myriad questions and challenges, not the least of which is demonstrating efficacy and safety. In light of these potential issues and because there are an increasing number of anticomplement therapy trials either planned or under way, the National Kidney Foundation facilitated an all-virtual scientific workshop entitled "Improving Clinical Trials for Anti-Complement Therapies in Complement-Mediated Glomerulopathies." Attended by patient representatives and experts in glomerular diseases, complement physiology, and clinical trial design, the aim of this workshop was to develop standards applicable for designing and conducting clinical trials for anticomplement therapies across a wide spectrum of complement-mediated glomerulopathies. Discussions focused on study design, participant risk assessment and mitigation, laboratory measurements and biomarkers to support these studies, and identification of optimal outcome measures to detect benefit, specifically for trials in complement-mediated diseases. This report summarizes the discussions from this workshop and outlines consensus recommendations.
阻断补体系统作为一种治疗策略已被提议用于多种肾小球疾病,但存在诸多问题和挑战,其中最突出的是证明疗效和安全性。鉴于这些潜在问题,并且由于越来越多的抗补体治疗试验正在计划或进行中,国家肾脏基金会组织了一次全虚拟科学研讨会,题为“改善补体介导性肾小球疾病中抗补体治疗的临床试验”。该研讨会邀请了患者代表以及肾小球疾病、补体生理学和临床试验设计方面的专家参加,旨在制定适用于广泛补体介导性肾小球疾病的抗补体治疗临床试验的设计和实施标准。讨论重点是研究设计、参与者风险评估和缓解、支持这些研究的实验室测量和生物标志物,以及确定最佳的疗效评估指标,特别是用于补体介导疾病的试验。本报告总结了该研讨会的讨论内容,并概述了共识建议。