Department of Dermatology, The George Washington School of Medicine and Health Sciences, 2150 Pennsylvania Ave, NW, Suite 2B-430, Washington, DC, 30037, USA.
Department of Dermatology, Oregon Health and Science University, 3303 S Bond Ave Building 1, 16th Floor, Portland, OR, 97239, USA.
Am J Clin Dermatol. 2022 Jan;23(1):1-11. doi: 10.1007/s40257-021-00639-y. Epub 2021 Oct 26.
The recent advent of numerous clinical trials for the treatment of moderate-to-severe atopic dermatitis has led to new and emerging therapeutic options for this chronic inflammatory skin disease. With this rapid development has come a lack of consistency in study designs, trial conduct, and statistical analyses. Healthcare providers are challenged to interpret how variations in study parameters may influence clinical trial results. Based on literature review and our experience as clinical trialists, we compiled a list of 22 key study parameters of contemporary clinical trials in moderate-to-severe atopic dermatitis and ranked the top study parameters that may have a significant effect on efficacy results. The top parameters included study comparators, rules for rescue treatment, washout periods for topical and systemic treatments, inclusion criteria such as disease severity by Eczema Area and Severity Index and/or Investigator Global Assessment scores, and the duration of the screening period. We describe considerations for these key parameters, with a focus on between-parameter interactions and effect on efficacy results. This may serve to inform the interpretation of atopic dermatitis clinical trials and raise the profile of the need to harmonize the clinical trial design.
近年来,针对中重度特应性皮炎的临床试验层出不穷,为这一慢性炎症性皮肤病带来了新的治疗选择。随着这一快速发展,研究设计、试验实施和统计分析方面缺乏一致性。医疗保健提供者面临的挑战是要解读研究参数的差异如何影响临床试验结果。基于文献回顾和我们作为临床试验人员的经验,我们列出了 22 个中重度特应性皮炎当代临床试验的关键研究参数,并对可能对疗效结果有重大影响的顶级研究参数进行了排名。顶级参数包括研究对照、抢救治疗规则、局部和全身治疗的洗脱期、纳入标准(如 Eczema Area and Severity Index 和/或研究者全球评估评分所代表的疾病严重程度)以及筛选期的持续时间。我们描述了这些关键参数的注意事项,重点关注参数之间的相互作用以及对疗效结果的影响。这有助于解释特应性皮炎临床试验,并提高协调临床试验设计的必要性。