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杜氏肌营养不良症新型数字终点的首次监管认定:多利益相关方对神经肌肉疾病患者及药物研发影响的观点

First Regulatory Qualification of a Novel Digital Endpoint in Duchenne Muscular Dystrophy: A Multi-Stakeholder Perspective on the Impact for Patients and for Drug Development in Neuromuscular Diseases.

作者信息

Servais Laurent, Camino Eric, Clement Aude, McDonald Craig M, Lukawy Jacek, Lowes Linda P, Eggenspieler Damien, Cerreta Francesca, Strijbos Paul

机构信息

MDUK Oxford Neuromuscular Centre, Department of Paediatrics, University of Oxford, Oxford, United Kingdom.

Division of Child Neurology, Centre de Référence des Maladies Neuromusculaires, Department of Pediatrics, University Hospital Liège and University of Liège, Liege, Belgium.

出版信息

Digit Biomark. 2021 Aug 5;5(2):183-190. doi: 10.1159/000517411. eCollection 2021 May-Aug.

Abstract

BACKGROUND

Functional outcome measures used to assess efficacy in clinical trials of investigational treatments for rare neuromuscular diseases like Duchenne muscular dystrophy (DMD) are performance-based tasks completed by the patient during hospital visits. These are prone to bias and may not reflect motor abilities in real-world settings. Digital tools, such as wearable devices and other remote sensors, provide the opportunity for continuous, objective, and sensitive measurements of functional ability during daily life. Maintaining ambulation is of key importance to individuals with DMD. Stride velocity 95th centile (SV95C) is the first wearable acquired digital endpoint to receive qualification from the European Medicines Agency (EMA) to quantify the ambulation ability of ambulant DMD patients aged ≥5 years in drug therapeutic studies; it is also currently under review for the US Food and Drug Administration (FDA) qualification.

SUMMARY

Focusing on SV95C as a key example, we describe perspectives of multiple stakeholders on the promise of novel digital endpoints in neuromuscular disease drug development.

摘要

背景

用于评估诸如杜氏肌营养不良症(DMD)等罕见神经肌肉疾病的研究性治疗方法在临床试验中疗效的功能结局指标,是患者在医院就诊期间完成的基于表现的任务。这些指标容易产生偏差,可能无法反映现实环境中的运动能力。数字工具,如可穿戴设备和其他远程传感器,为在日常生活中持续、客观且灵敏地测量功能能力提供了机会。保持行走能力对DMD患者至关重要。步速第95百分位数(SV95C)是首个获得欧洲药品管理局(EMA)资格认定的可穿戴式数字终点指标,用于在药物治疗研究中量化≥5岁能行走的DMD患者的行走能力;目前它也正在接受美国食品药品监督管理局(FDA)的资格审查。

总结

以SV95C作为关键示例,我们描述了多个利益相关者对神经肌肉疾病药物研发中新型数字终点指标前景的看法。

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