College of Medicine, University of Arkansas for Medical Sciences, Little Rock.
College of Medicine, Sidney Kimmel Medical College, Philadelphia, Pennsylvania.
JAMA Dermatol. 2022 Dec 1;158(12):1419-1428. doi: 10.1001/jamadermatol.2022.3911.
Acne and rosacea have substantial implications for quality of life, and it is therefore important to ensure the patient's voice is being captured in pivotal randomized clinical trials (RCTs). Although patient-reported outcome measures (PROMs) are a valuable tool to capture the patient perspective, little is known about use of PROMs in RCTs on acne and rosacea.
To characterize the use of PROMs in RCTs on acne and rosacea.
A systematic literature search was conducted using the search terms acne vulgaris and rosacea in the following databases: MEDLINE through PubMed, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. A modified search hedge for RCTs from the McGill Library was applied. All phase 2, 3, and 4 RCTs published between December 31, 2011, through December 31, 2021, that evaluated the efficacy and safety of therapies for acne and rosacea vs any comparator were eligible for inclusion.
A total of 2461 publications describing RCTs were identified, of which 206 RCTs met the inclusion criteria (163 trials [79%] on acne and 43 [21%] on rosacea). At least 1 PROM was used in 53% of trials (110) included; PROM use was more common in rosacea RCTs (67% [n = 29]) compared with acne RCTs (50% [n = 81]). At least 1 dermatology-specific (13% [n = 27]) or disease-specific (14% [n = 28]) PROM was included in the RCTs analyzed. Only 7% of trials (14) included a PROM as a primary outcome measure. There was no statistically significant increase in PROM inclusion over the study period (11 of 21 trials in 2011 vs 5 of 12 trials in 2021).
In this systematic review, PROMs were included in approximately one-half of acne and rosacea RCTs performed over the study period. In addition, PROMs were rarely used as a primary outcome measure, and inclusion of PROMs has not increased substantially over the past 10 years. Increasing use of PROMs in RCTs can ensure that the patient's perspective is captured during the development of new treatments for acne and rosacea.
痤疮和酒渣鼻对生活质量有重大影响,因此确保在关键性随机临床试验(RCT)中纳入患者的意见非常重要。虽然患者报告的结局测量(PROM)是捕捉患者观点的有价值的工具,但关于痤疮和酒渣鼻 RCT 中使用 PROM 的情况知之甚少。
描述痤疮和酒渣鼻 RCT 中使用 PROM 的情况。
使用以下数据库中的搜索词“寻常痤疮”和“酒渣鼻”进行了系统文献检索:MEDLINE 通过 PubMed、Embase、Cochrane 对照试验中心注册库和 Cochrane 系统评价数据库。应用 McGill 图书馆的 RCT 改良检索对冲。符合纳入标准的是 2011 年 12 月 31 日至 2021 年 12 月 31 日期间发表的评估痤疮和酒渣鼻治疗效果和安全性的所有 2 期、3 期和 4 期 RCT,与任何对照相比。
共确定了 2461 篇描述 RCT 的出版物,其中 206 项 RCT 符合纳入标准(163 项[79%]为痤疮,43 项[21%]为酒渣鼻)。至少使用了 1 种 PROM 的试验占 53%(110 项);与痤疮 RCT(50%[81 项])相比,酒渣鼻 RCT 中 PROM 的使用更为常见(67%[29 项])。分析的 RCT 中至少纳入了 1 种皮肤科专用(13%[27 项])或疾病专用(14%[28 项])的 PROM。只有 7%的试验(14 项)将 PROM 作为主要结局指标。在研究期间,PROM 的纳入并没有明显增加(2011 年的 21 项试验中有 11 项,2021 年的 12 项试验中有 5 项)。
在这项系统评价中,研究期间进行的痤疮和酒渣鼻 RCT 中约有一半纳入了 PROM。此外,PROM 很少作为主要结局指标,在过去 10 年中,PROM 的纳入量并没有显著增加。在 RCT 中更多地使用 PROM 可以确保在开发痤疮和酒渣鼻的新疗法时纳入患者的意见。