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包涵体肌炎临床结局评估的研究现状:系统综述。

Current status of clinical outcome measures in inclusion body myositis: a systematised review.

机构信息

Yale University School of Medicine, New Haven, CT, USA.

Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

出版信息

Clin Exp Rheumatol. 2023 Mar;41(2):370-378. doi: 10.55563/clinexprheumatol/ifacv3. Epub 2023 Feb 3.

Abstract

OBJECTIVES

Sporadic inclusion body myositis (IBM) is a debilitating idiopathic inflammatory myopathy (IIM) which affects hand function, ambulation, and swallowing. There is no approved pharmacological therapy for IBM, and there is a lack of suitable outcome measure to assess the effect of an intervention. The IBM scientific interest group under IMACS reviewed the previously used outcome measures in IBM clinical studies to lay the path for developing a core set of outcome measures in IBM.

METHODS

In this systematised review, we have extracted all outcome measures reported in IBM clinical studies to determine what measures were being used and to assess the need for optimising outcome measures in IBM.

RESULTS

We found 13 observational studies, 17 open-label clinical trials, and 15 randomised control trials (RCTs) in IBM. Six-minute walk distance, IBM-functional rating scale (IBM-FRS), quantitative muscle testing, manual muscle testing, maximal voluntary isometric contraction testing, and thigh muscle volume measured by MRI were used as primary outcome measures. Twelve different outcome measures of motor function were used in IBM clinical trials. IBM-FRS was the most used measure of functionality. Swallowing function was reported as a secondary outcome measure in only 3 RCTs.

CONCLUSIONS

There are inconsistencies in using outcome measures in clinical studies in IBM. The core set measures developed by the IMACS group for other IIMs are not directly applicable to IBM. As a result, there is an unmet need for an IBM-specific core set of measures to facilitate the evaluation of new potential therapeutics for IBM.

摘要

目的

散发性包涵体肌炎(IBM)是一种使人衰弱的特发性炎症性肌病(IIM),影响手部功能、行走和吞咽。目前尚无针对 IBM 的批准药物治疗方法,也缺乏合适的疗效评估指标来评估干预措施的效果。IMACS 下的 IBM 科学兴趣小组审查了 IBM 临床研究中以前使用的疗效评估指标,为 IBM 制定核心疗效评估指标奠定了基础。

方法

在这项系统综述中,我们提取了 IBM 临床研究报告的所有疗效评估指标,以确定正在使用哪些指标,并评估优化 IBM 疗效评估指标的必要性。

结果

我们在 IBM 中发现了 13 项观察性研究、17 项开放标签临床试验和 15 项随机对照试验(RCT)。6 分钟步行距离、IBM 功能评分量表(IBM-FRS)、定量肌肉测试、手动肌肉测试、最大自主等长收缩测试以及 MRI 测量的大腿肌肉体积被用作主要疗效评估指标。12 种不同的运动功能疗效评估指标用于 IBM 临床试验。IBM-FRS 是功能评估中最常用的指标。仅在 3 项 RCT 中报告了吞咽功能作为次要疗效评估指标。

结论

在 IBM 的临床研究中,疗效评估指标的使用存在不一致性。IMACS 小组为其他 IIM 制定的核心指标集不适用于 IBM。因此,需要制定特定于 IBM 的核心指标集,以促进评估 IBM 新的潜在治疗方法。

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