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结节病演变风险指标-统一方案(RISE-UP):一项多中心、纵向、观察性研究协议,旨在确定预测结节病进展的临床特征。

Risk Indicators of Sarcoidosis Evolution-Unified Protocol (RISE-UP): protocol for a multi-centre, longitudinal, observational study to identify clinical features that are predictive of sarcoidosis progression.

机构信息

Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.

出版信息

BMJ Open. 2023 Apr 3;13(4):e071607. doi: 10.1136/bmjopen-2023-071607.

Abstract

INTRODUCTION

Sarcoidosis is a pulmonary and systemic granulomatous disease with a wide range of potential outcomes, from spontaneous resolution to end-stage organ damage and death. Currently, clinicians have no easy-to-use risk stratification tools for important clinical outcomes in sarcoidosis, such as progressive lung disease. This study will address two clinical practice needs: (1) development of a risk calculator that provides an estimate of the likelihood of pulmonary progression in sarcoidosis patients during the follow-up period and (2) determine the optimal interval for serial clinical monitoring (eg, 6, 12, 18 months) using these risk prediction tools.

METHODS AND ANALYSIS

The Risk Indicators of Sarcoidosis Evolution-Unified Protocol study is a National Institutes of Health-sponsored, longitudinal observational study of adults with pulmonary sarcoidosis who will be enrolled at five US tertiary care centres. Participants will be evaluated at approximately 6-month intervals for up to 60 months with collection of lung function, blood samples and clinical data. The target sample size is 557 and the primary objective is to determine which clinical features measured during a routine clinic visit carry the most prognostic information for predicting clinical progression of pulmonary sarcoidosis over the follow-up period. The primary outcome measure will be quantified by a clinically meaningful change in forced vital capacity, forced expiratory volume in 1 s or diffusing capacity of the lung for carbon monoxide. The secondary objective is to determine if blood biomarkers measured during a routine clinic visit can improve the risk assessment modelling for progression of pulmonary sarcoidosis over the follow-up period.

ETHICS AND DISSEMINATION

The study protocol has been approved by the Institutional Review Boards at each centre and the reliance Institutional Review Board overseeing the study (WCG, Protocol #20222400). Participants will provide informed consent prior to enrolment. Results will be disseminated via publication in a relevant peer-reviewed journal.

TRIAL REGISTRATION NUMBER

NCT05567133.

摘要

简介

结节病是一种肺部和全身性肉芽肿性疾病,其潜在结果范围广泛,从自发缓解到终末期器官损伤和死亡。目前,临床医生没有用于结节病重要临床结局(如进行性肺病)的简单易用的风险分层工具。本研究将满足两个临床实践需求:(1)开发一种风险计算器,用于估计结节病患者在随访期间肺部进展的可能性;(2)使用这些风险预测工具确定进行性临床监测的最佳间隔(例如,6、12、18 个月)。

方法和分析

结节病演变风险指标-统一方案研究是由美国国立卫生研究院资助的一项纵向观察性研究,纳入了五家美国三级护理中心的成人肺部结节病患者。参与者将在大约 6 个月的时间内接受评估,最长可达 60 个月,评估内容包括肺功能、血液样本和临床数据。目标样本量为 557 例,主要目标是确定在常规就诊期间测量的哪些临床特征对预测随访期间肺部结节病的临床进展具有最重要的预后信息。主要结局指标将通过用力肺活量、1 秒用力呼气量或一氧化碳弥散量的临床意义变化进行量化。次要目标是确定在常规就诊期间测量的血液生物标志物是否可以改善随访期间肺部结节病进展的风险评估模型。

伦理和传播

该研究方案已获得每个中心的机构审查委员会和负责监督该研究的机构审查委员会(WCG,方案 #20222400)的批准。参与者将在入组前提供知情同意。研究结果将通过在相关同行评议期刊上发表来传播。

试验注册号

NCT05567133。

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