School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
Nat Rev Rheumatol. 2023 Sep;19(9):592-602. doi: 10.1038/s41584-023-00993-7. Epub 2023 Jul 11.
Systemic lupus erythematosus (SLE) is a disease of high unmet therapeutic need. The challenge of accurately measuring clinically meaningful responses to treatment has hindered progress towards positive outcomes in SLE trials, impeding the approval of potential new therapies. Current primary end points used in SLE trials are based on legacy disease activity measures that were neither specifically designed for the clinical trial context, nor developed according to contemporary recommendations for clinical outcome assessments (COAs), such as that substantial patient input should be incorporated into their design. The Treatment Response Measure for SLE (TRM-SLE) Taskforce is a global collaboration of SLE clinician-academics, patients and patient representatives, industry partners and regulatory experts, established to realize the goal of developing a new COA for SLE clinical trials. The aim of this project is a novel COA designed specifically to measure treatment effects that are clinically meaningful to patients and clinicians, and intended for implementation in a trial end point that supports regulatory approval of novel therapeutic agents in SLE. This Consensus Statement reports the first outcomes of the TRM-SLE project, including a structured process for TRM-SLE development.
系统性红斑狼疮(SLE)是一种高度未满足治疗需求的疾病。准确衡量治疗临床意义反应的挑战阻碍了 SLE 试验取得积极结果的进展,从而阻碍了潜在新疗法的批准。目前 SLE 试验中使用的主要终点基于传统的疾病活动度测量方法,这些方法既不是专门为临床试验环境设计的,也不是根据当代临床结局评估(COA)建议开发的,例如,设计中应充分纳入患者的意见。SLE 治疗反应测量(TRM-SLE)工作组是一个由 SLE 临床医生-学者、患者和患者代表、行业合作伙伴和监管专家组成的全球合作组织,旨在实现为 SLE 临床试验开发新 COA 的目标。该项目的目的是开发一种专门用于衡量对患者和临床医生具有临床意义的治疗效果的新型 COA,并旨在用于支持新型治疗药物在 SLE 中监管批准的试验终点。本共识声明报告了 TRM-SLE 项目的首批成果,包括 TRM-SLE 开发的结构化流程。