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为老年科学试验选择合适的临床试验终点:迈向共识之路。

Selecting Appropriate Clinical Trial Endpoints for Geroscience Trials: A Path Towards Consensus.

作者信息

Kritchevsky Stephen, Zamora Ezequiel, Bhasin Shalender, Cohen Alan, Chandler Allison, Covinsky Kevin, Crane Heidi, Cummings Steven, Erlandson Kristine, Espeland Mark, Espinoza Sara, Ferrucci Luigi, Fleming Alexander, Forman Daniel, LaCroix-Fralish Michael, Gonzales Mitzi, Justice Jamie, Kiel Douglas, Kuchel George, Mannick Joan, Menetski Joseph, Miller Michael, Musi Nicolas, Newman Anne, Newman John, Owens Sarah Simpson, Pandey Ambarish, Reilly Kandice, Sedrak Mina, Wagner John, Whitson Heather, Williamson Jeff

机构信息

Wake Forest School of Medicine.

Wake Forest University School of Medicine.

出版信息

Res Sq. 2025 Feb 12:rs.3.rs-5920485. doi: 10.21203/rs.3.rs-5920485/v1.

Abstract

Using a modified Delphi process, we engaged 28 experts in clinical trials, geriatrics, and research translation to determine if there were consensus around what clinical endpoints should be used for trials evaluating the efficacy of interventions to prevent or treat multiple age-related conditions. Four focus groups developed themes. Statements related to those themes were circulated back to participants in a survey. There was consensus (more than 66% agreed or disagreed) that outcome measures should include multiple health dimensions including-age-related disease, function and patient reported outcomes that reflect participants goals; and be tailored to population characteristics. Experts felt that blood-based biomarkers would be unlikely to be accepted as primary endpoints of efficacy trials. Plausible components mentioned as part of a composite endpoint included mortality, mobility function and the onset of multiple age-related diseases. Our findings provide guidance on acceptable approaches to endpoint selection guiding the design of future geroscience trials.

摘要

我们采用改良的德尔菲法,邀请了28位临床试验、老年医学和研究转化领域的专家,以确定在评估预防或治疗多种与年龄相关疾病的干预措施疗效的试验中,对于应使用哪些临床终点是否存在共识。四个焦点小组确定了主题。与这些主题相关的陈述在一项调查中反馈给参与者。存在共识(超过66%的人同意或不同意),即结局指标应包括多个健康维度,包括与年龄相关的疾病、功能以及反映参与者目标的患者报告结局;并且应根据人群特征进行调整。专家们认为,基于血液的生物标志物不太可能被接受为疗效试验的主要终点。作为复合终点的一部分被提及的合理组成部分包括死亡率、活动功能以及多种与年龄相关疾病的发病情况。我们的研究结果为可接受的终点选择方法提供了指导,以指导未来老年科学试验的设计。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/882e/11844647/2e6cb9803405/nihpp-rs5920485v1-f0001.jpg

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