1
|
Chen SC, Bryce J, Chen M, Charmandari E, Choi JH, Dou X, Gong C, Hamza R, Harvey J, Hoffman AR, Horikawa R, Johannson G, Augusto de Lima Jorge A, Miller BS, Roehrich S, Sävendahl L, Tseretopoulou X, Vitali D, Wajnrajch M, Ahmed SF. Development of a Minimum Dataset for the Monitoring of Recombinant Human Growth Hormone Therapy in Children with Growth Hormone Deficiency: A GloBE-Reg Initiative. Horm Res Paediatr 2023; 97:365-373. [PMID: 37703843 PMCID: PMC11309066 DOI: 10.1159/000533763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/31/2023] [Indexed: 09/15/2023] Open
Abstract
INTRODUCTION Although there are some recommendations in the literature on the assessments that should be performed in children on recombinant human growth hormone (rhGH) therapy, the level of consensus on these measurements is not clear. The objective of the current study was to identify the minimum dataset (MDS) that could be measured in a routine clinical setting across the world, aiming to minimise burden on clinicians and improve quality of data collection. METHODS This study was undertaken by the growth hormone (GH) scientific study group in GloBE-Reg, a new project that has developed a common registry platform that can support long-term safety and effectiveness studies of drugs. Twelve clinical experts from 7 international endocrine organisations identified by the GloBE-Reg Steering Committee, 2 patient representatives, and representatives from 2 pharmaceutical companies with previous GH registry expertise collaborated to develop this recommendation. A comprehensive list of data fields routinely collected by each of the clinical and industry experts for children with growth hormone deficiency (GHD) was compiled. Each member was asked to determine the: (1) importance of the data field and (2) ease of data collection. Data fields that achieved 70% consensus in terms of importance qualified for the MDS, provided <50% deemed the item difficult to collect. RESULTS A total of 246 items were compiled and 27 were removed due to redundancies, with 219 items subjected to the grading system. Of the 219 items, 111 achieved at least 70% consensus as important data to collect when monitoring children with GHD on rhGH treatment. Sixty-nine of the 219 items were deemed easy to collect. Combining the criteria of importance and ease of data collection, 63 met the criteria for the MDS. Several anomalies to the MDS rule were identified and highlighted for discussion, including whether the patients were involved in current or previous clinical trials, need for HbA1c monitoring, other past medical history, and adherence, enabling formulation of the final MDS recommendation of 43 items; 20 to be completed once, 14 every 6 months, and 9 every 12 months. CONCLUSION In summary, this exercise performed through the GloBE-Reg initiative provides a recommendation of the MDS requirement, collected through real-world data, for the monitoring of safety and effectiveness of rhGH in children with GHD, both for the current daily preparations and the newer long-acting GH.
Collapse
Affiliation(s)
- Suet Ching Chen
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK
- Office for Rare Conditions, University of Glasgow, Glasgow, UK
| | - Jillian Bryce
- Office for Rare Conditions, University of Glasgow, Glasgow, UK
| | - Minglu Chen
- Office for Rare Conditions, University of Glasgow, Glasgow, UK
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Jin-Ho Choi
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, South Korea
| | - Xinyu Dou
- Beijing Children’s Hospital, The Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Chunxiu Gong
- Beijing Children’s Hospital, The Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Rasha Hamza
- Department of Pediatrics, Pediatric Endocrinology Unit, Ain Shams University, Cairo, Egypt
| | | | - Andrew R. Hoffman
- Department of Medicine, Division of Endocrinology, Metabolism and Gerontology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Reiko Horikawa
- Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
| | - Gudmundur Johannson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Alexander Augusto de Lima Jorge
- Genetic-Endocrinology Unit, Endocrinology Division of Hospital das Clinicas of University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Bradley S. Miller
- University of Minnesota Medical School, MHealth Fairview Masonic Children’s Hospital, Minneapolis, MN, USA
| | - Sebastian Roehrich
- Novo Nordisk Health Care AG, Global Medical Affairs Rare Endocrine Disorders, Zurich, Switzerland
| | - Lars Sävendahl
- Department of Women’s and Children’s Health, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Xanthippi Tseretopoulou
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK
- Office for Rare Conditions, University of Glasgow, Glasgow, UK
| | | | - Michael Wajnrajch
- Pfizer Biopharmaceuticals, Global Medical Affairs, Rare Disease, New York, NY, USA
- Division of Paediatric Endocrinology, New York University Langone Medical Center, New York, NY, USA
| | - S. Faisal Ahmed
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK
- Office for Rare Conditions, University of Glasgow, Glasgow, UK
| |
Collapse
|
2
|
Felton T, Pattison N, Fletcher S, Finney S, Walsh T, Dark P. Co-enrolment to UK Critical Care Studies - A 2019 update. J Intensive Care Soc 2022; 23:53-57. [PMID: 37593536 PMCID: PMC10427850 DOI: 10.1177/1751143720971542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
In 2013, a group of clinicians on behalf of the National Institute for Health Research, collaborated with ICU Steps to produce guidance about people being enrolled in more than one critical care trial. This is referred to as "co-enrolment" and can be where a person takes part in one study at the same time as another study (or one after the other in a short time-frame). For instance, being part of a study looking at sepsis drugs and a mechanical ventilation weaning study. The drivers for developing this guidance were a lack of any existing guidance, nationally and internationally, at that time, and a desire to ensure high quality research is conducted. The emphasis was on making trials as safe as possible for patients and ensuring robust trial outcomes. Critical care was seen to lead in this, with our exemplar guidance used across all health research. We wish to revisit this guidance now that there is more experience of coenrolment in critical care trials. There is also more awareness of different consent models, such as deferred consent (taking consent when a person is awake and able to give consent) and consultee consent (asking families or independent professionals to consent). Consenting to coenrolment is an important ethical consideration for the revision of this guidance.
Collapse
Affiliation(s)
- Timothy Felton
- Acute Intensive Care Unit, Wythenshawe Hospital, Manchester University Foundation Trust, Manchester, UK
| | - Natalie Pattison
- School of Health and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, UK
| | - Simon Fletcher
- Anaesthetics and Intensive Care, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Simon Finney
- Intensive Care and Anaesthesia, Barts Health NHS Trust, London, UK
| | - Tim Walsh
- Intensive Care Unit, Royal Infirmary of Edinburgh, Little France, Edinburgh, UK
| | - Paul Dark
- Critical Care Unit, Salford Royal NHS Foundation Trust, Northern Care Alliance NHS Group, Greater Manchester, UK
| |
Collapse
|
3
|
Maslekar T, Peat S, Karim J, Moriarty C, Jayne DG, Chapman SJ. The reporting of coenrolment in protocols of publicly funded randomized controlled trials was infrequent and variable. J Clin Epidemiol 2021; 133:94-100. [PMID: 33484839 DOI: 10.1016/j.jclinepi.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 12/12/2020] [Accepted: 01/12/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To explore the approach to participant coenrolment in publicly funded randomized controlled trials (RCTs) and to consider its impact on study recruitment. STUDY DESIGN AND SETTING A cross-sectional study of the UK National Institute for Health Research Journals Library was undertaken. RCTs funded between 2010 and 2019 were eligible. The reporting of coenrolment criteria was assessed through inspection of publicly available study protocols. Where present, the approach to coenrolment was examined, including circumstances in which it was permitted/prohibited and the mechanism for decision-making. For completed RCTs, the impact on recruitment was explored by comparing rates of early recruitment (completion before the expected end date) and extensions (completion after the expected end date) between studies, which did and did not permit coenrolment. RESULTS Of 219 eligible protocols, coenrolment was addressed in 94 (42.9%). Twenty-three (24.5%) of these did not allow recruitment to multiple studies, while 71 (75.5%) permitted it according to a series of caveats, including considerations of study outcomes, intervention type, and patient burden. The final decision for coenrolment rested with the local recruitment team in 57 (60.6%) and with the central organizing team in 37 (39.4%). Early completion of recruitment occurred in 8 of 64 (12.5%) RCTs where coenrolment was permitted and 5 of 20 (25.0%) where it was not (P = 0.285). An extension to recruitment time was required in 31 of 64 (48.4%) RCTs where coenrolment was permitted and 9 of 11 (45.0%) where it was not (P = 0.788). CONCLUSIONS The reporting of coenrolment in protocols of publicly funded RCTs is infrequent, and where present, the approach to decision-making is widely variable. In this study, policies of coenrolment were not associated with gains in trial recruitment.
Collapse
Affiliation(s)
- Tanaya Maslekar
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK
| | - Samuel Peat
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK
| | - Jamshaid Karim
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK
| | - Catherine Moriarty
- John Goligher Colorectal Unit, St. James's University Hospital, Leeds, UK
| | - David G Jayne
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK
| | - Stephen J Chapman
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK.
| |
Collapse
|
4
|
Lane JA, Er V, Avery KNL, Horwood J, Cantwell M, Caro GP, Crozier A, Smith GD, Donovan JL, Down L, Hamdy FC, Gillatt D, Holly J, Macefield R, Moody H, Neal DE, Walsh E, Martin RM, Metcalfe C. ProDiet: A Phase II Randomized Placebo-controlled Trial of Green Tea Catechins and Lycopene in Men at Increased Risk of Prostate Cancer. Cancer Prev Res (Phila) 2018; 11:687-696. [PMID: 30309839 DOI: 10.1158/1940-6207.capr-18-0147] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 07/11/2018] [Accepted: 09/21/2018] [Indexed: 11/16/2022]
Abstract
Epidemiologic studies suggest that diet can alter prostate cancer risk. This study aimed to establish the feasibility and acceptability of dietary modification in men at increased risk of prostate cancer. Men were invited with a PSA level of 2.0-2.95 ng/mL or 3.0-19.95 ng/mL with negative prostate biopsies. Randomization (3 × 3 factorial design) to daily green tea and lycopene: green tea drink (3 cups, unblinded) or capsules [blinded, 600 mg flavan-3-ol ()-epigallocatechin-3-gallate (EGCG) or placebo] and lycopene-rich foods (unblinded) or capsules (blinded, 15 mg lycopene or placebo) for 6 months. Primary endpoints were randomization rates and intervention adherence (blinded assessment of metabolites) at 6 months with secondary endpoints of acceptability (from interviews), safety, weight, blood pressure, and PSA. A total of 133 of 469 (28.4%) men approached agreed to be randomized and 132 were followed-up (99.2%). Mean lycopene was 1.28 [95% confidence intervals (CI), 1.09-1.50, P = 0.003] times higher in the lycopene capsule group and 1.42 (95% CI, 1.21-1.66; P < 0.001) times higher in the lycopene-enriched diet group compared with placebo capsules. Median EGCG was 10.7 nmol/L (95% CI, 7.0-32.0) higher in in the active capsule group and 20.0 nmol/L (95% CI, 0.0-19.0) higher in the green tea drink group compared with placebo capsules (both P < 0.001). All interventions were acceptable and well tolerated although men preferred the capsules. Dietary prevention is acceptable to men at risk of prostate cancer. This intervention trial demonstrates that a chemoprevention clinical trial is feasible. Cancer Prev Res; 11(11); 687-96. ©2018 AACR.
Collapse
Affiliation(s)
- J Athene Lane
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom. .,NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, United Kingdom.,Bristol Randomised Trials Collaboration, University of Bristol, Bristol, United Kingdom
| | - Vanessa Er
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.,NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, United Kingdom
| | - Kerry N L Avery
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Jeremy Horwood
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.,Bristol Randomised Trials Collaboration, University of Bristol, Bristol, United Kingdom.,Collaboration for Leadership in Applied Health Research and Care West at University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Marie Cantwell
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Gema P Caro
- Department of Food and Health, IFAPA-Alameda del Obispo, Cordoba, Spain
| | - Alan Crozier
- Department of Nutrition, University of California Davis, Davis, California
| | - George Davey Smith
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.,Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Jenny L Donovan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.,Collaboration for Leadership in Applied Health Research and Care West at University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Liz Down
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - David Gillatt
- Bristol Urological Institute, North Bristol Trust, Bristol, United Kingdom
| | - Jeff Holly
- IGFs and Metabolic Endocrinology Group, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Rhiannon Macefield
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Hilary Moody
- Bristol Urological Institute, North Bristol Trust, Bristol, United Kingdom
| | - David E Neal
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - Eleanor Walsh
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Richard M Martin
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.,NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, United Kingdom.,Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Chris Metcalfe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.,Bristol Randomised Trials Collaboration, University of Bristol, Bristol, United Kingdom
| |
Collapse
|
5
|
Ajithkumar TV, Gilbert DC. Modern Challenges of Cancer Clinical Trials. Clin Oncol (R Coll Radiol) 2017; 29:767-769. [PMID: 29066171 DOI: 10.1016/j.clon.2017.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 09/20/2017] [Indexed: 12/14/2022]
Affiliation(s)
| | - D C Gilbert
- Sussex Cancer Centre and Brighton and Sussex Medical School, Brighton, UK
| |
Collapse
|