학술논문

Delivering clinical trials at home: protocol, design and implementation of a direct-to-family paediatric lupus trial
Document Type
article
Author
Laura E SchanbergS CannaA GromE MellinsA BrownS JonesE BakerA KempT DavisS JacksonK JonesT MasonA HansonJ JonesJ CooperT LeeJ ChangM HollandS JoshiL LimA MurphyK MooreB ferreiraS LiP LeeK AbulabanR AgbayaniS AkoghlanianE AndersonL Barillas-AriasK BaszisM BeckerH Bell-BrunsonH BenhamS BenselerT BeukelmanH BrunnerH BukulmezL CerracchioE ChalomK ChundruJ DeanF DedeogluV DempseyJ DrewB FeldmanP FergusonC FlemingL FrancoI GohD GoldsmithB GottliebT GrahamT GriffinM HanceK HickeyM HollanderJ HsuA HuberC HungA HuttenlocherL ImundoC InmanJ JaquithL JungD KingsburyK KleinM Klein-GitelmanS KramerS LapidusD LathamB MallaM MalloyA MartyniukK McConnellD McCurdyC McMullen-JacksonL MoorthyE MuscalS KimL FavierS MorganA JacksonL MarquesStephen J BalevicK HaywardJ NicholasD LovellJ HarrisE LawsonC MossN GeorgeA CooperRachel L RandellM AdamsS CooperM MillerC BlackM MitchellF De BenedettiM FoxK KaufmanA MerrittJ FullerM FitzgeraldA DavisC DavisL HendersonS MohanY KimuraL HarelR LaxerK McCarthyI FergusonE McCormickA HayM GuzmanE FoxP HillS McGuireJ LamJ BolandS BallingerE MENDOZAJ NOCTONN JohnsonS BowmanM IbarraS HongM GuevaraK JamesA AdamsB DONALDSONC KremerL CannonR NicolaiM FreemanD LevyK GerholdA InsalacoW BernalE KesslerC LinM LermanT HahnLindsay SinglerAnthony CunninghamMichael Cohen-WolkowiezChristoph P HornikN AbelJ AielloC AlejandroE AllenspachR AlperinM AlpizarG AmarilyoW AmblerS ArdoinS ArmendarizI BalboniS BalevicL BallengerN BalmuriF Barbar-SmileyM BasiagaE BeltzT BigleyB BinstadtM BlakleyJ BohnsackA BoneparthC BracagliaE BrooksM BrothersM BuckleyD BullockB CameronP CarperV CartwrightE CassidyA Chang-HoftmanV ChauhanP ChiraT ChinnH ClairmanD CoA ConfairH ConlonR ConnorC CorrellR CorvalanD CostanzoR CronL Curiel-DuranT CuringtonM CurryA DalrympleD De RanieriM De GuzmanN DelnayE DeSantisT DicksonJ DingleE DorseyS DoverJ DowlingK DriestQ DuK DuarteD DurkeeE DuvergerJ DvergstenA EberhardM EckertK EdeB EdelheitC EdensY EdgerlyM ElderB ErvinS FadrhoncC FailingD FairM FalconS FedericiJ FennellR FerruchoK FieldsT FinkelO FlynnL FogelK FritzS FroeseR FuhlbriggeD GerstbacherM GilbertM Gillispie-TaylorE GivercC GodiwalaH GoheerE GotschlichA GotteC GraciaS GrevichJ GriswoldP GuittarM HagerO HalyabarE HammelevS HaroO HarryE HartiganJ HausmannJ HeiartK HeklM HenricksonA HershS HillyerL HirakiM HiskeyP HobdayC HoffartM HorwitzJ HugginsJ HuiYuenJ HuntingtonG JanowS JaredC JusticeA JustinianoN KaranU KhalsaB KienzleM KitcharoensakkulT KlausmeierB KompelienA KosikowskiL KovalickJ KrackerJ LaiB LangB LapinA LaskyL LentiniS LiebermanN LingM LingisM LoD LowmanN LucaS LvovichC MadisonJ MadisonS Magni ManzoniJ MallerM MannionC ManosS MathusL McAllisterP McCurdy StokesI McHaleA McMonagleE MeidanR MercadoL MichalowskiP MiettunenD MilojevicE MirizioE MisajonR ModicaE Morgan DewittT MoussaV MrukR NadlerB NahalK NandaN NasahL NassiS NativM NatterJ NeelyB NelsonL NewhallL NgP NigrovicB NolanE OberleB Obispo
Source
Lupus Science and Medicine, Vol 8, Iss 1 (2021)
Subject
Immunologic diseases. Allergy
RC581-607
Language
English
ISSN
2053-8790
Abstract
Introduction Direct-to-family clinical trials efficiently provide data while reducing the participation burden for children and their families. Although these trials can offer significant advantages over traditional clinical trials, the process of designing and implementing direct-to-family studies is poorly defined, especially in children with rheumatic disease. This paper provides lessons learnt from the design and implementation of a self-controlled, direct-to-family pilot trial aimed to evaluate the effects of a medication management device on adherence to hydroxychloroquine in paediatric SLE.Methods Several design features accommodate a direct-to-family approach. Participants meeting eligibility criteria from across the USA were identified a priori through a disease registry, and all outcome data are collected remotely. The primary outcome (medication adherence) is evaluated using electronic medication event-monitoring, plasma drug levels, patient questionnaires and pill counts. Secondary and exploratory endpoints include (1) lupus disease activity measured by a remote SLE Disease Activity Index examination and the Systemic Lupus Activity Questionnaire; and (2) hydroxychloroquine pharmacokinetics and pharmacodynamics. Recruitment of the initial target of 20 participants was achieved within 10 days. Due to initial recruitment success, enrolment was increased to 26 participants. Additional participants who were interested were placed on a waiting list in case of dropouts during the study.Discussion and dissemination Direct-to-family trials offer several advantages but present unique challenges. Lessons learnt from the protocol development, design, and implementation of this trial will inform future direct-to-family trials for children and adults with rheumatic diseases. Additionally, the data collected remotely in this trial will provide critical information regarding the accuracy of teleresearch in lupus, the impact of adherence to hydroxychloroquine on disease activity and a pharmacokinetic analysis to inform paediatric-specific dosing of hydroxychloroquine.Trial registration number ClinicalTrials.gov Registry (NCT04358302).