A European pilot study in Dravet Syndrome to delineate what really matters for the patients and families.

PCOMs burden of the disease families’ expectations meaningful change meaningful outcomes

Journal

Epilepsia open
ISSN: 2470-9239
Titre abrégé: Epilepsia Open
Pays: United States
ID NLM: 101692036

Informations de publication

Date de publication:
07 Nov 2021
Historique:
revised: 26 10 2021
received: 13 07 2021
accepted: 31 10 2021
pubmed: 9 11 2021
medline: 9 11 2021
entrez: 8 11 2021
Statut: aheadofprint

Résumé

We aimed to identify caregivers' opinions on the outcome measures that matter in clinical trials in individuals with Dravet syndrome (DS). We conducted a prospective European multicenter study based on an 11 closed questions survey developed by the French reference center for rare epilepsies and DS patients' advocacy groups. Items included questions on seizures and daily life outcomes that a clinical trial on a therapy for individuals with DS should target. Statistical analyses were performed to evaluate the impact of the country of residence and of the patients' age. The survey was answered by 153 caregivers (68%: France, 28%: Germany, and 24%: Italy) off individuals with DS. Individuals with DS included 86 males (mean age of 11.4 [interquartile: 7-20.4] years). Families ranked as important almost all the items proposed. However, items related to daily life had the highest rank in all three countries compared to items about seizures (P = 0.02). Increase in individuals' age was associated with a higher age at diagnosis (ρ = 0.26, P = 0.02), and a lower impact of seizure duration (ρ = -0.25, P = 0.005) and on the need of hospital referral (ρ = -0.26, P = 0.005). These data can help tailor patient-centered outcome measures in future clinical and real-life trials for DS.

Identifiants

pubmed: 34747137
doi: 10.1002/epi4.12557
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Fondation Bettencourt Schueller
Organisme : Institut National de la Santé et de la Recherche Médicale
ID : ANR-10-IAHU-01

Informations de copyright

© 2021 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.

Références

Morel T, Cano SJ. Measuring what matters to rare disease patients - Reflections on the work by the IRDiRC taskforce on patient-centered outcome measures. Orphanet J Rare Dis. 2017;12:1-13.
Devinsky O, Cross JH, Laux L, Marsh E, Miller I, Nabbout R, et al Trial of cannabidiol for drug-resistant seizures in the dravet syndrome. N Engl J Med. 2017;376:2011-20.
Devinsky O, Patel AD, Cross JH, Villanueva V, Wirrell EC, Privitera M, et al Effect of cannabidiol on drop seizures in the lennox-gastaut syndrome. N Engl J Med. 2018;378:1888-97.
Miller I, Scheffer IE, Gunning B, Sanchez-Carpintero R, Gil-Nagel A, Perry MS, et al Dose-ranging effect of adjunctive oral cannabidiol vs placebo on convulsive seizure frequency in dravet syndrome: a randomized clinical trial. JAMA Neurol. 2020;77:613-21.
Nabbout R, Mistry A, Zuberi S, Villeneuve N, Gil-Nagel A, Sanchez-Carpintero R, et al Fenfluramine for treatment-resistant seizures in patients with dravet syndrome receiving stiripentol-inclusive regimens: a randomized clinical trial. JAMA Neurol. 2020;77:300-8.
European Medicine Agency-Committee for medicinal products for human use. Guideline on clinical investigation of medicinal products in the treatment of epileptic disorders. [Internet]. 2010 [cited 2020]. Available from: https://www.ema.europa.eu/en/documents/scientific-guideline/guideline-clinical-investigation-medicinal-products-treatment-epileptic-disorders-revision-2_en.pdf
Ben-Menachem E, Sander JW, Privitera M, Gilliam F. Measuring outcomes of treatment with antiepileptic drugs in clinical trials. Epilepsy Behav. 2010;18:24-30.
Wolff M, Cassé-Perrot C, Dravet C. Severe myoclonic epilepsy of infants (Dravet syndrome): Natural history and neuropsychological findings. Epilepsia. 2006;47:45-8.
Dravet C. The core Dravet syndrome phenotype. Epilepsia. 2011;52:3-9.
Claes L, Del-Favero J, Ceulemans B, Lagae L, Van Broeckhoven C, De Jonghe P. De novo mutations in the sodium-channel gene SCN1A cause severe myoclonic epilepsy of infancy. Am J Hum Genet. 2001;68:1327-32.
Wu YW, Sullivan J, McDaniel SS, Meisler MH, Walsh EM, Li SX, et al Incidence of dravet syndrome in a US population. Pediatrics. 2015;136:e1310-5.
Scheffer IE, Nabbout R. SCN1A-related phenotypes: Epilepsy and beyond. Epilepsia. 2019;60:S17-24.
Ragona F, Granata T, Bernardina BD, Offredi F, Darra F, Battaglia D, et al Cognitive development in Dravet syndrome: A retrospective, multicenter study of 26 patients. Epilepsia. 2011;52:386-92.
Knupp KG, Scarbro S, Wilkening G, Juarez-Colunga E, Kempe A, Dempsey A. Parental perception of comorbidities in children with dravet syndrome. Pediatr Neurol. 2017;76:60-5.
Villas N, Meskis MA, Goodliffe S. Dravet syndrome: Characteristics, comorbidities, and caregiver concerns. Epilepsy Behav. 2017;74:81-6.
Rodda JM, Scheffer IE, McMahon JM, Berkovic SF, Graham HK. Progressive gait deterioration in adolescents with Dravet syndrome. Arch Neurol. 2012;69:873-8.
Nabbout R, Auvin S, Chiron C, Irwin J, Mistry A, Bonner N, et al Development and content validation of a preliminary core set of patient- and caregiver-relevant outcomes for inclusion in a potential composite endpoint for Dravet Syndrome. Epilepsy Behav. 2018;78:232-42.
Lagae L, Brambilla I, Mingorance A, Gibson E, Battersby A. Quality of life and comorbidities associated with Dravet syndrome severity: a multinational cohort survey. Dev Med Child Neurol. 2018;60:63-72.
Sinoo C, de Lange IML, Westers P, Gunning WB, Jongmans MJ, Brilstra EH. Behavior problems and health-related quality of life in Dravet syndrome. Epilepsy Behav. 2019;90:217-27.
Skluzacek JV, Watts KP, Parsy O, Wical B, Camfield P. Dravet syndrome and parent associations: The IDEA League experience with comorbid conditions, mortality, management, adaptation, and grief. Epilepsia. 2011;52:95-101.
Strzelczyk A, Schubert-Bast S, Bast T, Bettendorf U, Fiedler B, Hamer HM, et al A multicenter, matched case-control analysis comparing burden-of-illness in Dravet syndrome to refractory epilepsy and seizure remission in patients and caregivers in Germany. Epilepsia. 2019;60:1697-710.
Nabbout R, Auvin S, Chiron C, Thiele E, Cross H, Scheffer IE, et al Perception of impact of Dravet syndrome on children and caregivers in multiple countries: looking beyond seizures. Dev Med Child Neurol. 2019;61:1229-36.
Brown MB, Forsythe AB. The anova and multiple comparisons for data with heterogeneous variances. Biometrics. 1974;30:719.
FDA, HHS. Guidance for industry use in medical product development to support labeling claims guidance for industry. Clin Fed Regist. 2009;FDA-2006-D-0362:1-39.
Patrick DL, Burke LB, Powers JH, Scott JA, Rock EP, Dawisha S, et al Patient-reported outcomes to support medical product labeling claims: FDA perspective. Value Health. 2007;10:S125-37.
Vodicka E, Kim K, Devine EB, Gnanasakthy A, Scoggins JF, Patrick DL. Inclusion of patient-reported outcome measures in registered clinical trials: Evidence from ClinicalTrials.gov (2007-2013). Contemp Clin Trials. 2015;43:1-9.
Mercieca-Bebber R, Williams D, Tait MA, Roydhouse J, Busija L, Sundaram CS, et al Trials with patient-reported outcomes registered on the Australian New Zealand Clinical Trials Registry (ANZCTR). Qual Life Res. 2018;27:2581-91.
Mercieca-Bebber R, King MT, Calvert MJ, Stockler MR, Friedlander M. The importance of patient-reported outcomes in clinical trials and strategies for future optimization. Patient Relat Outcome Meas. 2018;9:353-67.
Arends M, Hollak CEM, Biegstraaten M. Quality of life in patients with Fabry disease: A systematic review of the literature. Orphanet J Rare Dis. 2015;10:77. https://doi.org/10.1186/s13023-015-0296-8
International rare diseases research Consortium Patient-Centered Outcome Measures in the Field of Rare Diseases [Internet]. 2016. p. 1-30. Available from: https://irdirc.org/wp-content/uploads/2017/12/PCOM_Post-Workshop_Report_Final.pdf
Frost MH, Reeve BB, Liepa AM, Stauffer JW, Hays RD, Sloan JA. What is sufficient evidence for the reliability and validity of patient-reported outcome measures? Value Health. 2007;10:S94-105.
Snyder CF, Watson ME, Jackson JD, Cella D, Halyard MY, Sloan JA. Patient-reported outcome instrument selection: Designing a measurement strategy. Value Health. 2007;10:S76-85.
Losito E, Kuchenbuch M, Chemaly N, Laschet J, Chiron C, Kaminska A, et al Age-related “Sleep/nocturnal” tonic and tonic clonic seizure clusters are underdiagnosed in patients with Dravet Syndrome. Epilepsy Behav. 2017;74:33-40.
De Liso P, Chemaly N, Laschet J, Barnerias C, Hully M, Leunen D, et al Patients with dravet syndrome in the era of stiripentol: A French cohort cross-sectional study. Epilepsy Res. 2016;125:42-6.
Strzelczyk A, Kalski M, Bast T, Wiemer-Kruel A, Bettendorf U, Kay L, et al Burden-of-illness and cost-driving factors in Dravet syndrome patients and carers: A prospective, multicenter study from Germany. Eur J Paediatr Neurol. 2019;23:392-403.
de Lange IM, Gunning B, Sonsma ACM, van Gemert L, van Kempen M, Verbeek NE, et al Influence of contraindicated medication use on cognitive outcome in Dravet syndrome and age at first afebrile seizure as a clinical predictor in SCN1A-related seizure phenotypes. Epilepsia. 2018;59:1154-65.
Devinsky O, Patel AD, Thiele EA, Wong MH, Appleton R, Harden CL, et al Randomized, dose-ranging safety trial of cannabidiol in Dravet syndrome. Neurology. 2018;90:e1204-11.
Devinsky O, Nabbout R, Miller I, Laux L, Zolnowska M, Wright S, et al Long-term cannabidiol treatment in patients with Dravet syndrome: An open-label extension trial. Epilepsia. 2019;60:294-302.
Nabbout R, Kuchenbuch M. Impact of predictive, preventive and precision medicine strategies in epilepsy. Nat Rev Neurol. 2020;16:674-88.
Jones J, Hunter D. Qualitative Research: Consensus methods for medical and health services research. BMJ. 1995;311:376.
Goodman CM. The Delphi technique: a critique. J Adv Nurs. 1987;12:729-34.
Teng T, Lo Barco T, Marie E, Hallet A-S, Brambilla I, Flege S, et al Families driven drug development and clinical trials: a pilot study in Dravet Syndrome to delineate what really matters. 2021 [cited 2021]. Available from: https://www.researchsquare.com/article/rs-293272/v1

Auteurs

Nicole Chemaly (N)

Department of Pediatric Neurology, Reference Centre for Rare Epilepsies, Hôpital Necker-Enfants Malades, APHP, Member of ERN EpiCARE, Paris, France.
Laboratory of Translational Research for Neurological Disorders, INSERM MR1163, Imagine Institute, Paris, France.
Université de Paris, Paris, France.

Mathieu Kuchenbuch (M)

Department of Pediatric Neurology, Reference Centre for Rare Epilepsies, Hôpital Necker-Enfants Malades, APHP, Member of ERN EpiCARE, Paris, France.
Laboratory of Translational Research for Neurological Disorders, INSERM MR1163, Imagine Institute, Paris, France.

Théo Teng (T)

Department of Pediatric Neurology, Reference Centre for Rare Epilepsies, Hôpital Necker-Enfants Malades, APHP, Member of ERN EpiCARE, Paris, France.

Elodie Marie (E)

Alliance Syndrome Dravet, Malesherbes, France.

Gianluca D'Onofrio (G)

Department of Pediatric Neurology, Reference Centre for Rare Epilepsies, Hôpital Necker-Enfants Malades, APHP, Member of ERN EpiCARE, Paris, France.
Department of Women and Child Health, University of Padua, Padua, Italy.

Tommaso Lo Barco (T)

Department of Pediatric Neurology, Reference Centre for Rare Epilepsies, Hôpital Necker-Enfants Malades, APHP, Member of ERN EpiCARE, Paris, France.
Child Neuropsychiatry, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy.

Isabella Brambilla (I)

Dravet Italia Onlus, Affi, Italy.

Silke Flege (S)

Dravet-Syndrom e.V., Markkleeberg, Germany.

Anne-Sophie Hallet (AS)

Alliance Syndrome Dravet, Malesherbes, France.

Rima Nabbout (R)

Department of Pediatric Neurology, Reference Centre for Rare Epilepsies, Hôpital Necker-Enfants Malades, APHP, Member of ERN EpiCARE, Paris, France.
Laboratory of Translational Research for Neurological Disorders, INSERM MR1163, Imagine Institute, Paris, France.
Université de Paris, Paris, France.

Classifications MeSH