Elaboration of Consensus Clinical Endpoints to Evaluate Antimicrobial Treatment Efficacy in Future Hospital-acquired/Ventilator-associated Bacterial Pneumonia Clinical Trials.

Details

Serval ID
serval:BIB_F0650CF235A2
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Elaboration of Consensus Clinical Endpoints to Evaluate Antimicrobial Treatment Efficacy in Future Hospital-acquired/Ventilator-associated Bacterial Pneumonia Clinical Trials.
Journal
Clinical infectious diseases
Author(s)
Weiss E., Zahar J.R., Alder J., Asehnoune K., Bassetti M., Bonten MJM, Chastre J., De Waele J., Dimopoulos G., Eggimann P., Engelhardt M., Ewig S., Kollef M., Lipman J., Luna C., Martin-Loeches I., Pagani L., Palmer L.B., Papazian L., Poulakou G., Prokocimer P., Rello J., Rex J.H., Shorr A.F., Talbot G.H., Thamlikitkul V., Torres A., Wunderink R.G., Timsit J.F.
ISSN
1537-6591 (Electronic)
ISSN-L
1058-4838
Publication state
Published
Issued date
13/11/2019
Peer-reviewed
Oui
Volume
69
Number
11
Pages
1912-1918
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Randomized clinical trials (RCTs) in hospital-acquired and ventilator-associated bacterial pneumonia (HABP and VABP, respectively) are important for the evaluation of new antimicrobials. However, the heterogeneity in endpoints used in RCTs evaluating treatment of HABP/VABP may puzzle clinicians. The aim of this work was to reach a consensus on clinical endpoints to consider in future clinical trials evaluating antimicrobial treatment efficacy for HABP/VABP.
Twenty-six international experts from intensive care, infectious diseases, and the pharmaceutical industry were polled using the Delphi method.
The panel recommended a hierarchical composite endpoint including, by priority order, (1) survival at day 28, (2) mechanical ventilation-free days through day 28, and (3) clinical cure between study days 7 and 10 for VABP; and (1) survival (day 28) and (2) clinical cure (days 7-10) for HABP. Clinical cure was defined as the combination of resolution of signs and symptoms present at enrollment and improvement or lack of progression of radiological signs. More than 70% of the experts agreed to assess survival and mechanical ventilation-free days though day 28, and clinical cure between day 7 and day 10 after treatment initiation. Finally, the hierarchical order of endpoint components was reached after 3 Delphi rounds (72% agreement).
We provide a multinational expert consensus on separate hierarchical composite endpoints for VABP and HABP, and on a definition of clinical cure that could be considered for use in future HABP/VABP clinical trials.
Keywords
Delphi method, clinical cure, hierarchical composite endpoint, hospital-acquired bacterial pneumonia, multinational consensus
Pubmed
Web of science
Create date
18/03/2019 20:06
Last modification date
05/01/2020 7:18
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