Development of the Cutaneous Dermatomyositis Investigator Global Assessment (CDM-IGA): A De Novo IGA of Cutaneous Manifestations of Dermatomyositis.

IF 3.5 3区 医学 Q1 DERMATOLOGY Dermatology and Therapy Pub Date : 2024-08-01 Epub Date: 2024-07-08 DOI:10.1007/s13555-024-01220-1
Stephanie McKee, Jason Xenakis, Harriet Makin, Chris Marshall, Randall Winnette, Rohit Aggarwal, Sarah L Knight
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Abstract

Introduction: Dermatomyositis (DM) is a rare systemic autoimmune disease characterized by a distinctive debilitating skin rash and skeletal muscle weakness. It is unclear if existing clinical outcome assessment (COA) measures include the concepts of priority to patients and those necessary to fully capture improvements in the active cutaneous manifestations of DM. This study aimed to develop the Cutaneous Dermatomyositis Investigator Global Assessment (CDM-IGA), a de novo IGA, for use in clinical trials of adult DM.

Methods: Eight DM clinical experts participated in 60-min qualitative interviews consisting of concept elicitation and cognitive debriefing methodologies. Concept elicitation comprised open-ended questions with follow-up probes to explore clinicians' experiences of treating patients with DM, the impact of symptoms on patients' quality of life, and the severity levels of disease characteristics to explore DM progression. Cognitive debriefing required the clinical experts to perform a review of the CDM-IGA, designed to assess the severity of cutaneous disease activity of DM. After the interviews, a consensus meeting with three clinical experts was held to agree on any outstanding issues relating to the CDM-IGA.

Results: The CDM-IGA was iteratively developed using the opinions of nine clinical experts. Feedback provided by all clinicians agreed that erythema was the main active cutaneous manifestation of DM and should be the primary characteristic on the CDM-IGA, split by erythema color and extent. To determine cutaneous disease severity, experts suggested adding a metric called secondary changes, which combined erosion/ulceration and lichenification, which could modify the patient's final score. Three clinical experts suggested that a photo-guide to support assessments of erythema across different skin tones could be beneficial.

Conclusions: A novel CDM-IGA was developed for use with adult patients with DM in clinical trials, based on an iterative development process that combined qualitative feedback from clinical experts of DM and importantly adult patients living with DM.

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皮肤皮肌炎研究者全球评估(CDM-IGA)的开发:皮肌炎皮肤表现的新 IGA。
简介皮肌炎(Dermatomyositis,DM)是一种罕见的全身性自身免疫性疾病,其特点是皮疹和骨骼肌无力。目前尚不清楚现有的临床效果评估(COA)方法是否包含了患者优先考虑的概念,以及全面反映皮肌炎活动性皮肤表现改善情况所需的概念。本研究旨在开发皮肤皮肌炎研究者全球评估(CDM-IGA),这是一种全新的IGA,可用于成人DM的临床试验:方法:八位DM临床专家参加了60分钟的定性访谈,包括概念激发和认知汇报方法。概念激发包括开放式问题和后续探究,以探讨临床医生治疗DM患者的经验、症状对患者生活质量的影响以及疾病特征的严重程度,从而探索DM的进展。认知汇报要求临床专家对 CDM-IGA 进行回顾,CDM-IGA 用于评估 DM 皮肤疾病活动的严重程度。访谈结束后,三位临床专家召开了一次共识会议,就 CDM-IGA 相关的未决问题达成一致意见:CDM-IGA 是根据九位临床专家的意见反复制定的。所有临床医生提供的反馈意见一致认为,红斑是 DM 的主要活动性皮肤表现,应作为 CDM-IGA 的主要特征,按红斑颜色和范围划分。为了确定皮肤疾病的严重程度,专家建议增加一个称为继发性变化的指标,将糜烂/溃疡和苔藓化结合在一起,这可以改变患者的最终得分。三位临床专家建议使用照片指南来支持对不同肤色的红斑进行评估:在迭代开发过程中,结合了DM临床专家和重要的DM成年患者的定性反馈,开发出了用于临床试验中DM成年患者的新型CDM-IGA。
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来源期刊
Dermatology and Therapy
Dermatology and Therapy Medicine-Dermatology
CiteScore
6.00
自引率
8.80%
发文量
187
审稿时长
6 weeks
期刊介绍: Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.
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