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首页> 外文期刊>International journal of rheumatology >Development and Implementation of a Double-Blind Corticosteroid-Tapering Regimen for a Clinical Trial
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Development and Implementation of a Double-Blind Corticosteroid-Tapering Regimen for a Clinical Trial

机译:开发和实施双盲皮质激素治疗方案的临床试验。

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We describe the design and operationalization of a blinded corticosteroid-tapering regimen for a randomized trial of tocilizumab in giant cell arteritis (GCA). To our knowledge, no clinical trial in any disease has ever employed a blinded corticosteroid-tapering regimen, but this was necessary to the design of our trial which is likely to be relevant to other investigations of steroid-sparing regimens. Two standardized corticosteroid-tapering regimens are required for this GCA trial: a 6-month regimen in 3 arms (taken with tocilizumab 162 mg subcutaneously weekly or every other week or with placebo) and a 12-month regimen with placebo (fourth arm). Investigators select initial prednisone doses, tapered in an open-label fashion until 20 mg/day. Doses <20 mg/day are blinded. At least 27 blinded blister packs are required to ensure blinding and encourage compliance. This permits all possible daily doses but requires ≤5 capsules/day. The number of capsules taken at any point during tapering is identical across groups. Our approach may be extrapolated to trials beyond GCA.
机译:我们描述了tocilizumab在巨细胞动脉炎(GCA)中的随机试验的盲法糖皮质激素治疗方案的设计和操作化。据我们所知,在任何疾病的临床试验中都没有使用过盲目的皮质类固醇药物治疗方案,但这对我们的试验设计是必要的,这可能与其他类固醇激素治疗方案有关。这项GCA试验需要两种标准化的糖皮质激素治疗方案:3臂治疗(6个月方案)(每周一次或隔周与皮下注射托珠单抗162μmg或隔周一起服用,或与安慰剂一起服用)和12个月的安慰剂治疗(第四组)。研究者选择泼尼松初始剂量,以开放标签的方式逐渐减少剂量,直至每天20 mg。每天<20μmg的剂量是盲的。至少需要27个盲孔吸塑包装,以确保致盲并鼓励顺从性。这允许所有可能的日剂量,但每天需要≤5粒胶囊。各组之间在渐缩过程中任何时候服用的胶囊数量相同。我们的方法可能会外推到GCA以外的试验。

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