EULAR recommendations for conducting clinical studies and/or clinical trials in systemic vasculitis: focus on anti-neutrophil cytoplasm antibody-associated vasculitis.
OBJECTIVE
To develop the European League Against Rheumatism (EULAR) recommendations for conducting clinical studies and/or clinical trials in systemic vasculitis.


METHODS
An expert consensus group was formed consisting of rheumatologists, nephrologists and specialists in internal medicine representing five European countries and the USA, a clinical epidemiologist and representatives from regulatory agencies. Using an evidence-based and expert opinion-based approach in accordance with the standardised EULAR operating procedures, the group identified nine topics for a systematic literature search through a modified Delphi technique. On the basis of research questions posed by the group, recommendations were derived for conducting clinical studies and/or clinical trials in systemic vasculitis.


RESULTS
Based on the results of the literature research, the expert committee concluded that sufficient evidence to formulate guidelines on conducting clinical trials was available only for anti-neutrophil cytoplasm antibody-associated vasculitides (AAV). It was therefore decided to focus the recommendations on these diseases. Recommendations for conducting clinical trials in AAV were elaborated and are presented in this summary document. It was decided to consider vasculitis-specific issues rather than general issues of trial methodology. The recommendations deal with the following areas related to clinical studies of vasculitis: definitions of disease, activity states, outcome measures, eligibility criteria, trial design including relevant end points, and biomarkers. A number of aspects of trial methodology were deemed important for future research.


CONCLUSIONS
On the basis of expert opinion, recommendations for conducting clinical trials in AAV were formulated. Furthermore, the expert committee identified a strong need for well-designed research in non-AAV systemic vasculitides.
Hellmich
Bernhard
B
Department of Rheumatology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
Flossmann
Oliver
O
Gross
Wolfgang L
WL
Bacon
Paul
P
Cohen-Tervaert
Jan Willem
JW
Guillevin
Loic
L
Jayne
David
D
Mahr
Alfred
A
Merkel
Peter A
PA
Raspe
Heiner
H
Scott
David G I
DG
Witter
James
J
Yazici
Hasan
H
Luqmani
Raashid A
RA
D000906:Antibodies / Q000276:immunology*; D015415:Biomarkers / Q000032:analysis; D002986:Clinical Trials as Topic / Q000592:standards*; D003593:Cytoplasm / Q000276:immunology*; D005060:Europe; D017408:Guidelines as Topic; D006801:Humans; D007391:International Cooperation; D009504:Neutrophils / Q000276:immunology*; D011788:Quality of Life; D012008:Recurrence; D012074:Remission Induction; D012107:Research Design / Q000592:standards; D016896:Treatment Outcome; D014657:Vasculitis / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*
D000906:Antibodies; D015415:Biomarkers