medidux

  • 文章类型: Journal Article
    背景:在癌症患者的临床研究中越来越多地使用电子患者报告结果(ePRO)的评估,并能够在患者的日常生活中进行结构化和标准化的数据收集。到目前为止,很少有研究或分析关注ePROs对患者的医疗益处。
    目的:当前的探索性分析旨在初步表明,与不使用真实世界护理应用程序的对照组相比,使用ConsiliumCare应用程序(最近更名为medidux;mobileHealthAG)对ePro的副作用进行结构化和定期自我评估对癌症患者的计划外咨询和住院的发生率具有可识别的影响。为了分析这一点,使用ConsiliumCare应用程序记录的癌症患者的计划外会诊和住院治疗的发生率,作为患者报告结局(PRO)研究的一部分,我们将其与在标准护理治疗期间在瑞士2个肿瘤中心收集的癌症患者的可比人群的相应数据进行回顾性比较.
    方法:PRO研究中接受新辅助或非治疗性全身治疗的癌症患者(本分析中包括178例)通过ConsiliumCare应用程序在90天的观察期内对副作用进行了自我评估。在这个时期,参与医师记录了计划外(紧急)会诊和住院情况.将这些事件的发生率与从瑞士2个肿瘤中心获得的一组癌症患者的回顾性数据进行比较。
    结果:两组患者在年龄和性别比例方面具有可比性,以及癌症实体和癌症分期联合委员会的分布。总的来说,每组139例患者接受化疗,39例接受其他治疗。看着所有的病人,Consilium组和对照组在每位患者的事件中没有发现显著差异(比值比0.742,90%CI0.455~1.206).然而,多元回归模型显示,Consilium组和"化疗"因子之间的相互作用项在5%水平上显著(P=.048).这激发了相应的亚组分析,表明在接受化疗的患者亚组中,干预组的风险相关降低。相应的比值比为0.53,90%CI0.288-0.957相当于Consilium组患者的风险减半,并表明临床相关效应在双侧10%水平上显著(P=.08,Fisher精确检验)。
    结论:PRO研究的计划外会诊和住院情况与来自癌症患者的可比队列的回顾性数据的比较表明,定期使用基于应用程序的ePRO对接受化疗的患者具有积极作用。这些数据将在正在进行的随机PRO2研究(在ClinicalTrials.gov;NCT05425550注册)中得到验证。
    背景:ClinicalTrials.govNCT03578731;https://www.clinicaltrials.gov/ct2/show/NCT03578731.
    RR2-10.2196/29271。
    BACKGROUND: The evaluation of electronic patient-reported outcomes (ePROs) is increasingly being used in clinical studies of patients with cancer and enables structured and standardized data collection in patients\' everyday lives. So far, few studies or analyses have focused on the medical benefit of ePROs for patients.
    OBJECTIVE: The current exploratory analysis aimed to obtain an initial indication of whether the use of the Consilium Care app (recently renamed medidux; mobile Health AG) for structured and regular self-assessment of side effects by ePROs had a recognizable effect on incidences of unplanned consultations and hospitalizations of patients with cancer compared to a control group in a real-world care setting without app use. To analyze this, the incidences of unplanned consultations and hospitalizations of patients with cancer using the Consilium Care app that were recorded by the treating physicians as part of the patient reported outcome (PRO) study were compared retrospectively to corresponding data from a comparable population of patients with cancer collected at 2 Swiss oncology centers during standard-of-care treatment.
    METHODS: Patients with cancer in the PRO study (178 included in this analysis) receiving systemic therapy in a neoadjuvant or noncurative setting performed a self-assessment of side effects via the Consilium Care app over an observational period of 90 days. In this period, unplanned (emergency) consultations and hospitalizations were documented by the participating physicians. The incidence of these events was compared with retrospective data obtained from 2 Swiss tumor centers for a matched cohort of patients with cancer.
    RESULTS: Both patient groups were comparable in terms of age and gender ratio, as well as the distribution of cancer entities and Joint Committee on Cancer stages. In total, 139 patients from each group were treated with chemotherapy and 39 with other therapies. Looking at all patients, no significant difference in events per patient was found between the Consilium group and the control group (odds ratio 0.742, 90% CI 0.455-1.206). However, a multivariate regression model revealed that the interaction term between the Consilium group and the factor \"chemotherapy\" was significant at the 5% level (P=.048). This motivated a corresponding subgroup analysis that indicated a relevant reduction of the risk for the intervention group in the subgroup of patients who underwent chemotherapy. The corresponding odds ratio of 0.53, 90% CI 0.288-0.957 is equivalent to a halving of the risk for patients in the Consilium group and suggests a clinically relevant effect that is significant at a 2-sided 10% level (P=.08, Fisher exact test).
    CONCLUSIONS: A comparison of unplanned consultations and hospitalizations from the PRO study with retrospective data from a comparable cohort of patients with cancer suggests a positive effect of regular app-based ePROs for patients receiving chemotherapy. These data are to be verified in the ongoing randomized PRO2 study (registered on ClinicalTrials.gov; NCT05425550).
    BACKGROUND: ClinicalTrials.gov NCT03578731; https://www.clinicaltrials.gov/ct2/show/NCT03578731.
    UNASSIGNED: RR2-10.2196/29271.
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  • 文章类型: Journal Article
    背景:曲妥珠单抗对人类表皮生长因子受体2(HER2)阳性乳腺癌(BC)的治疗产生了重大影响。抗HER2生物类似物如Ogivri在临床试验中已证明与曲妥珠单抗(使用赫赛汀作为参考产品)的安全性和临床等效性。据我们所知,对于使用电子患者报告结局(ePROs)的生物仿制药治疗患者的副作用和生活质量(QoL),目前尚无真实报道.
    目的:这项前瞻性观察性研究(OGIPRO研究)的主要目的是比较在接受曲妥珠单抗生物相似物Ogivri(前瞻性队列)治疗的HER2阳性BC患者中,与治疗副作用相关的ePRO数据。从单独使用Herceptin或联合使用Pertuzinmab和/或N2007CT031N35ctoalv治疗的历史
    方法:患者在(新)辅助和姑息治疗中单独使用Ogivri或与帕妥珠单抗和/或化疗和激素疗法联合使用。患者使用medidux应用程序动态记录症状(根据不良事件通用术语标准[CTCAE]),幸福感(根据东部肿瘤协作组绩效状态量表),QoL(使用EQ-5D-5L问卷),认知能力,和重要参数超过6周。主要终点是平均CTCAE评分。关键次要终点包括平均幸福感评分。将该前瞻性队列的数据与历史队列的数据进行比较(n=38例患者;中位年龄51,范围31-78岁)。
    结果:总体而言,53名中位年龄为54岁(范围31-87岁)的女性患者被纳入OGIPRO研究。分析了50例患者的平均CTCAE评分,这些患者有关于症状的可用数据,而在有可用数据的52例患者中评估了平均幸福感评分。两个队列中最常见的症状包括疲劳,味觉障碍,恶心,腹泻,粘膜干燥,关节不适,刺痛,睡眠障碍,头痛,和食欲减退。大多数患者在两个队列中都经历了轻微(0级)或轻度(1级)毒性。前瞻性和历史队列的平均CTCAE评分具有可比性(分别为29.0和30.3;平均差-1.27,95%CI-7.24至4.70;P=.68)。同样,曲妥珠单抗生物相似物Ogivri和赫赛汀治疗组的平均健康评分无显著差异(分别为74.3和69.8;平均差异4.45,95%CI-3.53~12.44;P=.28).
    结论:用曲妥珠单抗生物仿制药Ogivri治疗HER2阳性BC患者可产生等效症状,不良事件,以及通过ePRO数据确定的接受赫赛汀治疗的患者的健康状况。因此,当调查真实世界的耐受性和类似治疗化合物的结果时,将ePRO系统集成到研究和临床实践中可以提供可靠的信息.
    背景:ClinicalTrials.govNCT05234021;https://clinicaltrials.gov/study/NCT05234021。
    BACKGROUND: Trastuzumab has had a major impact on the treatment of human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC). Anti-HER2 biosimilars such as Ogivri have demonstrated safety and clinical equivalence to trastuzumab (using Herceptin as the reference product) in clinical trials. To our knowledge, there has been no real-world report of the side effects and quality of life (QoL) in patients treated with biosimilars using electronic patient-reported outcomes (ePROs).
    OBJECTIVE: The primary objective of this prospective observational study (OGIPRO study) was to compare the ePRO data related to treatment side effects collected with the medidux app in patients with HER2-positive BC treated with the trastuzumab biosimilar Ogivri (prospective cohort) to those obtained from historical cohorts treated with Herceptin alone or combined with pertuzumab and/or chemotherapy (ClinicalTrials.gov NCT02004496 and NCT03578731).
    METHODS: Patients were treated with Ogivri alone or combined with pertuzumab and/or chemotherapy and hormone therapy in (neo)adjuvant and palliative settings. Patients used the medidux app to dynamically record symptoms (according to the Common Terminology Criteria for Adverse Events [CTCAE]), well-being (according to the Eastern Cooperative Oncology Group Performance Status scale), QoL (using the EQ-5D-5L questionnaire), cognitive capabilities, and vital parameters over 6 weeks. The primary endpoint was the mean CTCAE score. Key secondary endpoints included the mean well-being score. Data of this prospective cohort were compared with those of the historical cohorts (n=38 patients; median age 51, range 31-78 years).
    RESULTS: Overall, 53 female patients with a median age of 54 years (range 31-87 years) were enrolled in the OGIPRO study. The mean CTCAE score was analyzed in 50 patients with available data on symptoms, while the mean well-being score was evaluated in 52 patients with available data. The most common symptoms reported in both cohorts included fatigue, taste disorder, nausea, diarrhea, dry mucosa, joint discomfort, tingling, sleep disorder, headache, and appetite loss. Most patients experienced minimal (grade 0) or mild (grade 1) toxicities in both cohorts. The mean CTCAE score was comparable between the prospective and historical cohorts (29.0 and 30.3, respectively; mean difference -1.27, 95% CI -7.24 to 4.70; P=.68). Similarly, no significant difference was found for the mean well-being score between the groups treated with the trastuzumab biosimilar Ogivri and Herceptin (74.3 and 69.8, respectively; mean difference 4.45, 95% CI -3.53 to 12.44; P=.28).
    CONCLUSIONS: Treatment of patients with HER2-positive BC with the trastuzumab biosimilar Ogivri resulted in equivalent symptoms, adverse events, and well-being as found for patients treated with Herceptin as determined by ePRO data. Hence, integration of an ePRO system into research and clinical practice can provide reliable information when investigating the real-world tolerability and outcomes of similar therapeutic compounds.
    BACKGROUND: ClinicalTrials.gov NCT05234021; https://clinicaltrials.gov/study/NCT05234021.
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