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Table 2 Core outcomes proposed across inflammatory conditions

From: Outcome selection for tissue-agnostic drug trials for immune-mediated inflammatory diseases: a systematic review of core outcome sets and regulatory guidance

Category

Domain

Sub-domain/group

RA [50]

AS [22]

PsA [39]

SS [60]

CD [30]

UC [30]

SLE [56]

jSLE

JIA

Uv [64]

Sum

Disease activity

             
 

Patient global assessment of wellbeing

 

✓†

✓*†

✓*†

    

✓*†

✓*

 

5

 

Clinician global assessment of disease activity

 

✓†

 

✓*

  

✓*

✓

✓*†

✓*

 

6

 

Disease activity

 

✓*

✓

 

✓†

✓*†

✓*†

✓*†~

✓*†

✓*

 

8

  

Low disease activity

✓*

         

1

 

Musculoskeletal (MSK) disease activity

Peripheral joints

 

✓*†

✓*†

       

2

  

Enthesitis

 

✓*†

✓*†

     

✓

 

3

  

Dactylitis

  

✓*†

     

✓

 

2

  

Spine symptoms

  

✓*†

       

1

 

Tender joints

 

✓*†

✓

        

2

 

Swollen joints

 

✓*†

✓*

        

2

 

Joint or structural damage

 

✓*†

✓*†

✓*

     

✓

✓†

5

 

Organ damage

    

✓†

  

✓*†~

✓*

  

3

 

Systemic inflammation

   

✓*†

       

1

 

Ocular surface damage

    

✓

      

1

 

Visual acuity

          

✓†

1

 

Grade of cells in anterior chamber

          

✓†

1

 

Grade of flare in anterior chamber

          

✓†

1

 

Flares

       

✓*

   

1

 

Comorbidities

 

✓†

         

1

 

Biomarkers

Auto-antibody status

✓†

  

✓

   

✓†

  

3

  

Anti-drug antibody

     

✓*

    

1

  

Acute phase reactants

✓*†

✓*†

✓*

 

✓*

✓*

  

✓*

 

6

  

Unspecified

      

✓

  

✓†

2

 

Laboratory indices

        

✓*†

  

1

 

MAS

         

✓

 

1

 

Skin disease activity

Skin

  

✓*†

       

1

  

Nails

  

✓*†

       

1

  

Itching

  

✓†

       

1

 

Perianal disease activity

            
  

Dev of perianal abscess

    

✓

     

1

  

Dev of a new/recurrent fistula

    

✓

     

1

  

Unplanned surgical intervention

    

✓

     

1

  

Faecal diversion/ proctectomy

    

✓

     

1

Clinical endpoints

Mucosal healing (endoscopic)

     

✓*~

✓*

    

2

 

Histological evaluation of mucosal inflammation

      

✓*

    

1

 

Symptomatic remission

     

✓*

✓*

    

2

 

Clinical remission

 

✓*†

   

✓*†~

✓†*

    

3

 

Remission without steroid

     

✓*~

✓*

    

2

 

Complete clinical response

     

✓~

     

1

 

Sustained clinical benefit

     

✓~

     

1

 

Radiological remission

     

✓~

     

1

 

Radiological response

     

✓~

     

1

 

Deep remission

     

✓~

     

1

 

Occlusive symptoms (absence)

     

✓~

     

1

 

Endoscopic remission

     

✓~

      
 

Bowel damage progression

     

✓~

     

1

 

Treatment and therapeutic failure

     

✓~

     

1

 

Long term efficacy

     

✓~

     

1

 

Steroid free

     

✓~

     

1

 

Clinical success/benefit

     

✓~

     

1

 

Fistula healing

     

✓*

     

1

 

Time to remission

     

✓*

✓*

    

2

 

Time to response

     

✓*

✓*

    

2

 

Clinical assessment of drainage

     

✓*

     

1

 

Salivary flow

    

✓

      

1

 

Ophthalmic outcome

    

✓

      

1

 

Symptom free survival

     

✓~

     

1

 

Overall survival

     

✓†

✓†

    

2

 

Colorectal cancer

     

✓†

✓†

    

2

Symptoms, QOL, function

             
 

Pain

 

✓*†

✓*†

✓*†

 

✓†

✓†

  

✓*

 

6

 

Anaemia

     

✓†

✓†

    

2

 

Morning stiffness

         

✓*

 

1

 

Spinal stiffness and mobility

  

✓*†

        

1

 

Fatigue

 

✓*

✓*†

✓†

✓

✓†

✓†

✓*

 

✓

 

8

 

Fever

         

✓

 

1

 

HRQOL (Generic)

 

✓†

✓*

✓*†

✓†

✓

 

✓*†~

✓*

✓

✓†

9

 

HRQOL (Specific)

  

✓*

✓*†

✓

✓*~

✓*

✓*~

   

6

 

Physical function/Disability

 

✓*†

✓*†

✓*†

 

✓†~

✓†~

✓*

  

✓†

7

 

Function (General)

 

✓*

  

✓†

    

✓*

 

3

 

Psychosocial function

 

✓

   

✓

    

✓

3

 

Psychological health/emotional well being

 

✓

 

✓

 

✓#

✓

    

4

 

Sexual activity

     

✓#

     

1

 

Overall control

     

✓

✓

    

2

 

Work limitation/productivity

 

✓

✓

✓

 

✓#

 

✓*

   

5

 

Sicca symptoms

Dry eyes

   

✓†

      

1

  

Dry mouth

   

✓†

      

1

 

Change in bowel symptoms

     

✓†

✓†

    

2

 

Rectal bleeding

      

✓*

    

1

 

Stool frequency

      

✓*

    

1

 

Stool consistency

      

✓

    

1

 

Impact of fistula

     

✓

✓

    

2

 

Global assessment of incontinence

     

✓

     

1

Healthcare utilisation

             
 

Surgery

 

✓

   

✓~

✓

   

✓

4

 

Reduction in surgical procedures

     

✓*

     

1

 

Time spent/number of hospital visits

     

✓†

✓†

   

✓†

3

 

DMARD use

 

✓†

       

✓

 

2

 

Steroid use

 

✓†

   

✓†

✓*†

✓*~

  

✓

5

 

Non-drug treatments

 

✓

         

1

Others

             
 

SAE/safety outcomes

    

✓

 

✓*†

✓†~

 

✓

 

4

 

Toxicity

    

✓

  

✓†

   

2

 

Death/cause of death

 

✓

    

✓

✓~

   

3

 

Cost/Cost-effectiveness

    

✓

      

1

 

Weight

 

✓†

   

✓†

✓†

    

3

 

Nutritional status

     

✓

✓

    

2

 

Disease duration

 

✓†

         

1

 

Smoking

 

✓†

         

1

Paediatric-specific

             
 

Parent global assessment of disease activity

      

✓

 

✓†

  

2

 

Growth

     

✓*

✓

 

✓†

✓

 

4

 

Improved growth pattern

     

✓*

     

1

 

Normalised growth

     

✓*

     

1

 

School absence

          

✓†

1

 

Extra-intestinal manifestations

     

✓*

     

1

  1. AS ankylosing spondylitis, CD Crohn’s disease, DMARDs disease-modifying anti-rheumatic drugs, HRQOL health-related quality of life, JIA juvenile idiopathic arthritis, MAS macrophage activation syndrome, PsA psoriatic arthritis, RA rheumatoid arthritis, SAE serious adverse event, SLE systemic lupus erythematosus, jSLE juvenile SLE, SS Sjogren’s syndrome, UC ulcerative colitis, uV uveitis
  2. *Suggested by EMA and/or FDA
  3. †Proposed as part of core outcome set by non-regulatory research groups
  4. # It was suggested that these 3 domains along with ‘Lifestyle restriction based on toileting needs’ be combined to give a ‘patient priorities’ score (Sahnan 2018)
  5. ~ Proposed as critical or important endpoints for CD by Danese et al. [25] or suggested as endpoints for SLE by Gordon [54]
  6. Definitions
  7. Symptomatic remission—complete absence of occlusive symptoms—abdominal pain and/or nausea and/or vomiting and/or bloating and/or diet restriction after meals (Danese 2018)
  8. Sustained clinical benefit—no additional treatment and daily life nearly symptom-free, or additional treatment (except surgery) with good function in society
  9. Radiological remission—bowel wall thickness (< 3 mm), bowel dilation (diameter < 25 mm). Bowel stricture (diameter > 10 mm)
  10. Deep remission—complete mucosal healing and clinical/biochemical remission (defined as HBI score < 5 ± CRP < 5 mg/L or calprotectin < 50 mg/g)
  11. Treatment failure - Any CD-related surgery, or hospitalisation, or penetrating complication, or need for corticosteroids or biological drug
  12. Therapeutic failure - CD-related surgery, or drug discontinuation because of lack of efficacy, or loss of response, or failure to respond to dose escalation or intolerance, or drug switched to another drug because of inadequate response/loss of response
  13. Fistula healing - Closure and maintenance of closed fistula without development of new fistulas or abscesses