End points for sickle cell disease clinical trials: renal and cardiopulmonary, cure, and low-resource settings.

Farrell AT1, Panepinto J2, Desai AA3, Kassim AA4, Lebensburger J5, Walters MC6, Bauer DE7,8,9, Blaylark RM10,11, DiMichele DM12, Gladwin MT13, Green NS14, Hassell K15, Kato GJ16, Klings ES17, Kohn DB18,19,20, Krishnamurti L21, Little J22, Makani J23, Malik P24,25, McGann PT24,25, Minniti C26, Morris CR27,28, Odame I29,30, Oneal PA1, Setse R1, Sharma P31, Shenoy S32.

Author information

1: US Food and Drug Administration, White Oak, MD.
2: Pediatric Hematology, Medical College of Wisconsin/Children's Wisconsin, Milwaukee, WI.
3: Krannert Institute of Cardiology, Department of Medicine, Indiana University, Indianapolis, IN.
4: Division of Hematology/Oncology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN.
5: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL.
6: UCSF Benioff Children's Hospital, Oakland, CA.
7: Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA.
8: Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA.
9: Department of Pediatrics, Harvard Medical School, Boston, MA.
10: Children's Hospitals and Clinics of MN, Minneapolis, MN.
11: Sickle Cell Foundation of Minnesota, Minneapolis, MN.
12: National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
13: Pittsburgh Heart, Lung, and Blood Vascular Medicine Institute, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
14: Department of Pediatrics, Columbia University Medical Center, New York, NY.
15: Division of Hematology, Department of Medicine, University of Colorado, Aurora, CO.
16: Division of Hematology-Oncology and Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
17: The Pulmonary Center, Boston University School of Medicine, Boston, MA.
18: Department of Microbiology, Immunology & Molecular Genetics.
19: Department of Pediatrics, and.
20: Department of Molecular & Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
21: Aflac Cancer and Blood Disorders Center, Emory University, Children's Healthcare of Atlanta, Atlanta, GA.
22: Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC.
23: Department of Haematology and Blood Transfusion, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania.
24: Cancer and Blood Disease Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
25: Department of Pediatrics, University of Cincinnati, Cincinnati, OH.
26: Division of Hematology, Montefiore Health System, Albert Einstein College of Medicine, New York, NY.
27: Division of Pediatric Emergency Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
28: Children's Healthcare of Atlanta, Atlanta, GA.
29: The Hospital for Sick Children, Toronto, ON, Canada.
30: University of Toronto, Toronto, ON, Canada.
31: Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD; and.
32: Division of Pediatric Hematology Oncology and Stem Cell Transplant, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO.

Abstract

To address the global burden of sickle cell disease and the need for novel therapies, the American Society of Hematology partnered with the US Food and Drug Administration to engage the work of 7 panels of clinicians, investigators, and patients to develop consensus recommendations for clinical trial end points. The panels conducted their work through literature reviews, assessment of available evidence, and expert judgment focusing on end points related to patient-reported outcome, pain (non-patient-reported outcomes), the brain, end-organ considerations, biomarkers, measurement of cure, and low-resource settings. This article presents the findings and recommendations of the end-organ considerations, measurement of cure, and low-resource settings panels as well as relevant findings and recommendations from the biomarkers panel.