Clinical efficacy assessment in severe vernal keratoconjunctivitis: preliminary validation of a new penalties-adjusted corneal fluorescein staining score

Introduction and objective: Vernal keratoconjunctivitis (VKC) is a rare allergic eye condition that occurs in children and is characterised by a combination of debilitating symptoms. Repeated use of topical corticosteroid rescue therapy is often necessary in severe forms. This study aims to assess t...

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Main Authors: Andrea Leonardi, Maëva Dupuis-Deniaud, Dominique Bremond-Gignac
Format: Article
Language:English
Published: MDPI AG 2020-01-01
Series:Journal of Market Access & Health Policy
Subjects:
Online Access:http://dx.doi.org/10.1080/20016689.2020.1748492
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author Andrea Leonardi
Maëva Dupuis-Deniaud
Dominique Bremond-Gignac
author_facet Andrea Leonardi
Maëva Dupuis-Deniaud
Dominique Bremond-Gignac
author_sort Andrea Leonardi
collection DOAJ
description Introduction and objective: Vernal keratoconjunctivitis (VKC) is a rare allergic eye condition that occurs in children and is characterised by a combination of debilitating symptoms. Repeated use of topical corticosteroid rescue therapy is often necessary in severe forms. This study aims to assess the validity of a new composite endpoint: the penalties-adjusted corneal staining score (PACS-S) proposed as primary endpoint in VEKTIS trial evaluating the efficacy of a new corticosteroid-sparing treatment, VERKAZIA® (ciclosporin 1 mg/ml eye drops), in severe VKC patients. Methodology: This research comprised a systematic literature review to identify efficacy endpoints being proposed in clinical trials for pediatric patients with severe VKC, followed by a remote expert advisory board assessing the validity of the PACS-S. Results: While no agreed or validated endpoint for assessing efficacy in VKC was identified when VEKTIS trial started, the experts’ board acknowledged a high face validity of PACS-S as a subjective integrated measure matching the current clinical practice. A fair external validity was considered with regards to VEKTIS trial secondary endpoints. Conclusion: PACS-S appears to be a reliable, valid and clinically meaningful primary endpoint that allows significant improvement over existing endpoints in severe VKC trials. Additional research is needed to validate this endpoint.
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spelling doaj-art-bbde86baff57484e87bb46715c8a43142025-08-20T02:54:40ZengMDPI AGJournal of Market Access & Health Policy2001-66892020-01-018110.1080/20016689.2020.17484921748492Clinical efficacy assessment in severe vernal keratoconjunctivitis: preliminary validation of a new penalties-adjusted corneal fluorescein staining scoreAndrea Leonardi0Maëva Dupuis-Deniaud1Dominique Bremond-Gignac2University of PaduaMDSTAT ConsultingParis Descartes UniversityIntroduction and objective: Vernal keratoconjunctivitis (VKC) is a rare allergic eye condition that occurs in children and is characterised by a combination of debilitating symptoms. Repeated use of topical corticosteroid rescue therapy is often necessary in severe forms. This study aims to assess the validity of a new composite endpoint: the penalties-adjusted corneal staining score (PACS-S) proposed as primary endpoint in VEKTIS trial evaluating the efficacy of a new corticosteroid-sparing treatment, VERKAZIA® (ciclosporin 1 mg/ml eye drops), in severe VKC patients. Methodology: This research comprised a systematic literature review to identify efficacy endpoints being proposed in clinical trials for pediatric patients with severe VKC, followed by a remote expert advisory board assessing the validity of the PACS-S. Results: While no agreed or validated endpoint for assessing efficacy in VKC was identified when VEKTIS trial started, the experts’ board acknowledged a high face validity of PACS-S as a subjective integrated measure matching the current clinical practice. A fair external validity was considered with regards to VEKTIS trial secondary endpoints. Conclusion: PACS-S appears to be a reliable, valid and clinically meaningful primary endpoint that allows significant improvement over existing endpoints in severe VKC trials. Additional research is needed to validate this endpoint.http://dx.doi.org/10.1080/20016689.2020.1748492severe vernal keratoconjunctivitisallergic keratoconjunctivitis penalties-adjusted corneal staining scoreendpointrescue therapyciclosporin
spellingShingle Andrea Leonardi
Maëva Dupuis-Deniaud
Dominique Bremond-Gignac
Clinical efficacy assessment in severe vernal keratoconjunctivitis: preliminary validation of a new penalties-adjusted corneal fluorescein staining score
Journal of Market Access & Health Policy
severe vernal keratoconjunctivitis
allergic keratoconjunctivitis penalties-adjusted corneal staining score
endpoint
rescue therapy
ciclosporin
title Clinical efficacy assessment in severe vernal keratoconjunctivitis: preliminary validation of a new penalties-adjusted corneal fluorescein staining score
title_full Clinical efficacy assessment in severe vernal keratoconjunctivitis: preliminary validation of a new penalties-adjusted corneal fluorescein staining score
title_fullStr Clinical efficacy assessment in severe vernal keratoconjunctivitis: preliminary validation of a new penalties-adjusted corneal fluorescein staining score
title_full_unstemmed Clinical efficacy assessment in severe vernal keratoconjunctivitis: preliminary validation of a new penalties-adjusted corneal fluorescein staining score
title_short Clinical efficacy assessment in severe vernal keratoconjunctivitis: preliminary validation of a new penalties-adjusted corneal fluorescein staining score
title_sort clinical efficacy assessment in severe vernal keratoconjunctivitis preliminary validation of a new penalties adjusted corneal fluorescein staining score
topic severe vernal keratoconjunctivitis
allergic keratoconjunctivitis penalties-adjusted corneal staining score
endpoint
rescue therapy
ciclosporin
url http://dx.doi.org/10.1080/20016689.2020.1748492
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AT dominiquebremondgignac clinicalefficacyassessmentinseverevernalkeratoconjunctivitispreliminaryvalidationofanewpenaltiesadjustedcornealfluoresceinstainingscore