Recommendations for the conduct of clinical trials for drugs to treat or prevent sarcopenia

Jean Yves Reginster, Cyrus C. Cooper, René Rizzoli, John A Kanis, Geoff Appelboom, Ivan Bautmans, Heike A. Bischoff-Ferrari, Maarten Boers, Maria Luisa Brandi, Olivier Bruyère, Antonio Cherubini, Bruno Flamion, Roger A. Fielding, Andrea Ildiko Gasparik, Luc van Loon, Eugene McCloskey, Bruce H. Mitlak, Alberto Pilotto, Suzanne Reiter-Niesert, Yves RollandYannis Tsouderos, Marjolein Visser, Alfonso J Cruz-Jentoft

Research output: Contribution to journalArticle

Abstract

PURPOSE: Sarcopenia is an age-related muscle condition which is frequently a precursor of frailty, mobility disability and premature death. It has a high prevalence in older populations and presents a considerable social and economic burden. Potential treatments are under development but, as yet, no guidelines support regulatory studies for new drugs to manage sarcopenia. The objective of this position paper is therefore to suggest a set of potential endpoints and target population definitions to stimulate debate and progress within the medico-scientific and regulatory communities.

METHODS: A multidisciplinary expert working group was hosted by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, which reviewed and discussed the recent literature from a perspective of clinical experience and guideline development. Relevant parallels were drawn from the development of definition of osteoporosis as a disease and clinical assessment of pharmaceutical treatments for that indication.

RESULTS: A case-finding decision tree is briefly reviewed with a discussion of recent prevalence estimations of different relevant threshold values. The selection criteria for patients in regulatory studies are discussed according to the aims of the investigation (sarcopenia prevention or treatment) and the stage of project development. The possible endpoints of such studies are reviewed and a plea is made for the establishment of a core outcome set to be used in all clinical trials of sarcopenia.

CONCLUSIONS: The current lack of guidelines for the assessment of new therapeutic treatments for sarcopenia could potentially hinder the delivery of effective medicines to patients at risk.

Original languageEnglish
Pages (from-to)47-58
Number of pages12
JournalAging clinical and experimental research
Volume28
Issue number1
DOIs
Publication statusPublished - Feb 2016

Keywords

  • Aged
  • Clinical Trials as Topic
  • Humans
  • Medication Therapy Management
  • Practice Guidelines as Topic
  • Research Design
  • Sarcopenia
  • Journal Article
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

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    Reginster, J. Y., Cooper, C. C., Rizzoli, R., Kanis, J. A., Appelboom, G., Bautmans, I., Bischoff-Ferrari, H. A., Boers, M., Brandi, M. L., Bruyère, O., Cherubini, A., Flamion, B., Fielding, R. A., Gasparik, A. I., van Loon, L., McCloskey, E., Mitlak, B. H., Pilotto, A., Reiter-Niesert, S., ... Cruz-Jentoft, A. J. (2016). Recommendations for the conduct of clinical trials for drugs to treat or prevent sarcopenia. Aging clinical and experimental research, 28(1), 47-58. https://doi.org/10.1007/s40520-015-0517-y