Rethinking clinical trials in restless legs syndrome: A roadmap.

Garcia-Borreguero, Diego; Black, Jed; Earley, Christopher J; Fulda, Stephany; Högl, Birgit; Manconi, Mauro; Ondo, William; Roth, Thomas; Trenkwalder, Claudia; Winkelman, John W (2024). Rethinking clinical trials in restless legs syndrome: A roadmap. Sleep medicine reviews, 77(101978), p. 101978. Elsevier 10.1016/j.smrv.2024.101978

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The number of large clinical trials of restless legs syndrome (RLS) have decreased in recent years, this coincides with reduced interest in developing and testing novel pharmaceuticals. Therefore, the International Restless Legs Syndrome Study Group (IRLSSG) formed a task force of global experts to examine the causes of these trends and make recommendations to facilitate new clinical trials. In our article, we delve into potential complications linked to the diagnostic definition of RLS, identify subpopulations necessitating more attention, and highlight issues pertaining to endpoints and study frameworks. In particular, we recommend developing alternative scoring methods for more accurate RLS diagnosis, thereby improving clinical trial specificity. Furthermore, enhancing the precision of endpoints will increase study effect sizes and mitigate study costs. Suggestions to achieve this include developing online, real-time sleep diaries with high-frequency sampling of nightly sleep latency and the use of PLMs as surrogate markers. Furthermore, to reduce the placebo response, strategies should be adopted that include placebo run-in periods. As RLS is frequently a chronic condition, priority should be given to long-term studies, using a randomized, placebo-controlled, withdrawal design. Lastly, new populations should be investigated to develop targeted treatments such as mild RLS, pregnancy, hemodialysis, or iron-deficient anemia.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Manconi, Mauro

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1532-2955

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

09 Aug 2024 13:43

Last Modified:

10 Sep 2024 00:15

Publisher DOI:

10.1016/j.smrv.2024.101978

PubMed ID:

39102777

Uncontrolled Keywords:

Clinical trials Endpoints Future Industry Pharmaceutical Restless legs syndrome Study designs Treatment

BORIS DOI:

10.48350/199504

URI:

https://boris.unibe.ch/id/eprint/199504

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