Marvel J, Gargon E, Howse C, Chohan A, Mayhew M, Kenney G, Stone L, Fisher BA, Steenackers M, Williamson N, Perella C, and Goswami P
Introduction: Several clinical outcome assessment (COA) instruments assess Sjögren's disease (Sjögren's) symptoms, but do not provide comprehensive assessment of the health-related quality of life (HRQoL) impact of Sjögren's. This study aimed to develop a patient-reported outcome (PRO) instrument for the assessment of HRQoL, intended for use in clinical trials and clinical practice in the assessment of treatment benefit., Methods: Review of study sponsor proprietary data and qualitative interviews informed the development of a conceptual model, the Sjögren's Related Quality of Life (SRQoL) and patient global impression of severity (PGI-S) and change (PGI-C) items. Combined concept elicitation and cognitive debriefing interviews with patients with Sjögren's explored their HRQoL impact experience and content validity of the SRQoL and PGI items., Results: Twenty participants were interviewed about their Sjögren's experience. Following inductive analysis of interviews, concepts were categorized into eight domains: emotional well-being (e.g., worry and stress; n = 20/20; 100%), sleep (e.g., daytime sleepiness and waking up during the night; n = 20/20; 100%), activities of daily living (e.g., difficulty looking at screens and difficulty driving; n = 20/20; 100%), cognition (e.g., concentration difficulties and word finding difficulties; n = 19/20; 95.0%), physical functioning (e.g., difficulty walking and difficulty exercising; n = 19/20; 95.0%), social and family functioning (e.g., dependent on others and relationship difficulties; n = 17/20; 85.0%), work (n = 15/20; 75.0%), and sexual functioning (n = 12/20; 60.0%). SRQoL and PGI items, instructions, response options, and recall period were well understood and relevant to participants., Conclusions: The SRQoL is a new PRO instrument to assess Sjögren's impact on HRQoL, developed in accordance with regulatory guidance. This study provides considerable insight into the patient experience of Sjögren's and evidence to support the content validity of the SRQoL. Future research should evaluate the psychometric properties of the SRQoL to support its use in clinical trials and clinical practice and further validate its use as an assessment of treatment benefit., Competing Interests: Declarations Conflict of Interest Jessica Marvel is an employee of Novartis Services Inc. Monia Steenackers, Chiara Perella, and Pushpendra Goswami are employees and shareholders of Novartis AG. Gayle Kenney was an employee and shareholder of Novartis AG at the time of this research. Elizabeth Gargon, Chloe Howse, Aishwarya Chohan, and Megan Mayhew are employees of Adelphi Values Ltd, a health outcomes agency who were paid by Novartis to conduct the research described in this manuscript. Nicola Williamson was an employee of Adelphi Values at the time of research and is now an employee and shareholder of UCB. Linda Stone has been a patient advocate representing Sjögren’s for Novartis and Servier. Benjamin Fisher has undertaken consultancy for Novartis, BMS, Servier, Galapagos, Roche, UCB, Sanofi, Janssen, Otsuka, Amgen, and AstraZeneca, and has received research funding from Janssen, Servier, Galapagos, Celgene, Novartis, and AstraZeneca. Ethical Approval Ethical approval and oversight was provided by Salus Institutional Review Board in the USA and Reading Independent Ethics Committee in the UK. Approval notices (protocol number NO9433A) were received in December 2022. The study was performed and developed in accordance with the Declaration of Helsinki and its later amendments in line with Good Clinical Practice guidelines. All subjects provided informed consent to participate in the study. Data Availability The datasets generated during and/or analyzed during the current study are not publicly available to protect participant confidentiality., (© 2024. The Author(s).)