Collaboration between patient organisations and a clinical research sponsor in a rare disease condition: learnings from a community advisory board and best practice for future collaborations

Annelise Roennow, Maureen Sauvé, Joep Welling, Robert J Riggs, Ann Tyrrell Kennedy, Ilaria Galetti, Edith Brown, Catarina Leite, Alex Gonzalez, Alexandra Paula Portales Guiraud, François Houÿez, Rob Camp, Annie Gilbert, Martina Gahlemann, Lizette Moros, Jose Luis Luna Flores, Friedrich Schmidt, Wiebke Sauter, Henrik Finnern, Annelise Roennow, Maureen Sauvé, Joep Welling, Robert J Riggs, Ann Tyrrell Kennedy, Ilaria Galetti, Edith Brown, Catarina Leite, Alex Gonzalez, Alexandra Paula Portales Guiraud, François Houÿez, Rob Camp, Annie Gilbert, Martina Gahlemann, Lizette Moros, Jose Luis Luna Flores, Friedrich Schmidt, Wiebke Sauter, Henrik Finnern

Abstract

Introduction Transparent collaborations between patient organisations (POs) and clinical research sponsors (CRS) can identify and address the unmet needs of patients and caregivers. These insights can improve clinical trial participant experience and delivery of medical innovations necessary to advance health outcomes and standards of care. We share our experiences from such a collaboration undertaken surrounding the SENSCIS® clinical trial (NCT02597933), and discuss its impact during, and legacy beyond, the trial.Summary We describe the establishment of a community advisory board (CAB): a transparent, multiyear collaboration between the scleroderma patient community and a CRS. We present shared learnings from the collaboration, which is split into three main areas: (1) the implementation and conduct of the clinical trial; (2) analysis and dissemination of the results; and (3) aspects of the collaboration not related to the trial.1. The scleroderma CAB reviewed and provided advice on trial conduct and reporting. This led to the improvement and optimisation of trial procedures; meaningful, patient-focused adaptations were made to address challenges relevant to scleroderma-associated interstitial lung disease patients.2. To ensure that results of the trial were accessible to lay audiences and patients, written lay summaries were developed by the trial sponsor with valuable input from the CAB to ensure that language and figures were understandable.3. The CAB and the CRS also collaborated to co-develop opening tools for medication blister packs and bottles. In addition, to raise disease awareness among physicians, patients and caregivers, educational materials to improve diagnosis and management of scleroderma were co-created and delivered by the CAB and CRS.Conclusions This collaboration between POs and a CRS, in a rare disease condition, led to meaningful improvements in patient safety, comfort and self-management and addressed information needs. This collaboration may serve as a template of best practice for future collaborations between POs, research sponsors and other healthcare stakeholders.

Keywords: clinical trials; interstitial lung disease; medical education & training.

Conflict of interest statement

Competing interests: The authors have read and understood the BMJ policy on declaration of interests and have the following interests to declare:AR, MS, JW, RJR, ATK, IG, EB, CL, AGo, APPG, FH and RC did not receive any personal payments for their contributions to this article.AR, MS, JW, RJR, ATK, IG, EB, CL and APPG declare payments from Boehringer Ingelheim International GmbH to their respective POs (FESCA aisbl., Scleroderma Canada and Scleroderma Foundation, USA) for participation in community advisory board meetings and payment of travel expenses. AGo declares that Boehringer Ingelheim International GmbH paid for their travel expenses for participation in community advisory board meetings. AR, MS, JW and RJR declare that their POs (FESCA aisbl., Scleroderma Canada and Scleroderma Foundation, USA) received additional payments from Boehringer Ingelheim International GmbH for speaker and advisory services including payment of travel expenses. FH and RC declare that Boehringer Ingelheim International GmbH paid for their travel expenses for speaker and advisory services including one BI internal meeting and community advisory board meetings.RJR declares that the Scleroderma Foundation (USA) has received sponsorships in support of the annual scleroderma awareness raising campaign and the Scleroderma National Patient Education Conference from both Boehringer Ingelheim International GmbH and Boehringer Ingelheim Pharmaceuticals. FH and RC declare that EURORDIS-Rare Diseases Europe has received sponsorships from Boehringer Ingelheim International GmbH for the EURORDIS Round Table of Companies and the European Conference on Rare Diseases and Orphan Products. AR and ATK declare that FESCA aisbl. has received sponsorships in support of their annual scleroderma awareness raising campaign and World Scleroderma Conference from Boehringer Ingelheim International GmbH. MS declares that Scleroderma Canada has received sponsorships in support of their Scleroderma Canada Patient Conference from Boehringer Ingelheim International GmbH. These sponsorships are not related to this article. AGi has worked with the research sponsor (BI) as a paid consultant since September 2016. MG, LM, JLLF, FS, WS and HF are paid employees of the research sponsor (BI).

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Areas covered by the memorandum of understanding between the research sponsor and scleroderma patient organisations.* Signed by Canadian and European Scleroderma patient organisations.
Figure 2
Figure 2
Process for receiving and implementing CAB advice. CAB, community advisory board.
Figure 3
Figure 3
Patient-focused adaptations to the scleroderma-associated interstitial lung disease trial based on the community advisory board's advice.
Figure 4
Figure 4
3D design images of the medication opening tools for bottles and blister packs.
Figure 5
Figure 5
SO RARE disease awareness cards designed for physicians and patients. The image of hands used in the SO RARE cards is an Alamy Stock Photo, licensed for use until November 2022 (reference OY20206909)).

References

    1. Holm KE, Casaburi R, Cerreta S, et al. . Patient involvement in the design of a patient-centered clinical trial to promote adherence to supplemental oxygen therapy in COPD. Patient 2016;9:271–9. 10.1007/s40271-015-0150-z
    1. Price A, Albarqouni L, Kirkpatrick J, et al. . Patient and public involvement in the design of clinical trials: an overview of systematic reviews. J Eval Clin Pract 2018;24:240–53. 10.1111/jep.12805
    1. Pushparajah DS. Making patient engagement a reality. Patient 2018;11:1–8. 10.1007/s40271-017-0264-6
    1. US Food & Drug Administration CDER patient-focused drug development, 2019. Available: [Accessed 5 Dec 2019].
    1. European Medicines Agency EMA and FDA reinforce collaboration on patient engagement, 2016. Available: [Accessed 5 Dec 2019].
    1. Cabinet Office (UK) Medicines, medical devices and blood regulation and safety: marketing authorisations, variations and licensing guidance, 2019. Available: [Accessed 5 Dec 2019].
    1. National Institute for Health and Care Excellence Making a positive impact, 2019. Available: [Accessed 5 Dec 2019].
    1. National Institute for Health and Care Excellence Guide to the processes of technology appraisal, 2018. Available: [Accessed 5 Dec 2019].
    1. Scottish Medicines Consortium Making a submission, 2019. Available: [Accessed 5 Dec 2019].
    1. European Network for Health Technology Assessment Submission & methodology, 2019. Available: [Accessed 5 Dec 2019].
    1. Innovative Medicines Initiative IMI mission and objectives, 2019. Available: [Accessed 5 Dec 2019].
    1. Patient Focused Medicines Development Integrating the voice of the patient across the lifecycle of medicine, 2019. Available: [Accessed 5 Dec 2019].
    1. International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use ICH Harmonised guideline: general considerations for clinical studies, 2019. Available: [Accessed 5 Dec 2019].
    1. European Patients' Academy Guidance for patient involvement in industry-led medicines R&D, 2016. Available: [Accessed 5 Dec 2019].
    1. The Denver principles. Women Alive 2000;12.
    1. Kwakkenbos L, Thombs BD, Khanna D, et al. . Performance of the patient-reported outcomes measurement information System-29 in scleroderma: a scleroderma patient-centered intervention network cohort study. Rheumatology 2017;56:1302–11. 10.1093/rheumatology/kex055
    1. Innovative Medicines Initiative Paradigm, 2019. Available: [Accessed 5 Dec 2019].
    1. PREFER Home page, 2019. Available: [Accessed 5 Dec 2019].
    1. Smith V, Scirè CA, Talarico R, et al. . Systemic sclerosis: state of the art on clinical practice guidelines. RMD Open 2018;4:e000782. 10.1136/rmdopen-2018-000782
    1. EURORDIS EURORDIS charter for collaboration in clinical research in rare diseases, 2009. Available: [Accessed 5 Dec 2019].
    1. Hoos A, Anderson J, Boutin M, et al. . Partnering with patients in the development and lifecycle of medicines: a call for action. Ther Innov Regul Sci 2015;49:929–39. 10.1177/2168479015580384
    1. Distler O, Allanore Y, Denton CP, et al. . Factors influencing early referral, early diagnosis and management in patients with diffuse cutaneous systemic sclerosis. Rheumatology 2018;57:813–7. 10.1093/rheumatology/kex504
    1. Page SJ, Persch AC, Recruitment PAC. Recruitment, retention, and blinding in clinical trials. Am J Occup Ther 2013;67:154–61. 10.5014/ajot.2013.006197
    1. Thornton H. Patient and public involvement in clinical trials. BMJ 2008;336:903–4. 10.1136/bmj.39547.586100.80
    1. Adams RJ. Improving health outcomes with better patient understanding and education. Risk Manag Healthc Policy 2010;3:61–72. 10.2147/RMHP.S7500
    1. Tapp H, Derkowski D, Calvert M, et al. . Patient perspectives on engagement in shared decision-making for asthma care. Fam Pract 2017;34:353–7. 10.1093/fampra/cmw122
    1. Stein S, Bogard E, Boice N, et al. . Principles for interactions with biopharmaceutical companies: the development of guidelines for patient advocacy organizations in the field of rare diseases. Orphanet J Rare Dis 2018;13:18. 10.1186/s13023-018-0761-2
    1. The Economist Intelligence Unit The innovation imperative: the future of drug development. Part I: research methods and findings, 2018. Available: [Accessed 10 Jan 2020].
    1. Supple D, Roberts A, Hudson V, et al. . From tokenism to meaningful engagement: best practices in patient involvement in an EU project. Res Involv Engagem 2015;1:5. 10.1186/s40900-015-0004-9
    1. Hunter A, Facey K, Thomas V, et al. . EUPATI guidance for patient involvement in medicines research and development: health technology assessment. Front Med 2018;5:270. 10.3389/fmed.2018.00231
    1. Kirwan JR, de Wit M, Frank L, et al. . Emerging guidelines for patient engagement in research. Value Health 2017;20:481–6. 10.1016/j.jval.2016.10.003
    1. Distler O, Highland KB, Gahlemann M, et al. . Nintedanib for systemic sclerosis-associated interstitial lung disease. N Engl J Med 2019;380:2518–28. 10.1056/NEJMoa1903076
    1. McCoy MS, Carniol M, Chockley K, et al. . Conflicts of interest for patient-advocacy organizations. N Engl J Med 2017;376:880–5. 10.1056/NEJMsr1610625
    1. Ozieranski P, Rickard E, Mulinari S. Exposing drug industry funding of UK patient organisations. BMJ 2019;365:l1806. 10.1136/bmj.l1806
    1. Moberly T. NHS joint working with industry is out of public sight. BMJ 2019;364:l1353. 10.1136/bmj.l1353
    1. Salisbury H. Helen Salisbury: who let the drug companies in? BMJ 2019;365:l1581. 10.1136/bmj.l1581
    1. efpia Working together with patients, 2019. Available:
    1. Association of the British Pharmaceutical Industry Code of practice for the pharmaceutical industry 2019, 2019. Available:
    1. European Medicines Agency Getting involved, 2019. Available: [Accessed 5 Dec 2019].
    1. Boehringer Ingelheim International GmbH, Federation of European Scleroderma Associations, The Scleroderma Society of Canada. Memorandum of understanding between Boehringer Ingelheim (BI), Federation of European Scleroderma Associations (FESCA), The Scleroderma Society of Canada (SSC) . Regarding the SENSCIS™ trial, its extension trial and areas of collaboration not related to the trial (the 'Collaboration'), 2016. Available: [Accessed 5 Dec 2019].
    1. Boehringer Ingelheim How we collaborate with patient organisations, 2018. Available: [Accessed 5 Dec 2019].
    1. Pauling JD, Saketkoo LA, Matucci-Cerinic M, et al. . The patient experience of Raynaud's phenomenon in systemic sclerosis. Rheumatology 2019;58:18–26. 10.1093/rheumatology/key026
    1. Watson HR, Robb R, Belcher G, et al. . Seasonal variation of Raynaud's phenomenon secondary to systemic sclerosis. J Rheumatol 1999;26:1734–7.
    1. European Commission Summaries of clinical trial results for laypersons, 2017. Available: [Accessed 5 Dec 2019].
    1. Boehringer Ingelheim GmbH A study to compare nintedanib with placebo for patients with scleroderma-related lung fibrosis (SENSCIS® study, 1199.214), 2019. Available: [Accessed 5 Dec 2019].
    1. Boehringer Ingelheim GmbH SENSCIS®: a study to compare nintedanib with placebo for patients with scleroderma-related lung fibrosis, 2019. Available: [Accessed 5 Dec 2019].
    1. YouMagine Blister pack opener, 2019. Available: [Accessed 5 Dec 2019].
    1. Thingiverse Blister pack opener, 2018. Available: [Accessed 5 Dec 2019].

Source: PubMed

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