Evidence map›Paper›PMID 41091701›Full record

ArticlePloS one2025

Key outcomes in treatment of activated phosphoinositide 3-kinase delta syndrome: An e-Delphi panel study and responder threshold application.

Julia E M Upton, Kelli W Williams, Andrew Cant, Ana Santos, João Bana E Costa, Jason Bradt, Amanda Harrington, Chad Gwaltney

Registry-linked trialAbstract readConsensus Statement
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02435173 (An Open-label, Non-randomized, Within-patient Dose-finding Study Followed by a Randomized, Subject, Investigator and Sponsor Blinded Placebo Controlled Study to Assess the Efficacy and Safety of CDZ173), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02435173 phase2 / phase3completednot on this map

An Open-label, Non-randomized, Within-patient Dose-finding Study Followed by a Randomized, Subject, Investigator and Sponsor Blinded Placebo Controlled Study to Assess the Efficacy and Safety of CDZ173 (Leniolisib) in Patients With APDS/PASLI (Activated Phosphoinositide 3-kinase Delta Syndrome/ p110δ-activating Mutation Causing Senescent T Cells, Lymphadenopathy and Immunodeficiency)

TypeinterventionalSponsorNovartis PharmaceuticalsRan2015 to 2021Enrolled37ConditionsCommon Variable Immunodeficiency (CVID), APDS / PASLIArmsCDZ173, Placebo
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Julia E M UptonDivision of Immunology and Allergy, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0001-5320-4232
Kelli W WilliamsMedical University of South Carolina, Charleston, South Carolina, United States of America.
Andrew CantNewcastle University, Newcastle upon Tyne, United Kingdom.
Ana SantosCEGIST, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.
João Bana E CostaDecision Eyes Lda, Lisbon, Portugal.
Jason BradtPharming Healthcare, Inc., Warren, New Jersey, United States of America.
Amanda HarringtonPharming Healthcare, Inc., Warren, New Jersey, United States of America.ORCID https://orcid.org/0009-0001-8294-5002
Chad GwaltneyGwaltney Consulting, Westerly, Rhode Island, United States of America.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundActivated phosphoinositide 3-kinase delta syndrome (APDS) is an ultra-rare, underrecognized inborn error of immunity. This study aimed to identify outcomes important in evaluating APDS treatment effectiveness and percent change in specific outcomes indicating a clinically meaningful benefit.

methodsIn this e-Delphi panel study, 28 globally based APDS experts used a 5-point Likert scale (Strongly Disagree to Strongly Agree) to indicate level of agreement that an outcome was an important measure of APDS treatment effectiveness in adult and pediatric patients at 3 and 6 months after treatment initiation. A threshold of ≥75% responding with "Agree" or "Strongly Agree" was considered consensus. Percent meaningful improvement in 6 outcomes was assessed and applied to APDS trial data (NCT02435173).

resultsTwenty-four panelists participated; e-Delphi rounds 1-5 were completed by 23, 21, 18, 17, and 16 panelists, respectively. Outcomes with the highest degree of consensus included lymph node size/volume, clinician overall impression of disease activity, antibiotic use, patient/caregiver-reported social outcomes and patient quality of life, hospitalizations, thrombocytopenia, spleen volume, lymphopenia, and anemia. Panelists indicated within-patient clinically meaningful improvements in adult patients ranged from median values of 20%-25% in lymph nodes, naïve B-cell to total B-cell ratio, spleen volume, hemoglobin, platelets, and lymphocytes at 3 months, and 25%-30% at 6 months. Panelists indicated within-patient clinically meaningful improvements in pediatric patients ranged from median values of 20%-27.5% at 3 months and 22.5%-45% at 6 months in the same 6 outcomes. In an application of responder thresholds, treatment with leniolisib resulted in significant and meaningful improvements in disease hallmarks, including lymph node size, spleen volume, and naïve B-cell ratio.

conclusionThis study provides expert consensus on outcomes important in assessing APDS treatment effectiveness and improvement thresholds in 6 treatment outcomes indicative of a clinically meaningful benefit. These outcomes may help optimize APDS treatment in the clinic.

Indexed as

Class I Phosphatidylinositol 3-KinasesPrimary Immunodeficiency DiseasesAdultChildFemaleHumansMaleQuality of LifeTreatment OutcomeClass I Phosphatidylinositol 3-Kinases

Identifiers

PMID41091701
PMCPMC12527126

What Socratic holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.