Publications by authors named "Kevin Carroll"

Background: Chronic lung infection with Pseudomonas aeruginosa is associated with increased exacerbations and mortality in people with bronchiectasis. The PROMIS-I and PROMIS-II trials investigated the efficacy and safety of 12-months of inhaled colistimethate sodium delivered via the I-neb.

Methods: Two randomised, double-blind, placebo-controlled trials of twice per day colistimethate sodium versus placebo were conducted in patients with bronchiectasis with P aeruginosa and a history of at least two exacerbations requiring oral antibiotics or one requiring intravenous antibiotics in the previous year in hospitals in Argentina, Australia, Belgium, Canada, France, Germany, Greece, Israel, Italy, Netherlands, New Zealand, Poland, Portugal, Spain, Switzerland, the UK, and the USA.

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  • The CALCIPHYX trial tested hexasodium fytate, a potential treatment for calciphylaxis, a rare condition causing painful skin lesions, in a double-blind, placebo-controlled setting.
  • Out of the randomised patients, both those receiving hexasodium fytate and the placebo group showed similar improvements in wound assessment and pain scores after 12 weeks, indicating no significant benefit from the treatment over placebo.
  • Serious adverse events were lower in the fytate group compared to the placebo group, suggesting that hexasodium fytate may be safer, but there was no substantial difference in healing or pain reduction between the two groups.
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Stone, MH, Hornsby, G, Mizuguchi, S, Sato, K, Gahreman, D, Duca, M, Carroll, K, Ramsey, MW, Stone, ME, and Haff, GG. The use of free weight squats in sports: a narrative review-squatting movements, adaptation, and sports performance: physiological. J Strength Cond Res 38(8): 1494-1508, 2024-The squat and its variants can provide numerous benefits including positively affecting sports performance and injury prevention, injury severity reduction, and rehabilitation.

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In several therapeutic areas, including chronic kidney disease (CKD) and immunoglobulin A nephropathy (IgAN), there is a growing interest in how best to analyze estimated glomerular filtration rate (eGFR) data over time in randomized clinical trials including how to best accommodate situations where the rate of change is not anticipated to be linear over time, often due to possible short term hemodynamic effects of certain classes of interventions. In such situations, concerns have been expressed by regulatory authorities that the common application of single slope analysis models may induce Type I error inflation. This article aims to offer practical advice and guidance, including SAS codes, on the statistical methodology to be employed in an eGFR rate of change analysis and offers guidance on trial design considerations for eGFR endpoints.

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  • Duchenne muscular dystrophy (DMD) is a serious genetic disorder caused by a lack of dystrophin, and the study explores the potential of givinostat, a histone deacetylase inhibitor, to improve outcomes for affected children.* -
  • Conducted as a phase 3, double-blind, placebo-controlled trial across 41 sites in 11 countries, researchers tested the safety and efficacy of givinostat in boys aged 6 and older who were already on corticosteroid treatment.* -
  • The primary goal was to assess the four-stair climb performance after 72 weeks of treatment, comparing changes between those given givinostat and the placebo, while monitoring safety throughout the study.*
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When autistic youth are asked to assess their own social skills, they frequently rate themselves more favorably than their parents rate them. The magnitude of this informant discrepancy has been shown to relate to key clinical outcomes such as treatment response. It has been proposed that this discrepancy arises from difficulties with Theory of Mind.

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  • Patients with chronic kidney disease (CKD) are at a higher risk of being hospitalized for heart failure, especially when treated with daprodustat compared to the conventional drug darbepoetin, although the difference isn't statistically significant.
  • The study analyzed data from two trials, ASCEND-D and ASCEND-ND, focusing on how daprodustat impacts heart failure hospitalization rates among CKD patients with and without dialysis.
  • Key risk factors for heart failure hospitalizations included a history of heart failure, diabetes, and higher blood pressure, but the increase in hospitalizations attributed to daprodustat compared to conventional treatments wasn't statistically conclusive.
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Chae, S, Long, SA, Lis, RP, McDowell, KW, Wagle, JP, Carroll, KM, Mizuguchi, S, and Stone, MH. Combined accentuated eccentric loading and rest redistribution in high-volume back squat: Acute stimulus and fatigue. J Strength Cond Res 38(4): 648-655, 2024-The purpose of this study was to examine acute stimulus and fatigue responses to combined accentuated eccentric loading and rest redistribution (AEL + RR).

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Tunneled catheters are frequently used in patients with end-stage renal disease who require hemodialysis access. Catheter-related atrial thrombus is a documented complication of prolonged catheter use. The incidence of catheter-related atrial thrombus is 2% to 29%, with a high mortality rate approaching 20%, raising concerns for serious complications and death in the absence of an established universal management plan.

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Chae, S, Long, SA, Lis, RP, McDowell, KW, Wagle, JP, Carroll, KM, Mizuguchi, S, and Stone, MH. Combined accentuated eccentric loading and rest redistribution in high-volume back squat: Acute kinetics and kinematics. J Strength Cond Res 38(4): 640-647, 2024-The purpose of this study was to explore acute kinetic and kinematic responses to combined accentuated eccentric loading and rest redistribution (AEL + RR).

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Random coefficient (RC) models are commonly used in clinical trials to estimate the rate of change over time in longitudinal data. Trials utilizing a surrogate endpoint for accelerated approval with a confirmatory longitudinal endpoint to show clinical benefit is a strategy implemented across various therapeutic areas, including immunoglobulin A nephropathy. Understanding conditional power (CP) and information fraction calculations of RC models may help in the design of clinical trials as well as provide support for the confirmatory endpoint at the time of accelerated approval.

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Burke, BI, Carroll, KM, Travis, SK, Stone, ME, and Stone, MH. Two days versus four days of training cessation following a step-taper in powerlifters. J Strength Cond Res 37(12): e625-e632, 2023-Tapering and training cessation are methods of training load management aimed at optimizing athlete preparedness leading into competition.

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  • The ASCEND-ND trial raised concerns about daprodustat having a higher risk of cancer-related adverse events compared to darbepoetin in patients with anemia due to chronic kidney disease (CKD), but this was not seen in the dialysis-focused ASCEND-D trial.* -
  • Both trials involved randomizing patients to receive either daprodustat or various types of erythropoiesis-stimulating agents (ESAs), with different dosing schedules, and used statistical models to analyze the safety of the treatments.* -
  • The findings indicated that the perceived increased risk of cancer-related adverse events for daprodustat in ASCEND-ND may have been biased due to under-counting of events in the darbepo
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The relationship between asymmetry and performance is still undetermined in the literature. Methods of assessing asymmetry have been inconsistent and focused on the analysis of jumping asymmetry. Dual ground reaction forces are prevalent in athlete monitoring, though underutilized in asymmetry research.

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  • Daprodustat is being tested as an oral alternative to traditional ESAs for treating anemia in patients with chronic kidney disease starting dialysis, with limited past studies on this topic.
  • The clinical trial involved a randomized, open-label design across 90 centers in 14 countries, focusing on patients who were either set to begin dialysis soon or had started within the last 90 days.
  • The main goal was to compare the effectiveness and safety of daprodustat to darbepoetin alfa by assessing changes in hemoglobin levels and monitoring adverse events over a treatment period of 28 to 52 weeks.
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Background: Calcific uraemic arteriolopathy (CUA; calciphylaxis) is a rare disease seen predominantly in patients receiving dialysis. Calciphylaxis is characterized by poorly healing or non-healing wounds, and is associated with mortality, substantial morbidity related to infection and typically severe pain. In an open-label Phase 2 clinical trial, SNF472, a selective inhibitor of vascular calcification, was well-tolerated and associated with improvement in wound healing, reduction of wound-related pain and improvement in wound-related quality of life (QoL).

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  • Anaemia is a common issue for patients with chronic kidney disease (CKD), and it's crucial to evaluate new treatments like daprodustat compared to the existing drug, darbepoetin alfa.
  • The ASCEND-ND trial involved 3,872 adult participants across 39 countries, focusing on those with specific hemoglobin levels and assessing various health characteristics related to CKD.
  • The study aims to determine the effectiveness and safety of daprodustat in treating CKD-related anaemia in patients not on dialysis, providing important insights into managing this condition.
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  • Daprodustat, a new oral treatment for anemia in chronic kidney disease (CKD) patients not on dialysis, was compared to the standard treatment darbepoetin alfa in a phase 3 clinical trial to evaluate effectiveness and safety.* -
  • The study included 3872 participants, revealing that daprodustat resulted in a slightly higher increase in hemoglobin levels (0.74 g/dL) compared to darbepoetin alfa (0.66 g/dL), meeting noninferiority benchmarks for effectiveness.* -
  • Cardiovascular safety outcomes showed daprodustat was also noninferior to darbepoetin alfa, with similar rates of major adverse cardiovascular events (19.5% vs. 19
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  • A phase 3 trial compared the effectiveness of an oral drug called daprodustat to injectable erythropoiesis-stimulating agents (ESAs) in increasing hemoglobin levels in CKD patients on dialysis with low hemoglobin.
  • Results showed that daprodustat increased hemoglobin by an average of 0.28 g/dL, while the ESA group had an increase of 0.10 g/dL, indicating that daprodustat was noninferior to ESAs.
  • Cardiovascular events were similar in both groups, with 25.2% of daprodustat patients and 26.7% of ESA patients experiencing major adverse events, confirming dap
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Batch-to-batch pharmacokinetic (PK) variability of orally inhaled drug products has been documented and can render single-batch PK bioequivalence (BE) studies unreliable; results from one batch may not be consistent with a repeated study using a different batch, yet the goal of PK BE is to deliver a product comparison that is interpretable beyond the specific batches used in the study. We characterized four multiple-batch PK BE approaches to improve outcome reliability without increasing the number of clinical study participants. Three approaches include multiple batches directly in the PK BE study with batch identity either excluded from the statistical model ("Superbatch") or included as a fixed or random effect ("Fixed Batch Effect," "Random Batch Effect").

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Pharmacokinetic differences between manufacturing batches, well established for inhaled drug products, preclude control of patient risk in the customary two-way (single batch) pharmacokinetic bioequivalence crossover design if batches are randomly chosen. European regulators have recommended selecting a "typical" in vitro batch to represent each product in pharmacokinetic bioequivalence testing. We explored the feasibility of this approach to control patient risk (the "false equivalence", or Type I, error rate).

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Shiga toxin-producing (STEC) can cause severe disease and large outbreaks. In England, the incidence and clinical significance of STEC serogroups other than O157 (non-O157) is unknown due to a testing bias for detection of STEC O157. Since 2013, the implementation of PCR to detect all STEC serogroups by an increasing number of diagnostic laboratories has led to an increase in the detection of non-O157 STEC.

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An outbreak surveillance system for Salmonella integrating whole genome sequencing (WGS) and epidemiological data was developed in South East and London in 2016-17 to assess local WGS clusters for triage and investigation. Cases genetically linked within a 5 single-nucleotide polymorphism (SNP) single linkage cluster were assessed using a set of locally agreed thresholds based on time, person and place, for reporting to local health protection teams (HPTs). Between September 2016 and September 2017, 230 unique 5-SNP clusters (442 weekly reports) of non-typhoidal Salmonella 5-SNP WGS clusters were identified, of which 208 unique 5-SNP clusters (316 weekly reports) were not reported to the HPTs.

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