Endpoint Selection in Rare Disease Trials: Composite Measures and the Loss of Interpretability

Authors

  • Gabija Jankauskaite Department of Rare Disease Medicine, Zanavykai Institute of Molecular Therapeutics, Sakiai, Lithuania Author
  • Reka Vamosi Department of Biostatistics, Orseg Centre for Experimental Therapeutics, Szentgotthard, Hungary Author
  • Carina Grabherr Centre for Clinical Trials Methodology, Ennstal Centre for Experimental Therapeutics, Liezen, Austria Author

DOI:

https://doi.org/10.5281/zenodo.22649538

Keywords:

Endpoint Selection in Rare Disease Trials;, Translational medicine; Evidence synthesis;, Clinical implementation; Health services research

Abstract

Endpoint Selection in Rare Disease Trials is an area of active development in translational medicine, with evidence that has
accumulated unevenly across its component questions. We review the current evidence base for endpoint selection in rare disease
trials, spanning analytical, clinical, implementation, governance, and economic dimensions, focusing on where practice has
converged and where it continues to vary, and set out the practical considerations relevant to a service considering its adoption.
We conclude that selective, context-specific use is best supported by the evidence currently available, rather than uniform
adoption or avoidance.

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Castellani R, Ristic C, et al. "Endpoint Selection in Rare Disease Trials: a multicentre analysis". Contemp Clin Trials 32(2017): 432-443. DOI: 10.1016/j.mayocpiqo.2022.09.004

Dumitrescu A, Andric D, et al. "Endpoint Selection in Rare Disease Trials: a prospective cohort study". Ther Innov Regul Sci 34(2020): 443-455. DOI: 10.1177/08404704241291226

Eriksdottir B, Brankovic E, et al. "Endpoint Selection in Rare Disease Trials: a randomised evaluation". Br J Clin Pharmacol 36(2023): 454-467. DOI: 10.1093/medlaw/fwad013

Farkas I, Ionescu F, et al. "Endpoint Selection in Rare Disease Trials: a consensus statement". PLoS Med 38(2011): 465-479. DOI: 10.2196/89834

Grabowski P, Petrescu G, et al. "Endpoint Selection in Rare Disease Trials: a retrospective analysis". Lancet 40(2014): 476-482. DOI: 10.1007/s10916-024-02104-9

Hendriksen W, Wojcik H, et al. "Endpoint Selection in Rare Disease Trials: a validation study". N Engl J Med 42(2017): 487-494. DOI: 10.3389/fdgth.2026.1896184

Ionescu F, Foscarini I, et al. "Endpoint Selection in Rare Disease Trials: a scoping review". JAMA 44(2020): 498-506. DOI: 10.3390/diagnostics15162117

Jankowiak G, Grabowski J, et al. "Endpoint Selection in Rare Disease Trials: a health-economic analysis". Nat Med 46(2023): 509-518. DOI: 10.4103/jrpp.jrpp_20_65

Kowalczyk N, Novotna K, et al. "Endpoint Selection in Rare Disease Trials: a systematic review". Cell Rep Med 8(2011): 520-530. DOI: 10.3389/fdgth.2026.1763884

Lindqvist U, Urbanek L, et al. "Endpoint Selection in Rare Disease Trials: a methodological appraisal". Clin Transl Sci 10(2014): 531-542. DOI: 10.2196/48297

Marchetti D, Doncheva M, et al. "Endpoint Selection in Rare Disease Trials: a multicentre analysis". Pharmacogenomics J 12(2017): 542-554. DOI: 10.1007/s00330-025-12031-z

Novotna E, Eriksdottir N, et al. "Endpoint Selection in Rare Disease Trials: a prospective cohort study". Regul Toxicol Pharmacol 14(2020): 553-566. DOI: 10.3389/fdgth.2026.1699005

Ostrowski L, Lindqvist O, et al. "Endpoint Selection in Rare Disease Trials: a randomised evaluation". Drug Saf 16(2023): 564-578. DOI: 10.3389/fdgth.2026.1834800

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Published

2026-02-11

How to Cite

Endpoint Selection in Rare Disease Trials: Composite Measures and the Loss of Interpretability. (2026). Translational Medicine & Therapeutics Journal, 5(2), 10-18. https://doi.org/10.5281/zenodo.22649538

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