TY - JOUR JF - Clinical Journal of the American Society of Nephrology A1 - Parfrey, PS A1 - Block, GA A1 - Correa-Rotter, R A1 - Drueke, TB A1 - Floege, J A1 - Herzog, CA A1 - London, GM A1 - Mahaffey, KW A1 - Moe, SM A1 - Wheeler, DC A1 - Chertow, GM ID - discovery1472692 N2 - The effect of the calcimimetic cinacalcet on cardiovascular disease in patients undergoing hemodialysis with secondary hyperparathyroidism (sHPT) was evaluated in the EVOLVE trial. This was the largest (in size) and longest (in duration) randomized controlled clinical trial undertaken in this population. During planning, execution, analysis and reporting of the trial many lessons were learned, including those related to the use of a composite cardiovascular primary endpoint, definition of endpoints (particularly heart failure and severe unremitting HPT), importance of age for optimal stratification at randomization, use of unadjusted and adjusted intention-to-treat analysis for the primary outcome, how to respond to a lower than predicted event rate during the trial, development of a pre-specified analytic plan that accounted for non-adherence and for co-interventions that diminished the power of the trial to observe a treatment effect, determination of the credibility of a subgroup effect, use of adverse effects database to investigate rare diseases, collection of blood for biomarker measurement not designated prior to trial initiation, and interpretation of the benefits to harms ratio for individual patients. It is likely that many of these issues will arise in planning of future trials in chronic kidney disease. SN - 1555-905X PB - American Society of Nephrology UR - http://dx.doi.org/10.2215/CJN.06370615 IS - 3 TI - Lessons learned from EVOLVE for the planning of future global randomized trials in chronic kidney disease EP - 546 AV - public Y1 - 2016/05/27/ VL - 11 SP - 539 ER -