Affiliation:
1. IQVIA, Stockholm, Sweden
2. IQVIA, London, UK
3. PTC Therapeutics Switzerland GmbH, Zug, Switzerland
Abstract
Background: Clinical medical management guidelines of Duchenne muscular dystrophy (DMD) emphasize prevention and early identification and treatment. Objective: The objective of our study was to review, synthesize, and grade published evidence of the impact of the timing of clinical interventions in DMD. Methods: We searched PubMed, Embase, and the Cochrane Library for records published from inception up until November 19, 2021, reporting evidence of the impact of the timing of clinical interventions in DMD. We assessed the quality of evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. Results: We included 12 publications encompassing 1,623 patients with DMD from seven countries (Australia, France, Germany, Italy, Japan, the United Kingdom, and the United States of America). Six (50%) studies reported evidence of an impact of the timing of initiation of glucocorticoids on loss of ambulation, cardiomyopathy, fractures, forced vital capacity, and height and BMI; four (33%) of cardiac medication (i.e., angiotensin-converting enzyme inhibitors, β-blockers, and eplerenone) on left ventricular size and function and survival; one (8%) of lower limb surgery on motor quotient and loss of ambulation; and one (8%) of ataluren on lower extremity and motor function. The overall quality of the body of evidence was low. Conclusion: While there is a clinical rationale for anticipatory diagnostic and therapeutic strategies, evidence of the impact of the timing of initiation of treatments in patients with DMD is still emerging. Further research of this topic is warranted to inform treatment guidelines in this indication.
Subject
Neurology (clinical),Neurology
Reference22 articles.
1. The muscular dystrophies;Emery;Lancet,2002
2. Diagnosis and management of Duchenne muscular dystrophy, part Diagnosis, and neuromuscular, rehabilitation, endocrine, and gastrointestinal and nutritional management;Birnkrant;Lancet Neurol,2018
3. Health-Related Quality of Life in Patients with Duchenne Muscular Dystrophy: A Multi-National, Cross-Sectional Study;Landfeldt;Dev Med Child Neurol,2016
4. Duchenne muscular dystrophy and caregiver burden: A systematic review;Landfeldt;Dev Med Child Neurol,2018
5. The Burden of Duchenne Muscular Dystrophy: An International, Cross-Sectional Study;Landfeldt;Neurology,2014
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