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日本肌肉萎缩症新型全国登记系统(Remudy)中杜氏和贝克型肌肉萎缩症患者的特征

Characteristics of Japanese Duchenne and Becker muscular dystrophy patients in a novel Japanese national registry of muscular dystrophy (Remudy).

作者信息

Nakamura Harumasa, Kimura En, Mori-Yoshimura Madoka, Komaki Hirofumi, Matsuda Yu, Goto Kanako, Hayashi Yukiko K, Nishino Ichizo, Takeda Shin'ichi, Kawai Mitsuru

出版信息

Orphanet J Rare Dis. 2013 Apr 19;8:60. doi: 10.1186/1750-1172-8-60.

Abstract

BACKGROUND

Currently, clinical trials for new therapeutic strategies are being planned for Duchenne and Becker muscular dystrophies (DMD/BMD). However, it is difficult to obtain adequate numbers of patients in clinical trials. As solutions to these problems, patient registries are an important resource worldwide, especially in rare diseases such as DMD/BMD.

METHODS

We developed a national registry of Japanese DMD/BMD patients in collaboration with TREAT-NMD. The registry includes male Japanese DMD/BMD patients whose genetic status has been confirmed by genetic analysis. The registry includes patients throughout Japan.

RESULTS

As of February 2012, 583 DMD and 105 BMD patients were registered. Most individuals aged less than 20 years. In terms of genetic mutations of registrants of DMD and BMD, deletion of exons was the most frequent (61.4% and 79.0%) followed by point mutations (24.5% and 14.3%) and duplications (13.6% and 4.8%), respectively. 43.6% of DMD are capable of walking, and 76.2% of BMD registrants are able to walk. 41.1% of DMD registrants in the database were treated using steroids. 29.5% of DMD and 23.8% of BMD registrants were prescribed one cardiac medicine at least. 22% of DMD used ventilator support, and non-invasive support was common. Small numbers of DMD and BMD registrants, only 3.9% and 1.0% of them, have received scoliosis surgery. 57 (9.8%) patients were eligible to clinical trial focused on 'skipping' exon 51.

CONCLUSIONS

The Remudy has already demonstrated utility in clinical researches and standardization of patients care for DMD/BMD. This new DMD/BMD patient registry facilitates the synchronization of clinical drug development in Japan with that in other countries.

摘要

背景

目前,正在为杜氏和贝克氏肌营养不良症(DMD/BMD)规划新治疗策略的临床试验。然而,在临床试验中很难获得足够数量的患者。作为解决这些问题的办法,患者登记库是全球重要的资源,尤其是在DMD/BMD等罕见病领域。

方法

我们与TREAT-NMD合作建立了日本DMD/BMD患者全国登记库。该登记库纳入了经基因分析确认基因状态的日本男性DMD/BMD患者。登记库涵盖了全日本的患者。

结果

截至2012年2月,登记了583例DMD患者和105例BMD患者。大多数患者年龄小于20岁。就DMD和BMD登记者的基因突变而言,外显子缺失最为常见(分别为61.4%和79.0%),其次是点突变(分别为24.5%和14.3%)和重复(分别为13.6%和4.8%)。43.6%的DMD患者能够行走,76.2%的BMD登记者能够行走。数据库中41.1%的DMD登记者接受了类固醇治疗。29.5%的DMD登记者和23.8%的BMD登记者至少服用过一种心脏药物。22%的DMD患者使用了呼吸机支持,且无创支持较为常见。只有少量DMD和BMD登记者(分别仅为3.9%和1.0%)接受了脊柱侧弯手术。57名(9.8%)患者符合针对外显子51“跳跃”的临床试验条件。

结论

Remudy已在DMD/BMD的临床研究和患者护理标准化方面展现出效用。这个新的DMD/BMD患者登记库有助于日本临床药物研发与其他国家同步。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0653/3639029/5c22cde16fdd/1750-1172-8-60-1.jpg

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