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一种用于确定脊髓性肌萎缩症发病率和适合研究人群的多源方法。

A multi-source approach to determine SMA incidence and research ready population.

作者信息

Verhaart Ingrid E C, Robertson Agata, Leary Rebecca, McMacken Grace, König Kirsten, Kirschner Janbernd, Jones Cynthia C, Cook Suzanne F, Lochmüller Hanns

机构信息

John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK.

Clinical Trials Unit, Medical Center, University of Freiburg, Freiburg, Germany.

出版信息

J Neurol. 2017 Jul;264(7):1465-1473. doi: 10.1007/s00415-017-8549-1. Epub 2017 Jun 20.

Abstract

In spinal muscular atrophy (SMA), degeneration of motor neurons causes progressive muscular weakness, which is caused by homozygous deletion of the SMN1 gene. Available epidemiological data on SMA are scarce, often outdated, and limited to relatively small regions or populations. Combining data from different sources including genetic laboratories and patient registries may provide better insight of the disease epidemiology. To investigate the incidence of genetically confirmed SMA, and the number of patients who are able and approachable to participate in new clinical trials and observational research, we used both genetic laboratories, the TREAT-NMD Global SMA Patient Registry and the Care and Trial Sites Registry (CTSR). In Europe, 4653 patients were genetically diagnosed by the genetic laboratories in the 5-year period 2011 to 2015, with 992 diagnosed in 2015 alone. The data provide an estimated incidence of SMA in Europe of 1 in 3900-16,000 live births. Patient numbers in the national patient registries and CTSR were considerably lower. By far, most patients registered in the national patient registries and the CTSR live in Europe and are reported to have SMA type II. Considerable differences between countries in patient participation in the registries were observed. Our findings indicate that not all patients with SMA are accessed by specialist healthcare services and these patients may not have access to research opportunities and optimal care.

摘要

在脊髓性肌萎缩症(SMA)中,运动神经元变性导致进行性肌无力,这是由SMN1基因的纯合缺失引起的。现有的关于SMA的流行病学数据稀缺,往往过时,且仅限于相对较小的地区或人群。整合来自不同来源的数据,包括基因实验室和患者登记处的数据,可能会更好地洞察该疾病的流行病学情况。为了调查基因确诊的SMA的发病率,以及有能力且可参与新临床试验和观察性研究的患者数量,我们使用了基因实验室、TREAT-NMD全球SMA患者登记处和护理与试验站点登记处(CTSR)。在欧洲,2011年至2015年的5年期间,基因实验室对4653例患者进行了基因诊断,仅2015年就诊断出992例。这些数据表明,欧洲SMA的估计发病率为每3900 - 16000例活产中有1例。国家患者登记处和CTSR中的患者数量要少得多。到目前为止,在国家患者登记处和CTSR中登记的大多数患者生活在欧洲,据报告患有II型SMA。观察到各国在患者参与登记方面存在相当大的差异。我们的研究结果表明,并非所有SMA患者都能获得专科医疗服务,这些患者可能无法获得研究机会和最佳护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38a0/5502065/eb550a0bb75b/415_2017_8549_Fig1_HTML.jpg

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