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自然病史、临床试验准备和基因发现:神经肌肉疾病患者登记研究的进展。

Natural History, Trial Readiness and Gene Discovery: Advances in Patient Registries for Neuromuscular Disease.

机构信息

MRC Centre for Neuromuscular Diseases, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, NE1 3BZ, UK.

出版信息

Adv Exp Med Biol. 2017;1031:97-124. doi: 10.1007/978-3-319-67144-4_5.

Abstract

Inherited neuromuscular diseases (NMDs) are genetic disorders that affect the skeletal muscles or the nerves controlling muscle function. With a new generation of diagnostic options and recent advances in translational research improving the opportunities for therapy development for these rare conditions, capturing patient information in databases collecting a range of clinical and genetic data together with contact details has assumed an increasingly important role in trial planning and recruitment as well as natural history data collection. Here we provide an overview of a decade of patient registration activities in the NMD field, with a particular focus on patient registries set up with trial readiness in mind. A summary is provided of databases collecting precise genetic information focused on confirming the causative mutation and their evolution into registries that combine genetic data with additional clinical information useful for trial feasibility and recruitment. Use of these systems for a range of purposes beyond trial recruitment, including natural history assessment, care standards monitoring, genotype-phenotype correlation and disease burden evaluation is also described within the context of research networks (TREAT-NMD) and European Reference Networks (ERN-EURO-NMD). New initiatives including registries using controlled vocabularies for computational accessibility that focus on phenotypic data capture for gene discovery are analysed, and examples of the lessons learned at every stage are provided in order to allow new patient registration initiatives to benefit from the extensive experience gained.

摘要

遗传性神经肌肉疾病(NMDs)是一类遗传疾病,影响骨骼肌或控制肌肉功能的神经。随着新一代诊断选择和转化研究的最新进展,为这些罕见疾病的治疗开发提供了更多机会,因此,在临床试验规划和招募以及自然病史数据收集方面,将一系列临床和遗传数据以及联系方式一起纳入数据库中记录患者信息,已变得越来越重要。在这里,我们概述了 NMD 领域十年来的患者登记活动,重点介绍了为临床试验准备而设立的患者登记处。本文还概述了专注于确认致病突变的精确遗传信息数据库的建立及其发展成为综合遗传数据和其他有助于临床试验可行性和招募的临床信息的登记处。在研究网络(TREAT-NMD)和欧洲参考网络(ERN-EURO-NMD)的背景下,还描述了这些系统在临床试验招募以外的各种用途,包括自然病史评估、护理标准监测、基因型-表型相关性和疾病负担评估。本文还分析了包括使用计算可访问性控制词汇表的登记处在内的新举措,这些举措专注于基因发现的表型数据捕获,并提供了在每个阶段获得的经验教训,以便使新的患者登记倡议能够受益于所获得的广泛经验。

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