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探索重症肌无力的结局和特征:登记研究的原理、目的和设计 - EXPLORE-MG 登记研究。

Exploring outcomes and characteristics of myasthenia gravis: Rationale, aims and design of registry - The EXPLORE-MG registry.

机构信息

Department of Neurology, Yale School of Medicine, New Haven, CT, USA.

Department of Neurology, Yale School of Medicine, New Haven, CT, USA; Department of Immunobiology, Yale School of Medicine, New Haven, CT, USA.

出版信息

J Neurol Sci. 2020 Jul 15;414:116830. doi: 10.1016/j.jns.2020.116830. Epub 2020 Apr 16.

Abstract

OBJECTIVES

Though much information exists about the diagnosis, treatment, and epidemiology of myasthenia gravis (MG), a comprehensive data registry and biorepository is critical to better understand disease mechanisms, treatment outcomes, and the impact of treatment strategies. We aimed to design and implement the "Exploring Outcomes and Characteristics of Myasthenia Gravis (EXPLORE-MG) Registry" to address these knowledge gaps.

METHODS

A web-based, non-interventional, longitudinal, observational disease and outcomes registry was developed; incorporating NIH recommended common data elements for the study of MG. Individuals diagnosed with MG based on prespecified criteria were eligible to participate. The registry was further strengthened by a complementary biorepository. An interim analysis was completed on registry data collected through data-lock in 2017.

RESULTS

A total of 232 MG patients, followed at the Yale MG Clinic from 2011 to 2017, were enrolled, which included 2142 total visit entries. Of the 232 MG patients (mean age 60 years, range 17-99; female:male, 1.04:1), 165 were acetylcholine receptor antibody-positive, 20 were muscle-specific kinase antibody-positive, and 47 were seronegative. This cohort consisted of 64 patients with ocular disease, 168 patients with generalized disease, and 65 patients post-thymectomy, including 20 with thymoma-associated MG.

CONCLUSIONS

Identification of key clinical features that may predict treatment responsiveness or provide insight into patient outcomes is essential to improve patient care. As current research focuses on the development of patient-tailored, targeted-treatment regimens, this registry can help provide important clinical and epidemiological data from a large contemporary patient cohort with long-term follow-up.

REGISTRATION

ClinicalTrials.gov Identifier: NCT03792659.

摘要

目的

尽管有大量关于重症肌无力 (MG) 的诊断、治疗和流行病学的信息,但全面的数据登记和生物库对于更好地了解疾病机制、治疗结果以及治疗策略的影响至关重要。我们旨在设计和实施“探索重症肌无力特征和结局 (EXPLORE-MG) 登记研究”以解决这些知识空白。

方法

我们开发了一个基于网络的、非干预性的、纵向的、观察性疾病和结局登记研究,纳入了 NIH 推荐的用于 MG 研究的常见数据元素。符合既定标准的 MG 患者有资格参与。该登记研究通过补充生物库进一步得到加强。2017 年通过数据锁定完成了登记研究数据的中期分析。

结果

共纳入 232 例 2011 年至 2017 年在耶鲁大学 MG 诊所就诊的 MG 患者,共包括 2142 次就诊记录。232 例 MG 患者(平均年龄 60 岁,范围 17-99 岁;女性:男性,1.04:1)中,165 例乙酰胆碱受体抗体阳性,20 例肌特异性激酶抗体阳性,47 例抗体阴性。该队列包括 64 例眼肌型疾病患者、168 例全身型疾病患者和 65 例胸腺切除术后患者,其中 20 例为胸腺瘤相关 MG。

结论

确定可能预测治疗反应性或为患者结局提供深入了解的关键临床特征对于改善患者护理至关重要。由于目前的研究侧重于开发针对患者的靶向治疗方案,该登记研究可以帮助从一个具有长期随访的大型当代患者队列中提供重要的临床和流行病学数据。

登记信息

ClinicalTrials.gov 标识符:NCT03792659。

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