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一项为期 3 年的成人 GNE 肌病非干预性、观察性疾病监测项目的结果。

Results from a 3-year Non-interventional, Observational Disease Monitoring Program in Adults with GNE Myopathy.

机构信息

Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK.

APHP, Centre de référence de pathologie neuromusculaire, Institut de Myologie, Groupe Hospitalier Pitié-Salpetrière, Paris, France.

出版信息

J Neuromuscul Dis. 2021;8(2):225-234. doi: 10.3233/JND-200565.

Abstract

BACKGROUND

GNE myopathy is a rare, autosomal recessive, muscle disease caused by mutations in GNE and is characterized by rimmed vacuoles on muscle biopsy and progressive distal to proximal muscle weakness.

OBJECTIVE

Investigate the clinical presentation and progression of GNE myopathy.

METHODS

The GNE Myopathy Disease Monitoring Program was an international, prospective, observational study in subjects with GNE myopathy. Muscle strength was assessed with hand-held dynamometry (HHD), with upper extremity (UE) and lower extremity (LE) composite scores reflecting upper and lower extremity muscle groups, respectively. The GNE myopathy-Functional Activity Scale (GNEM-FAS) was used to further assess impairment in mobility, upper extremity function, and self-care.

RESULTS

Eighty-seven of 101 enrolled subjects completed the trial until study closure by the sponsor; 60 completed 36 months. Mean (SD) HHD UE composite score decreased from 34.3 kg (32.0) at baseline to 29.4 kg (32.6) kg at month 36 (LS mean change [95%CI]: -3.8 kg [-5.9, -1.7]; P = 0.0005). Mean (SD) HHD LE composite score decreased from 32.0 kg (34.1) at baseline to 25.5 kg (31.2) at month 36 (LS mean change [95%CI]: -4.9 [-7.7, -2.2]; P = 0.0005). GNEM-FAS scores were more severe at baseline in subjects who walked <200 meters versus ≥200 meters in 6 minutes; in both groups, GNEM-FAS total, mobility, UE, and self-care scores decreased from baseline through month 36.

CONCLUSIONS

These findings demonstrate progressive decline in muscle strength in GNE myopathy and provide insight into the appropriate tools to detect clinically meaningful changes in future GNE myopathy interventional trials.

摘要

背景

GNE 肌病是一种罕见的常染色体隐性遗传性肌肉疾病,由 GNE 基因突变引起,其特征是肌肉活检时有镶边空泡和进行性远近端肌肉无力。

目的

研究 GNE 肌病的临床表现和进展。

方法

GNE 肌病疾病监测计划是一项国际、前瞻性、观察性研究,纳入 GNE 肌病患者。肌肉力量采用手持测力计(HHD)进行评估,上肢(UE)和下肢(LE)综合评分分别反映上肢和下肢肌群。GNE 肌病-功能活动量表(GNEM-FAS)用于进一步评估运动、上肢功能和自我护理的受损情况。

结果

在研究赞助商关闭研究之前,101 名入组患者中有 87 名完成了试验;60 名患者完成了 36 个月的试验。HHD UE 综合评分的平均值(标准差)从基线时的 34.3 kg(32.0)下降到 36 个月时的 29.4 kg(32.6)(LS 均值变化[95%CI]:-3.8 kg[-5.9,-1.7];P=0.0005)。HHD LE 综合评分的平均值(标准差)从基线时的 32.0 kg(34.1)下降到 36 个月时的 25.5 kg(31.2)(LS 均值变化[95%CI]:-4.9 [-7.7,-2.2];P=0.0005)。在 6 分钟内行走<200 米的患者基线时 GNEM-FAS 评分更严重,而在这两组患者中,GNEM-FAS 总分、移动能力、上肢和自我护理评分均从基线下降至 36 个月。

结论

这些发现表明 GNE 肌病的肌肉力量逐渐下降,并提供了关于在未来 GNE 肌病干预试验中检测有临床意义变化的适当工具的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d72a/8075380/1052f39041dd/jnd-8-jnd200565-g001.jpg

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