Boczán Judit, Klivényi Péter, Kálmán Bernadette, Széll Márta, Karcagi Veronika, Zádori Dénes, Molnár Judit Mária
Debreceni Egyetem, Általános Orvosi Kar, Neurológiai Tanszék, Debrecen.
Szegedi Tudományegyetem, Neurológiai Klinika, Szeged.
Ideggyogy Sz. 2021 Mar 30;74(3-4):79-86. doi: 10.18071/isz.74.0079.
Background - Spinal muscular atrophy (SMA) is an autosomal recessive, progressive neuromuscular disorder resulting in a loss of lower motoneurons. Recently, new disease-modifying treatments (two drugs for splicing modification of SMN2 and one for SMN1 gene replacement) have become available. Purpose - The new drugs change the progression of SMA with neonatal and childhood onset. Increasing amount of data are available about the effects of these drugs in adult patients with SMA. In this article, we summarize the available data of new SMA therapies in adult patients.
Methods - Members of the Executive Committee of the Hungarian Clinical Neurogenetic Society surveyed the literature for palliative treatments, randomized controlled trials, and retrospective and prospective studies using disease modifying therapies in adult patients with SMA. Patients - We evaluated the outcomes of studies focused on treatments of adult patients mainly with SMA II and III.
In this paper, we present our consensus statement in nine points covering palliative care, technical, medical and safety considerations, patient selection, and long-term monitoring of adult patients with SMA.
This consensus statement aims to support the most efficient management of adult patients with SMA, and provides information about treatment efficacy and safety to be considered during personalized therapy. It also highlights open questions needed to be answered in future. Using this recommendation in clinical practice can result in optimization of therapy.
背景 - 脊髓性肌萎缩症(SMA)是一种常染色体隐性进行性神经肌肉疾病,会导致下运动神经元丧失。最近,新型疾病修正疗法(两种用于对SMN2进行剪接修饰的药物和一种用于SMN1基因替代的药物)已可供使用。目的 - 这些新药改变了新生儿和儿童期发病的SMA的疾病进展。关于这些药物对成年SMA患者影响的数据越来越多。在本文中,我们总结了成年SMA患者新型治疗方法的现有数据。
方法 - 匈牙利临床神经遗传学学会执行委员会成员查阅了有关姑息治疗、随机对照试验以及对成年SMA患者使用疾病修正疗法的回顾性和前瞻性研究的文献。患者 - 我们评估了主要针对II型和III型成年SMA患者治疗的研究结果。
在本文中,我们提出了九点共识声明,涵盖姑息治疗、技术、医学和安全考量、患者选择以及成年SMA患者的长期监测。
本共识声明旨在支持对成年SMA患者进行最有效的管理,并提供个性化治疗期间需考虑的治疗疗效和安全性信息。它还突出了未来需要回答的开放性问题。在临床实践中使用本建议可实现治疗的优化。