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瑞士接受诺西那生治疗的脊髓性肌萎缩症患者的真实生活结局数据评估。

Evaluation of real-life outcome data of patients with spinal muscular atrophy treated with nusinersen in Switzerland.

作者信息

Tscherter Anne, Rüsch Christina T, Baumann Dominique, Enzmann Cornelia, Hasselmann Oswald, Jacquier David, Jung Hans H, Kruijshaar Michelle E, Kuehni Claudia E, Neuwirth Christoph, Stettner Georg M, Klein Andrea

机构信息

Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.

Department of Pediatric Neurology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.

出版信息

Neuromuscul Disord. 2022 May;32(5):399-409. doi: 10.1016/j.nmd.2022.02.001. Epub 2022 Feb 9.

Abstract

Spinal muscular atrophy (SMA) is an autosomal recessive disorder causing progressive proximal muscular, respiratory, and bulbar weakness. We present outcome data on motor function, ventilation, nutrition, and language development of SMA patients treated with nusinersen in Switzerland. This multicenter, observational study included 44 patients. At treatment initiation, after 2 months and then every 4 months we assessed motor function with the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP-INTEND), Hammersmith Functional Motor Scale expanded (HFMSE) and 6-Minute Walk Test (6MWT). At treatment initiation, patients were 0.1-44.6 years old, treatment duration ranged from 6 to 41 months. All 11 SMA type 1 children achieved higher CHOP-INTEND scores at the last assessment compared to treatment initiation, 4 acquired stable sitting. Six type 1 children were <18 months-old at treatment initiation. Two of them did not need ventilation or nutritional support at the last assessment; three had delayed language development and 3 articulation difficulties. 5/21 SMA type 2 patients achieved higher HFMSE scores. All ambulant type 3 patients showed a gain in the 6MWT. Nusinersen is an effective treatment, with gains in motor function occurring particularly in children and SMA type 1, but also in type 2 and 3, adolescents and adults.

摘要

脊髓性肌萎缩症(SMA)是一种常染色体隐性疾病,可导致进行性近端肌肉、呼吸和延髓肌无力。我们展示了在瑞士接受诺西那生治疗的SMA患者的运动功能、通气、营养和语言发育的结果数据。这项多中心观察性研究纳入了44名患者。在开始治疗时、2个月后以及随后每4个月,我们使用费城儿童医院神经肌肉疾病婴儿测试(CHOP-INTEND)、扩展的哈默史密斯功能运动量表(HFMSE)和6分钟步行测试(6MWT)评估运动功能。开始治疗时,患者年龄为0.1至44.6岁,治疗持续时间为6至41个月。所有11名1型SMA儿童在最后一次评估时的CHOP-INTEND得分均高于开始治疗时,4名获得了稳定的坐姿。6名1型儿童在开始治疗时年龄小于18个月。其中2名在最后一次评估时不需要通气或营养支持;3名有语言发育延迟,3名有发音困难。21名2型SMA患者中有5名的HFMSE得分更高。所有能行走的3型患者在6MWT中都有进步。诺西那生是一种有效的治疗方法,运动功能改善尤其出现在儿童和1型SMA患者中,2型和3型、青少年及成人患者中也有改善。

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