Mori-Yoshimura Madoka, Yajima Hiroyuki, Oya Yasushi, Mizuno Katsuhiro, Noguchi Satoru, Nishino Ichizo, Takahashi Yuji
Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.
Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.
BMJ Neurol Open. 2022 Dec 1;4(2):e000362. doi: 10.1136/bmjno-2022-000362. eCollection 2022.
A number of clinical trials targeting GNE myopathy patients have been conducted. However, useful clinical parameters for postmarketing surveillance and long-term clinical observation have not yet been established.
We conducted a 5-year observational follow-up natural history study to identify evaluation parameters, which may be useful for the long-term observation of GNE myopathy patients.
Thirty-three genetically confirmed GNE myopathy patients were recruited and evaluated at study entry (baseline) and yearly in a 5-year follow-up. Hand-held dynamometer measurements of knee extension strength, grip power and pinch power, summed Manual Muscle Testing (MMT) score of 17 muscles, Gross Motor Function Measure (GMFM), 6 min walk test, percent vital capacity and percent forced vital capacity (%FVC), lean body mass (whole body, arms and legs), creatine kinase, Barthel Index, modified Rankin Scale and 36-item Short Form Survey national standard scores were examined.
Of the 33 patients, 22 (66%) completed evaluations for the entire 5-year follow-up period. These patients had a significant reduction in summed MMT score (p=0.005), GMFM (p=0.005), pinch power (p<0.001) and %FVC (p<0.001) at the fifth year evaluation relative to baseline. Among these parameters, summed MMT score, GMFM, pinch power and %FVC showed significant changes even in non-ambulant patients.
MMT, GMFM, pinch power and %FVC are useful parameters for the long-term evaluation of GNE myopathy patients.
已经开展了多项针对GNE肌病患者的临床试验。然而,尚未建立用于上市后监测和长期临床观察的有用临床参数。
我们进行了一项为期5年的观察性随访自然史研究,以确定可能有助于对GNE肌病患者进行长期观察的评估参数。
招募了33名经基因确诊的GNE肌病患者,在研究入组时(基线)进行评估,并在5年随访期间每年进行评估。测量膝关节伸展力量、握力和捏力的手持测力计,17块肌肉的手动肌力测试(MMT)总分,粗大运动功能测量(GMFM),6分钟步行试验,肺活量百分比和用力肺活量百分比(%FVC),瘦体重(全身、手臂和腿部),肌酸激酶,巴氏指数,改良Rankin量表和36项简明调查问卷国家标准分数。
33名患者中,22名(66%)完成了整个5年随访期的评估。与基线相比,这些患者在第5年评估时MMT总分(p=0.005)、GMFM(p=0.005)、捏力(p<0.001)和%FVC(p<0.001)显著降低。在这些参数中,即使是非行走患者,MMT总分、GMFM、捏力和%FVC也显示出显著变化。
MMT、GMFM、捏力和%FVC是用于GNE肌病患者长期评估的有用参数。