Prognostic Factors and Treatment‐Effect Modifiers in Spinal Muscular Atrophy
| العنوان: | Prognostic Factors and Treatment‐Effect Modifiers in Spinal Muscular Atrophy |
|---|---|
| المؤلفون: | Ksenija Gorni, Neil Hawkins, Monica Daigl, Francesco Muntoni, Giovanni Baranello, Anna Kotzeva, Laurent Servais, Rachel Evans, David Scott, Anadi Mahajan |
| المصدر: | Clinical Pharmacology & Therapeutics. 110:1435-1454 |
| بيانات النشر: | Wiley, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, Neuromuscular disease, Population, Oligonucleotides, Scoliosis, 030226 pharmacology & pharmacy, Muscular Atrophy, Spinal, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Pharmacology (medical), education, Cholestenones, Randomized Controlled Trials as Topic, Pharmacology, education.field_of_study, business.industry, Survival of motor neuron, Spinal muscular atrophy, Prognosis, medicine.disease, SMA, Muscle atrophy, Observational Studies as Topic, Treatment Outcome, Respiratory failure, 030220 oncology & carcinogenesis, medicine.symptom, business |
| الوصف: | Spinal muscular atrophy (SMA) is a rare, progressive neuromuscular disease characterized by loss of motor neurons and muscle atrophy. Untreated infants with type 1 SMA do not achieve major motor milestones, and death from respiratory failure typically occurs before 2 years of age. Individuals with types 2 and 3 SMA exhibit milder phenotypes and have better functional and survival outcomes. Herein, a systematic literature review was conducted to identify factors that influence the prognosis of types 1, 2, and 3 SMA. In untreated infants with type 1 SMA, absence of symptoms at birth, a later symptom onset, and a higher survival of motor neuron 2 (SMN2) copy number are all associated with increased survival. Disease duration, age at treatment initiation, and, to a lesser extent, baseline function were identified as potential treatment-modifying factors for survival, emphasizing that early treatment with disease-modifying therapies (DMT) is essential in type 1 SMA. In patients with types 2 and 3 SMA, factors considered prognostic of changes in motor function were SMN2 copy number, age, and ambulatory status. Individuals aged 6-15 years were particularly vulnerable to developing complications (scoliosis and progressive joint contractures) which negatively influence functional outcomes and may also affect the therapeutic response in patients. Age at the time of treatment initiation emerged as a treatment-effect modifier on the outcome of DMTs. Factors identified in this review should be considered prior to designing or analyzing studies in an SMA population, conducting population matching, or summarizing results from different studies on the treatments for SMA. |
| تدمد: | 1532-6535 0009-9236 |
| DOI: | 10.1002/cpt.2247 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5efd5668485247015d81e050819b714d https://doi.org/10.1002/cpt.2247 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....5efd5668485247015d81e050819b714d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15326535 00099236 |
|---|---|
| DOI: | 10.1002/cpt.2247 |