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Wang LH, Leung DG, Wagner KR, Lowry SJ, McDermott MP, Eichinger K, Higgs K, Walker M, Lewis L, Martens WB, Mul K, Sansone VA, Shieh P, Elsheikh B, LoRusso S, Butterfield RJ, Johnson N, Preston MR, Messina C, Carraro E, Tawil R, Statland J. Lean tissue mass measurements by dual-energy X-ray absorptiometry and associations with strength and functional outcome measures in facioscapulohumeral muscular dystrophy. Neuromuscul Disord 2023; 33:63-68. [PMID: 37400350 PMCID: PMC10527411 DOI: 10.1016/j.nmd.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023]
Abstract
Facioscapulohumeral muscular dystrophy (FSHD) is a slowly progressive disease of skeletal muscle. Dual energy X-ray absorptiometry (DEXA) is a widely available, cost-effective and sensitive technique for measuring whole body and regional lean tissue mass and has been used in prior clinical trials in neuromuscular diseases. The Clinical Trial Readiness to Solve Barriers to Drug Development in FSHD (ReSolve) study is a prospective, longitudinal, observational multisite study. We obtained concurrent DEXA scans and functional outcome measurements in 185 patients with FSHD at the baseline visit. We determined the associations between lean tissue mass in the upper and lower extremities and corresponding clinical outcome measures. There were moderate correlations between upper and lower extremity lean tissue mass and their corresponding strengths and function. Lean tissue mass obtained by DEXA scan may be useful as a biomarker in future clinical trials in FSHD.
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Affiliation(s)
- Leo H Wang
- University of Washington, Department of Neurology, WA, USA.
| | - Doris G Leung
- Kennedy Krieger Institute, The Johns Hopkins School of Medicine, MD, USA
| | - Kathryn R Wagner
- Kennedy Krieger Institute, The Johns Hopkins School of Medicine, MD, USA
| | | | - Michael P McDermott
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, NY, USA; University of Rochester Medical Center, Department of Neurology, NY, USA
| | - Katy Eichinger
- University of Rochester Medical Center, Department of Neurology, NY, USA
| | - Kiley Higgs
- University of Kansas Medical Center, Department of Neurology, KS, USA
| | - Michaela Walker
- University of Kansas Medical Center, Department of Neurology, KS, USA
| | - Leann Lewis
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, NY, USA
| | - William B Martens
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, NY, USA
| | | | - Valeria A Sansone
- The NEMO Clinical Center, Neurorehabilitation Unit, University of Milan, Department of Neurology, Milan, Italy
| | - Perry Shieh
- University of California, Los Angeles, CA, USA
| | | | | | | | | | | | - Carmelo Messina
- Galeazzi Institute, Radiology Department, University of Milan, Italy
| | - Elena Carraro
- The NEMO Clinical Center, Neurorehabilitation Unit, University of Milan, Department of Neurology, Milan, Italy
| | - Rabi Tawil
- University of Rochester Medical Center, Department of Neurology, NY, USA
| | - Jeff Statland
- University of Kansas Medical Center, Department of Neurology, KS, USA
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Pasnoor M, Bril V, Levine T, Trivedi J, Silvestri NJ, Phadnis M, Katzberg HD, Saperstein DS, Wolfe GI, Herbelin L, Higgs K, Heim AJ, Statland JM, Barohn RJ, Dimachkie MM. Phase 2 trial in acetylcholine receptor antibody-positive myasthenia gravis of transition from intravenous to subcutaneous immunoglobulin: The MGSCIg study. Eur J Neurol 2023; 30:1417-1424. [PMID: 36779862 DOI: 10.1111/ene.15745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/01/2023] [Accepted: 02/09/2023] [Indexed: 02/14/2023]
Abstract
BACKGROUND AND PURPOSE Data on maintenance therapy with subcutaneous immunoglobulin (SCIg) in myasthenia gravis (MG) are limited. We report on transitioning acetylcholine receptor (AChR) antibody-positive (Ab+) MG patients on stable intravenous immunoglobulin (IVIg) regimens as part of routine clinical care to SCIg 1:1.2. METHODS This multicenter North American open-label prospective investigator-initiated study had two components: the IVIg Stabilization Period (ISP) enrolling patients already on IVIg as part of routine clinical care (Weeks -10 to -1), followed by transition of stable MG subjects to SCIg in the Experimental Treatment Period (ETP; Weeks 0 to 12). We hypothesized that >65% of patients entering the ETP would have a stable Quantitative Myasthenia Gravis (QMG) score from Week 0 to Week 12. Secondary outcome measures included other efficacy measures, safety, tolerability, IgG levels, and treatment satisfaction. RESULTS We recruited 23 patients in the ISP, and 22 entered the ETP. A total of 12 subjects (54.5%) were female, and 18 (81.8%) were White, with mean age 51.4 ± 17 years. We obtained Week 12 ETP QMG data on 19 of 22; one subject withdrew from ETP owing to clinical deterioration, and two subjects withdrew due to dislike of needles. On primary analysis, 19 of 22 participants (86.4%, 95% confidence interval = 0.72-1.00) were treatment successes using last observation carried forward (p = 0.018). Secondary efficacy measures supported MG stability. SCIg was safe and well tolerated, and IgG levels were stable. Treatment satisfaction was comparable between ISP and ETP. CONCLUSIONS MG patients on IVIg as part of their routine clinical care remained stable on monthly IVIg dosage, and most maintained similar disease stability on SCIg.
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Affiliation(s)
- Mamatha Pasnoor
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Vera Bril
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Todd Levine
- HonorHealth Neurology, Phoenix, Arizona, USA
| | - Jaya Trivedi
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Milind Phadnis
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Hans D Katzberg
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Gil I Wolfe
- Department of Neurology, University at Buffalo, Buffalo, New York, USA
| | - Laura Herbelin
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kiley Higgs
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Andrew J Heim
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Jeffrey M Statland
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | | | - Mazen M Dimachkie
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
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Lewis L, Eichinger K, Dilek N, Higgs K, Walker M, Palmer D, Cooley JM, Johnson N, Tawil R, Statland J. Understanding the Perseverance of the Muscular Dystrophy Community One-Year into the COVID-19 Pandemic. J Neuromuscul Dis 2022; 9:517-523. [PMID: 35723112 DOI: 10.3233/jnd-220794] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION In this study, we examined the long-term social and health impacts of the coronavirus disease 2019 (COVID-19) pandemic on people with muscular dystrophy. METHODS We modified our prior COVID-19 Impact Survey to assess impacts from the continuing pandemic using feedback from muscular dystrophy experts, patients, and advocacy group/registry representatives. The survey assessed COVID-19 medical history, and the effects of the pandemic on social aspects, muscle disease, and medical care. We also used the validated 10-item Perceived Stress Scale. The de-identified, electronic survey was distributed to adults with muscular dystrophy via international patient registries and advocacy group websites from February 8, 2021 to March 22, 2021. RESULTS Respondents (n = 1243 : 49% Facioscapulohumeral Muscular Dystrophy (FSHD); 43% Myotonic Dystrophy (DM), and 8% Limb-Girdle Muscular Dystrophy (LGMD)) were mostly women and middle-aged (range 18-90 years). Rates of COVID-19 infections were low at 8% with zero deaths. Reported recovery times were also short with only 9% reporting a recovery period greater than eight weeks, and 7% requiring hospitalization with one individual requiring a ventilator. Major challenges reported during the pandemic included: stress management, particularly for those with LGMD, (27%) and wearing a mask (24%). The majority reported a slight worsening in their disease state. Respondents reported moderate stress levels (stress score = 16.4; range = 0-39), with higher stress levels reported by women and those under age 30 years. Seventy-percent of participants who had telemedicine visits were satisfied with the encounters; however, most reported a preference for in-person visits. CONCLUSIONS People with MD found ways to manage their stress and overcome obstacles during the COVID-19 pandemic. COVID-19 infection rates and medical complications were similar to a general population. Telemedicine visits may have a more permanent role in care.
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Affiliation(s)
- Leann Lewis
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Katy Eichinger
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Nuran Dilek
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Kiley Higgs
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Michaela Walker
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - David Palmer
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - John M Cooley
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Nicholas Johnson
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA
| | - Rabi Tawil
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Jeffrey Statland
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
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LoRusso S, Eichinger K, Higgs K, Lewis L, Walker M, Albert J, Langer M, Tawil R, Statland JM, Kimminau KS. A Roadmap to Patient Engagement: Facioscapulohumeral Muscular Dystrophy and the ReSolve Clinical Trial. Neurol Clin Pract 2021; 11:e722-e726. [PMID: 34840889 PMCID: PMC8610524 DOI: 10.1212/cpj.0000000000001074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/08/2021] [Indexed: 11/15/2022]
Abstract
We describe our efforts to overcome barriers to patient engagement in facioscapulohumeral muscular dystrophy (FSHD) and offer a roadmap that can be replicated in other rare neurologic disorders. We implemented an engagement plan during Clinical Trial Readiness to Solve Barriers to Drug Development for FSHD (ReSolve), an 18-month, multisite, observational study of individuals with FSHD. Elements of our engagement plan included conducting focus groups during protocol development, patient involvement on the ReSolve external advisory committee, creation of a patient advisory committee, and collaboration with patient advocacy groups. Patient feedback led to adaptations in the study protocol and to changes in recruitment and retention methods. Patient engagement ensures that the patient voice contributes to multiple aspects of trial design and implementation. Our engagement efforts exemplify how collaboration with patients and families can be accomplished in FSHD and the resultant roadmap process may be replicable in other rare neurologic diseases.
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Affiliation(s)
- Samantha LoRusso
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - Katy Eichinger
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - Kiley Higgs
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - Leann Lewis
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - Michaela Walker
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - James Albert
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - Michele Langer
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - Rabi Tawil
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - Jeffrey M Statland
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - Kim S Kimminau
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
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Eichinger K, Lewis L, Dilek N, Higgs K, Walker M, Palmer D, Cooley JM, Johnson N, Tawil R, Statland J. A patient-focused survey to assess the effects of the COVID-19 pandemic and social guidelines on people with muscular dystrophy. Muscle Nerve 2021; 64:321-327. [PMID: 34105174 PMCID: PMC8242695 DOI: 10.1002/mus.27349] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 06/01/2021] [Accepted: 06/06/2021] [Indexed: 11/24/2022]
Abstract
Introduction/Aims In this study, we examined the social and health impacts of the coronavirus disease 2019 (COVID‐19) pandemic and social guidelines on people with muscular dystrophies. Methods A prospective de‐identified electronic survey was distributed to adults with self‐reported facioscapulohumeral muscular dystrophy (FSHD), myotonic dystrophy (DM), and limb‐girdle muscular dystrophy (LGMD) enrolled in national registries or with patient advocacy groups. The COVID‐19 Impact Survey was developed by muscular dystrophy experts in association with patient collaborators and advocacy groups. The Perceived Stress Scale was used to measure perceived stress. Results Respondents (n = 774: 56% FSHD; 35% DM, and 9% LGMD) were mostly women and middle‐aged (range 19–87 y). Rates of COVID‐19 infections were low (<1%), compliance with local social distancing guidelines and policies high (98%). Major challenges reported during the pandemic included: obtaining treatment (40%), managing stress (37%), social distancing (36%), and obtaining essentials (34%). The majority reported a slight worsening in their disease state. Respondents reported moderate stress levels (stress score = 15.4; range = 0–35), with higher stress levels reported by women and those under age 30 y. Three‐quarters of participants who participated in telemedicine visits were satisfied with the encounters; however, most reported a preference for in‐person visits. Discussion People with muscular dystrophy reported moderate stress and challenges during the COVID‐19 pandemic. Interventions such as exercise and stress‐coping strategies, including strategies specific to women or individuals <30 y, may be important. Further investigation is needed into the role of telemedicine in the care of individuals with muscular dystrophy.
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Affiliation(s)
- Katy Eichinger
- Department of Neurology, University of Rochester, Rochester, New York, USA
| | - Leann Lewis
- Department of Neurology, University of Rochester, Rochester, New York, USA
| | - Nuran Dilek
- Department of Neurology, University of Rochester, Rochester, New York, USA
| | - Kiley Higgs
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Michaela Walker
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - David Palmer
- Patient collaborator, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - John M Cooley
- Patient collaborator, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Nicholas Johnson
- Department of Neurology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Rabi Tawil
- Department of Neurology, University of Rochester, Rochester, New York, USA
| | - Jeffrey Statland
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
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LoRusso S, Johnson N, McDermott M, Eichinger K, Butterfield R, Higgs K, Lewis L, Mul K, Van Engelen B, Sacconi S, Sansone V, Carraro E, Shieh P, Wagner K, Wang L, Statland J, Tawil R, the ReSolve Investigators. P.46Clinical trial readiness to solve barriers to drug development in FSHD (ReSolve): protocol of a large, multi-center prospective study. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pasnoor M, Bril V, Levine T, Trivedi J, Silvestri N, Phadnis M, Saperstein D, Nations S, Katzberg H, Wolfe G, Herbelin L, Higgs K, Heim A, Statland J, Barohn R, Dimachkie M. O.33Subcutaneous immunoglobulin in myasthenia gravis: results of a North American open label study. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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LoRusso S, Johnson NE, McDermott MP, Eichinger K, Butterfield RJ, Carraro E, Higgs K, Lewis L, Mul K, Sacconi S, Sansone VA, Shieh P, van Engelen B, Wagner K, Wang L, Statland JM, Tawil R. Clinical trial readiness to solve barriers to drug development in FSHD (ReSolve): protocol of a large, international, multi-center prospective study. BMC Neurol 2019; 19:224. [PMID: 31506080 PMCID: PMC6734593 DOI: 10.1186/s12883-019-1452-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/27/2019] [Indexed: 12/14/2022] Open
Abstract
Background Facioscapulohumeral muscular dystrophy (FSHD) is a dominantly-inherited progressive muscular dystrophy caused by de-repression of the DUX4 gene, which causes disease by a toxic-gain-of-function. As molecularly targeted drugs move from preclinical testing into human trials, it is essential that we validate clinical trial tools and methodology to facilitate the drug development process. Methods/design The primary goal of this study is to hasten drug development for FSHD by validating two novel clinical outcome assessments (COAs) and refining clinical trial strategies. We will perform an 18-month longitudinal study in 220 genetically confirmed and clinically affected participants using our FSHD Clinical Trial Research Network, comprised of 8 sites in the United States, and 3 collaborating sites in Europe. Visits occur at baseline and months 3, 12, and 18. At each visit we will collect: 1) a novel FSHD functional composite COA made up of 18 evaluator-administered motor tasks in the domains of shoulder/arm, hand, core/abdominal, leg, and balance function; and 2) electrical impedance myography as a novel muscle quality biomarker (US sites). Other COAs include 1) Domain 1 of the Motor Function Measure; 2) Reachable workspace; 3) orofacial strength using the Iowa Oral Performance Instrument; 4) lean muscle mass using dual-energy X-ray absorptiometry (DEXA); 5) strength as measured by quantitative myometry and manual muscle testing; and 6) the FSHD Health Index and other patient-reported outcomes. Plasma, DNA, RNA, and serum will be collected for future biomarker studies. We will use an industry standard multi-site training plan. We will evaluate the test-retest reliability, validity, and sensitivity to disease progression, and minimal clinically important changes of our new COAs. We will assess associations between demographic and genetic factors and the rate of disease progression to inform refinement of eligibility criteria for future clinical trials. Discussion To the best of our knowledge, this is the largest collaborative study of patients with FSHD performed in the US and Europe. The results of this study will enable more efficient clinical trial design. During the conduct of the study, relevant data will be made available for investigators or companies pursuing novel FSHD therapeutics. Trial registration clinicaltrials.gov NCT03458832; Date of registration: 1/11/2018 Electronic supplementary material The online version of this article (10.1186/s12883-019-1452-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Samantha LoRusso
- Department of Neurology, Ohio State University Wexner Medical Center, 395 W. 12th Ave., 7th Floor, Columbus, OH, 43210, USA
| | - Nicholas E Johnson
- Department of Neurology, Virginia Commonwealth University, 1101 East Marshall St, PO Box 980599, Richmond, VA, 23298, USA
| | - Michael P McDermott
- Department of Biostatistics and Computational Biology and Department of Neurology, University of Rochester Medical Center, 265 Crittenden Blvd., CU 420630, Rochester, NY, 14642, USA
| | - Katy Eichinger
- Department of Neurology, University of Rochester Medical Center, Box 673, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | - Russell J Butterfield
- Department of Pediatrics and Neurology, University of Utah, Eccles Institute of Human Genetics, Room 2260A, 15 N 2030 E, Salt Lake City, UT, 84112, USA
| | - Elena Carraro
- The NEMO Clinical Center, Neurorehabilitation Unit, University of Milan, Piazza dell'Ospedale Maggiore, 3, Milan, 20162, Italy
| | - Kiley Higgs
- Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Blvd, MS 2012, Kansas City, KS, 66160, USA
| | - Leann Lewis
- Department of Neurology, University of Rochester Medical Center, Box 673, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | - Karlien Mul
- Department of Neurology, Radboud University Medical Center, Reinier Postlaan 4 (935), 6525, GC, Nijmegen, The Netherlands
| | - Sabrina Sacconi
- Université Côte d'Azur, Peripheral Nervous System, Centre Hospitalier Universitaire de Nice, Muscle & ALS Department, Pasteur 2 Hospital, 30 Voie Romaine, 06001, Nice Cedex 1, France
| | - Valeria A Sansone
- The NEMO Clinical Center, Neurorehabilitation Unit, University of Milan, Piazza dell'Ospedale Maggiore, 3, Milan, 20162, Italy
| | - Perry Shieh
- Department of Neurology, University of California, Los Angeles, 300 Medical Plaza, Suite B-200, Los Angeles, CA, 90095, USA
| | - Baziel van Engelen
- Department of Neurology, Radboud University Medical Center, Reinier Postlaan 4 (935), 6525, GC, Nijmegen, The Netherlands
| | - Kathryn Wagner
- Center for Genetic Muscle Disorders, Kennedy Krieger Institute, 707 N. Broadway, Baltimore, MD, USA
| | - Leo Wang
- Department of Neurology, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA
| | - Jeffrey M Statland
- Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Blvd, MS 2012, Kansas City, KS, 66160, USA.
| | - Rabi Tawil
- Department of Neurology, University of Rochester Medical Center, Box 673, 601 Elmwood Ave, Rochester, NY, 14642, USA
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