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Quintana M, Shrader J, Slota C, Joe G, McKew JC, Fitzgerald M, Gahl WA, Berry S, Carrillo N. Bayesian model of disease progression in GNE myopathy. Stat Med 2018; 38:1459-1474. [PMID: 30511500 DOI: 10.1002/sim.8050] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 03/29/2018] [Revised: 09/25/2018] [Accepted: 11/08/2018] [Indexed: 12/31/2022]
Abstract
One Sentence Summary: A Bayesian repeated measures model based on quantitative muscle strength data from a prospective Natural History Study was developed to determine disease progression and design clinical trials for GNE myopathy, a rare and slowly progressive muscle disease. GNE myopathy is a rare muscle disease characterized by slowly progressive weakness and atrophy of skeletal muscles. To address the significant challenges of defining the natural history and designing clinical trials for GNE myopathy, we developed a Bayesian latent variable repeated measures model to determine disease progression. The model is based on longitudinal quantitative muscle strength data collected as part of a prospective Natural History Study. The GNE Myopathy Progression Model provides an understanding of disease progression that would have otherwise required a natural history of unfeasible duration. "Disease age," the model-generated measure of disease progression, highly correlates with a variety of clinical, functional and patient-reported outcomes. With the incorporation of a treatment effect parameter to the GNE Disease Progression Model, we describe a novel GNE Myopathy Disease Modification Analysis that significantly increases power and reduces the number of subjects required to test the effectiveness of novel therapies when compared to more traditional analysis methods. The GNE Myopathy Disease Progression Model and Disease Modification Analysis can be applied to muscle diseases with prospectively collected muscle strength data, and a variety of rare and slowly progressive diseases.
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Affiliation(s)
| | - J Shrader
- Department of Rehabilitation Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - C Slota
- Therapeutics for Rare and Neglected Diseases Program, National Institutes of Health, Bethesda, Maryland.,RTI Health Solutions, Durham, North Carolina
| | - G Joe
- Department of Rehabilitation Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - J C McKew
- Therapeutics for Rare and Neglected Diseases Program, National Institutes of Health, Bethesda, Maryland
| | | | - W A Gahl
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - S Berry
- Berry Consultants, Austin, Texas.,Kansas University Medical Center, Kansas City, Kansas
| | - N Carrillo
- Therapeutics for Rare and Neglected Diseases Program, National Institutes of Health, Bethesda, Maryland.,National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
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