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2018年10月2日 ;91 (14) 文章

Nusinersen患者年龄超过7个月与1型脊髓性肌萎缩症

一个队列研究

卡罗丽娜Aragon-Gawinska,Andreea m . Seferian,Aurore达,埃琳娜Gargaun,卡罗尔Vuillerot,克劳德通过,朱丽叶Ropars,Mondher Chouchane,英奇Cuppen,梅尔达•休斯,马约莉伊林沃思,奇亚拉Marini-Bettolo,杰罗姆Rambaud,杰西卡Taytard,梅勒妮Annoussamy,Mariacristina Scoto,特蕾莎修女Gidaro,Laurent Servais
第一次出版2018年8月29日, DOI: https://doi.org/10.1212/WNL.0000000000006281
卡罗丽娜Aragon-Gawinska
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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Andreea m . Seferian
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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Aurore达
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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埃琳娜Gargaun
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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卡罗尔Vuillerot
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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克劳德通过
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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朱丽叶Ropars
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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Mondher Chouchane
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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英奇Cuppen
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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梅尔达•休斯
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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马约莉伊林沃思
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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奇亚拉Marini-Bettolo
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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杰罗姆Rambaud
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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杰西卡Taytard
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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梅勒妮Annoussamy
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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Mariacristina Scoto
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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特蕾莎修女Gidaro
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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Laurent Servais
从研究所I-motion (K.A.-G。,A.M.S.,E.G., M.A., T.G., L.S.), Pediatric Intensive Care Unit (J. Rambaud), and Department of Pediatric Pneumology (J.T.), Armand Trousseau Hospital, Paris, France; Neuromuscular Reference Centre (A.D., L.S.), Citadelle Hospital, Liege, Belgium; Department of Pediatric Physical Medicine and Rehabilitation (C.V.), University Hospital of Lyon; Department of Child Neurology (C.C.), University Hospital of Toulouse; Department of Child Neurology (J. Ropars), University Hospital of Brest; Department of Pediatrics (M.C.), University Hospital of Dijon, France; Department of Neurology & Neurosurgery (I.C.), Brain Center Rudolf Magnus, UMC Utrecht, the Netherlands; Royal Manchester Children's Hospital (I.H.), Manchester; Department of Paediatric Neurology (M.I.) University Hospital Southampton; John Walton Muscular Dystrophy Research Centre (C.M.-B.), Institute of Genetic Medicine, Newcastle University; and Dubowitz Neuromuscular Centre (M.S.), UCL Great Ormond Street Institute of Child Health, London, UK.
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Nusinersen患者年龄超过7个月与1型脊髓性肌萎缩症
一个队列研究
卡罗丽娜Aragon-Gawinska,Andreea M。Seferian,Aurore达龙,埃琳娜Gargaun,卡罗尔Vuillerot,克劳德。通过,朱丽叶Ropars,MondherChouchane,英奇Cuppen,总统休斯,马约莉伊林沃思,奇亚拉Marini-Bettolo,杰罗姆Rambaud,杰西卡Taytard,媚兰Annoussamy,MariacristinaScoto,特蕾莎修女Gidaro,劳伦特Servais
首页 2018年10月, 91年 (14) e1312-e1318; DOI:10.1212 / WNL.0000000000006281

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客观的的安全性和临床疗效评价nusinersen患者年龄超过7个月与1型脊髓性肌萎缩症(SMA1)。

方法SMA1患者接受nusinersen鞘内注射的扩展访问程序的一部分(EAP;NCT02865109)。我们评估患者治疗前启动(M0)和2个月(M2)和治疗后6个月(M6)启动。生存、呼吸和营养数据收集。运动功能评估与修改的哈默史密斯婴儿神经系统检查第2部分(HINE-2)和理疗师尺度调整患者年龄(费城儿童医院的婴儿测试神经肌肉疾病和运动机能的测量20 - 32)。

结果我们对33名儿童年龄在8.3到113.1个月2016年12月至2017年5月。所有的病人还活着,M6继续治疗。值修改的进展HINE-2得分是1.5分6个月的治疗后(p< 0.001)。随着时间的推移对呼吸支持的需求显著增加。患者没有统计上显著的差异2和那些提供3份运动神经元生存2 (SMN2)基因。

结论我们的结果符合的第三阶段研究nusinersen SMA1患者治疗前7个月大的时候,表明患者受益于nusinersen甚至在疾病的后期。

ClinicalTrials.gov标识符:NCT02865109。

证据的分类本研究患者的四级提供证据证明SMA1超过7个月,nusinersen是有益的。

术语表

切意愿=
费城儿童医院的婴儿神经肌肉疾病的考验;
学术用途英语=
扩展访问程序;
纽特=
一项研究评估的有效性和安全性Nusinersen(伊希斯396443)在婴儿脊髓性肌萎缩;
HINE-2=
哈默史密斯婴儿神经系统检查第2部分;
MFM=
运动功能测定;
M0=
治疗前;
平方米=
2个月的治疗;
M6=
6个月的治疗;
SMA=
脊髓性肌肉萎缩症;
SMN =
运动神经元生存

脚注

  • 去首页Neurology.org/N为充分披露。资金信息和披露认为作者相关的,如果有的话,年底提供这篇文章。

  • 类的证据:NPub.org/coe

  • 188bet官网app网址播客:NPub.org/k8h4jv

  • CME过程:NPub.org/cmelist

  • 收到了2018年1月26日。
  • 接受的最终形式2018年6月29日。
  • ©2018美国神经病学学会的首页
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