Growth pattern trajectories in boys with Duchenne muscular dystrophy.
Authors
Stimpson, Georgia
Raquq, Sarah
Chesshyre, Mary
Fewtrell, Mary
Ridout, Deborah
Sarkozy, Anna
Manzur, Adnan
Ayyar Gupta, Vandana
De Amicis, Ramona
Muntoni, Francesco
NorthStar Network
Publication Date
2022-01-24Journal Title
Orphanet J Rare Dis
ISSN
1750-1172
Publisher
Springer Science and Business Media LLC
Volume
17
Issue
1
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Stimpson, G., Raquq, S., Chesshyre, M., Fewtrell, M., Ridout, D., Sarkozy, A., Manzur, A., et al. (2022). Growth pattern trajectories in boys with Duchenne muscular dystrophy.. Orphanet J Rare Dis, 17 (1) https://doi.org/10.1186/s13023-021-02158-9
Abstract
OBJECTIVES: The objective of this study is to analyse retrospective, observational, longitudinal growth (weight, height and BMI) data in ambulatory boys aged 5-12 years with Duchenne muscular dystrophy (DMD). BACKGROUND: We considered glucocorticoids (GC) use, dystrophin isoforms and amenability to exon 8, 44, 45, 51 and 53 skipping drug subgroups, and the impact of growth on loss of ambulation. We analysed 598 boys, with 2604 observations. This analysis considered patients from the UK NorthStar database (2003-2020) on one of five regimes: "GC naïve", "deflazacort daily" (DD), "deflazacort intermittent" (DI), "prednisolone daily" (PD) and "prednisolone intermittent" (PI). A random slope model was used to model the weight, height and BMI SD scores (using the UK90). RESULTS: The daily regime subgroups had significant yearly height stunting compared to the GC naïve subgroup. Notably, the average height change for the DD subgroup was 0.25 SD (95% CI - 0.30, - 0.21) less than reference values. Those with affected expression of Dp427, Dp140 and Dp71 isoforms were 0.77 (95% CI 0.3, 1.24) and 0.82 (95% CI 1.28, 0.36) SD shorter than those with Dp427 and/or Dp140 expression affected respectively. Increased weight was not associated with earlier loss of ambulation, but taller boys still ambulant between the age of 10 and 11 years were more at risk of losing ambulation. CONCLUSION: These findings may provide further guidance to clinicians when counselling and discussing GCs commencement with patients and their carers and may represent a benchmark set of data to evaluate the effects of new generations of GC.
Keywords
Research, Pediatric neuromuscular diseases, Duchenne muscular dystrophy, Growth, Isoforms, Glucocorticoids, Prednisolone, Deflazacort
Sponsorship
Muscular Dystrophy UK (16NMDB-DB60-0004-5)
Identifiers
s13023-021-02158-9, 2158
External DOI: https://doi.org/10.1186/s13023-021-02158-9
This record's URL: https://www.repository.cam.ac.uk/handle/1810/333292
Rights
Licence:
http://creativecommons.org/licenses/by/4.0/
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