Reviews
Volume XLIII, n. 3 - September 2024
Transition and management of patients with Duchenne Muscular Dystrophy: a narrative review based on Italian experts’ opinion and real-world experience
Abstract
Objectives. Duchenne Muscular Dystrophy (DMD) is a severe, progressive, X-linked disorder affecting muscle integrity and resulting in muscle wasting, progressive functional loss and cardiomyopathy. Therapeutic strategies feature glucocorticoid corticosteroids plus gene therapy/stop codon read-through, plus standards of care. Prolonged survival, delayed loss of ambulation (LoA), innovative treatment prescriptions pose new clinical challenges, including identification of new outcome measures/targets and continuity of care.
Methods. We aimed to discuss challenges of transition from the ambulatory to the non-ambulatory phase, and from pediatric to adult care; collect experience on the importance of ongoing care and treatment in advanced disease stages and on the need to measure clinically relevant outcomes during disease progression after LoA.
Results. Following LoA the main management focus is on cardiac, respiratory and upper limbs function. Data on clinical needs, available treatments, standards of care, guidelines, frequency of follow-up, and transition should be collected in order to facilitate management optimisation. Shared protocols should be developed, especially for the acute setting.
Conclusions. Therapeutic continuity after LoA, its efficacy and safety and identification of clinically meaningful outcome measures should be identified and described in long-term longitudinal studies.
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Copyright (c) 2024 Acta Myologica
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