학술논문

Defining SOD1 ALS natural history to guide therapeutic clinical trial design
Document Type
article
Source
Journal of Neurology Neurosurgery & Psychiatry. 88(2)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Brain Disorders
Neurosciences
ALS
Rare Diseases
Clinical Research
Neurodegenerative
Clinical Trials and Supportive Activities
Adult
Age of Onset
Amyotrophic Lateral Sclerosis
Clinical Trials as Topic
Disease Progression
Humans
Middle Aged
Mutation
Research Design
Retrospective Studies
Superoxide Dismutase
Vital Capacity
Medical and Health Sciences
Psychology and Cognitive Sciences
Neurology & Neurosurgery
Clinical sciences
Language
Abstract
ImportanceUnderstanding the natural history of familial amyotrophic lateral sclerosis (ALS) caused by SOD1 mutations (ALSSOD1) will provide key information for optimising clinical trials in this patient population.ObjectiveTo establish an updated natural history of ALSSOD1.Design, setting and participantsRetrospective cohort study from 15 medical centres in North America evaluated records from 175 patients with ALS with genetically confirmed SOD1 mutations, cared for after the year 2000.Main outcomes and measuresAge of onset, survival, ALS Functional Rating Scale (ALS-FRS) scores and respiratory function were analysed. Patients with the A4V (Ala-Val) SOD1 mutation (SOD1A4V), the largest mutation population in North America with an aggressive disease progression, were distinguished from other SOD1 mutation patients (SOD1non-A4V) for analysis.ResultsMean age of disease onset was 49.7±12.3 years (mean±SD) for all SOD1 patients, with no statistical significance between SOD1A4V and SOD1non-A4V (p=0.72, Kruskal-Wallis). Total SOD1 patient median survival was 2.7 years. Mean disease duration for all SOD1 was 4.6±6.0 and 1.4±0.7 years for SOD1A4V. SOD1A4V survival probability (median survival 1.2 years) was significantly decreased compared with SOD1non-A4V (median survival 6.8 years; p