Novel approaches to analysis of the North Star Ambulatory Assessment (NSAA) in Duchenne muscular dystrophy (DMD) : Observations from a phase 2 trial

INTRODUCTION: The North Star Ambulatory Assessment (NSAA) tool is a key instrument for measuring clinical outcomes in patients with Duchenne muscular dystrophy (DMD). To gain a better understanding of the longitudinal utility of the NSAA, we evaluated NSAA data from a phase II trial of 120 patients with DMD treated with domagrozumab or placebo.

METHODS: The NSAA exploratory analyses included assessment of individual skills gained/lost, total skills gained/lost, cumulative loss of function, and the impact of transient loss of function due to a temporary disability on NSAA total score (temporary zero score).

RESULTS: There was no significant difference in the total number of NSAA skills gained (mean 1.41 and 1.04, respectively; p = 0.3314) or lost (3.90 vs. 5.0; p = 0.0998) between domagrozumab- vs. placebo-treated patients at week 49. However, domagrozumab-treated patients were less likely to lose the ability to perform a NSAA item (hazard ratio 0.80, 95% confidence interval [CI]: 0.65-0.98, p = 0.029) over 48-weeks vs. placebo-treated patients. When temporary zero scores were changed to "not obtainable" (8 values from 7 patients), domagrozumab-treated patients scored higher on the NSAA total score versus placebo-treated patients (difference at week 49: 2.0, 95% CI: 0.1-3.9, p = 0.0359).

CONCLUSIONS: These exploratory analyses reveal additional approaches to interpreting the NSAA data beyond just change in NSAA total score. These observations also highlight the importance of reporting items as "not obtainable" for a patient with a temporary/transient physical disability that impacts their ability to perform the NSAA test.

CLINICALTRIALS.GOV IDENTIFIER: NCT02310763.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:17

Enthalten in:

PloS one - 17(2022), 8 vom: 23., Seite e0272858

Sprache:

Englisch

Beteiligte Personen:

Muntoni, Francesco [VerfasserIn]
Guglieri, Michela [VerfasserIn]
Mah, Jean K [VerfasserIn]
Wagner, Kathryn R [VerfasserIn]
Brandsema, John F [VerfasserIn]
Butterfield, Russell J [VerfasserIn]
McDonald, Craig M [VerfasserIn]
Mayhew, Anna G [VerfasserIn]
Palmer, Jeffrey P [VerfasserIn]
Marraffino, Shannon [VerfasserIn]
Charnas, Lawrence [VerfasserIn]
Mercuri, Eugenio [VerfasserIn]

Links:

Volltext

Themen:

Clinical Trial, Phase II
Journal Article
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 25.08.2022

Date Revised 06.09.2022

published: Electronic-eCollection

ClinicalTrials.gov: NCT02310763

Citation Status MEDLINE

doi:

10.1371/journal.pone.0272858

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM345166086