Respiratory function and therapeutic expectations in DMD: families experience and perspective

Claudia Brogna 1,2, Simona Lucibello 1,2, Giorgia Coratti 1,2, Gianluca Vita 3, Valeria A. Sansone 4, Sonia Messina3 3,5, Emilio Albamonte 4, Francesca Salmin 4, Gloria Ferrantini 1,2, Elisa Pede 1,2, Chiara Consulo 3, Lavinia Fanelli 2, Nicola Forcina 2, Giulia Norcia 2, Marika Pane 1,2, Eugenio Mercuri 1,2

1 Pediatric Neurology, Università Cattolica del Sacro Cuore, Rome, Italy; 2 Centro Clinico Nemo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; 3 Nemo SUD Clinical Centre, University Hospital “G. Martino”, Messina, Italy; 4 The NEMO Center in Milan, Neurorehabilitation Unit, University of Milan, ASST Niguarda Hospital, Milan, Italy; 5 Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy

Objective. The aim of this study was to use a structured questionnaire in a large cohort of Duchenne Muscular Dystrophy (DMD) patients to assess caregivers and patients views on respiratory function and to establish if their responses were related to the patients’ age or level of functional impairment. 

Methods. Questionnaires were administered to caregivers in 205 DMD patients of age between 3 and 36 years (115 ambulant, 90 non-ambulant), and to 64 DMD patients (3 ambulant, 61 non-ambulant) older than 18 years, subdivided into groups according to age, FVC, ambulatory and ventilatory status.

Results. Some differences were found in relation to FVC % values (= 0.014), ambulatory (= 0.043) and ventilatory status (= 0.014). Nearly half of the caregivers expected deterioration over the next years, with the perspective of deterioration more often reported by caregivers of non-ambulant (p = 0.018) and ventilated patients (p = 0.004). Caregivers appeared to be aware of the relevance of respiratory function on quality of life (84%) showing willingness to enter possible clinical trials if these were aiming to stabilize the progression of respiratory function with a very high number of positive responses across the spectrum of age, FVC, ambulatory and ventilatory status. The boys older than 18 years showed similar results. 

Conclusions. Our study showed that the concern for respiratory function increases with age and with the reduction of FVC or the need for ventilation, but the need for intervention was acknowledged across the whole spectrum of age and functional status.

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