title: Mapping the differences in care for 5,000 spinal muscular atrophy patients, a survey of 24 national registries in North America, Australasia and Europe.
abstract: Spinal muscular atrophy (SMA) is an autosomal recessive genetic disorder characterised by the degeneration of motor neurons and progressive muscle weakness. It is caused by homozygous deletions in the survival motor neuron gene on chromosome 5. SMA shows a wide range of clinical severity, with SMA type I patients often dying before 2 years of age, whereas type III patients experience less severe clinical manifestations and can have a normal life span. Here, we describe the design, setup and utilisation of the TREAT-NMD national SMA patient registries characterised by a small, but fully standardised set of registry items and by genetic confirmation in all patients. We analyse a selection of clinical items from the SMA registries in order to provide a snapshot of the clinical data stratified by SMA subtype, and compare these results with published recommendations on standards of care. Our study included 5,068 SMA patients in 25 countries. A total of 615 patients were ventilated, either invasively (178) or non-invasively (437), 439 received tube feeding and 455 had had scoliosis surgery. Some of these interventions were not available to patients in all countries, but differences were also noted among high-income countries with comparable wealth and health care systems. This study provides the basis for further research, such as quality of life in ventilated SMA patients, and will inform clinical trial planning.
authors.affiliation: MRC Centre for Neuromuscular Diseases at Newcastle, Institute of Genetic Medicine, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK, catherine.bladen@ncl.ac.uk.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Bladen
authors.forename: Rachel
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authors.lastname: Thompson
authors.forename: Jacqueline M
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authors.lastname: Kostera-Pruszczyk
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authors.forename: Oznur
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authors.forename: Vedrana Milic
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authors.forename: Soledad
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authors.forename: Lilien
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authors.forename: Teodora
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authors.forename: Niculina
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authors.forename: Lawrence
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authors.lastname: Strenkova
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authors.lastname: Alejandro
authors.forename: Alatorre
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authors.lastname: Jimenez
authors.forename: Genaro Gabriel
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authors.forename: Gracia Viviana Gonzalez
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authors.lastname: Enriquez
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authors.lastname: Rodrigues
authors.forename: Richard
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authors.lastname: Youngs
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authors.lastname: Lahdetie
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authors.lastname: Angelkova
authors.forename: Pascal
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authors.lastname: Saugier-Veber
authors.forename: Jean-Marie
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authors.lastname: Cuisset
authors.forename: Clemens
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authors.lastname: Bloetzer
authors.forename: Pierre-Yves
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authors.lastname: Jeannet
authors.forename: Andrea
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authors.lastname: Klein
authors.forename: Andres
authors.initials: A
authors.lastname: Nascimento
authors.forename: Eduardo
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authors.lastname: Tizzano
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authors.lastname: Salgado
authors.forename: Eugenio
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authors.lastname: Mercuri
authors.forename: Thomas
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authors.lastname: Sejersen
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authors.lastname: Kirschner
authors.forename: Karen
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authors.lastname: Rafferty
authors.forename: Volker
authors.initials: V
authors.lastname: Straub
authors.forename: Kate
authors.initials: K
authors.lastname: Bushby
authors.forename: Jan
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authors.lastname: Verschuuren
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mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D044362:Australasia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005060:Europe / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D009134:Muscular Atrophy, Spinal / Q000453:epidemiology* / Q000503:physiopathology; D009656:North America / Q000453:epidemiology; D012042:Registries / Q000706:statistics & numerical data*; D055815:Young Adult