Journal article
Management of Select Adverse Events Following Delandistrogene Moxeparvovec Gene Therapy for Patients With Duchenne Muscular Dystrophy
Journal of neuromuscular diseases, Vol.11(3), pp.687-699
04/11/2024
DOI: 10.3233/JND-230185
PMCID: PMC11091590
PMID: 38607761
Abstract
Duchenne muscular dystrophy (DMD) is a rare, degenerative, recessive X-linked neuromuscular disease. Mutations in the gene encoding dystrophin lead to the absence of functional dystrophin protein. Individuals living with DMD exhibit progressive muscle weakness resulting in loss of ambulation and limb function, respiratory insufficiency, and cardiomyopathy, with multiorgan involvement. Adeno-associated virus vector-mediated gene therapy designed to enable production of functional dystrophin protein is a new therapeutic strategy. Delandistrogene moxeparvovec (Sarepta Therapeutics, Cambridge, MA) is indicated for treatment of ambulatory pediatric patients aged 4 through 5 years with DMD who have an indicated mutation in the DMD gene.
Evidence-based considerations for management of potential adverse events following gene therapy treatment for DMD are lacking in clinical literature. Our goal was to provide interdisciplinary consensus considerations for selected treatment-related adverse events (TRAEs) (vomiting, acute liver injury, myocarditis, and immune-mediated myositis) that may arise following gene therapy dosing with delandistrogene moxeparvovec.
An interdisciplinary panel of 12 specialists utilized a modified Delphi process to develop consensus considerations for the evaluation and management of TRAEs reported in delandistrogene moxeparvovec clinical studies. Panelists completed 2 Questionnaires prior to gathering for an in-person discussion. Consensus was defined as a majority (≥58% ; 7/12) of panelists either agreeing or disagreeing.
Panelists agreed that the choice of baseline assessments should be informed by individual clinical indications, the treating provider's judgment, and prescribing information. Corticosteroid dosing for treatment of TRAEs should be optimized by considering individual risk versus benefit for each indication. In all cases involving patients with a confirmed TRAE, consultations with appropriate specialists were suggested.
The Delphi Panel established consensus considerations for the evaluation and management of potential TRAEs for patients receiving delandistrogene moxeparvovec, including vomiting, acute liver injury, myocarditis, and immune-mediated myositis.
Details
- Title: Subtitle
- Management of Select Adverse Events Following Delandistrogene Moxeparvovec Gene Therapy for Patients With Duchenne Muscular Dystrophy
- Creators
- Craig M Zaidman - Washington University in St. Louis School of MedicineNatalie L Goedeker - Washington University in St. Louis School of MedicineAmal A Aqul - The University of Texas Southwestern Medical CenterRussell J Butterfield - University of UtahAnne M ConnollyRonald G Crystal - Weill Cornell MedicineKara E Godwin - Sarepta Therapeutics (United States)Kan N HorKatherine D Mathews - University of IowaCrystal M Proud - Children's Hospital of The King's DaughtersElizabeth Kula Smyth - Sarepta Therapeutics (United States)Aravindhan Veerapandiyan - University of Arkansas for Medical SciencesPaul B Watkins - University of North Carolina at Chapel HillJerry R Mendell
- Resource Type
- Journal article
- Publication Details
- Journal of neuromuscular diseases, Vol.11(3), pp.687-699
- DOI
- 10.3233/JND-230185
- PMID
- 38607761
- PMCID
- PMC11091590
- NLM abbreviation
- J Neuromuscul Dis
- eISSN
- 2214-3602
- Language
- English
- Electronic publication date
- 04/11/2024
- Academic Unit
- Neurology; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Neurology (Pediatrics)
- Record Identifier
- 9984585056202771
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