Medical management of muscle weakness in Duchenne muscular dystrophy

PLoS One. 2020 Oct 19;15(10):e0240687. doi: 10.1371/journal.pone.0240687. eCollection 2020.

Abstract

Introduction: Duchenne muscular dystrophy (DMD) is a childhood onset muscular dystrophy leading to shortened life expectancy. There are gaps in published DMD care guidelines regarding recently approved DMD medications and alternative steroid dosing regimens.

Methods: A list of statements about use of currently available therapies for DMD in the United States was developed based on a systematic literature review and expert panel feedback. Panelists' responses were collected using a modified Delphi approach.

Results: Among corticosteroid regimens, either deflazacort or prednisone weekend dosing was preferred when payer requirements do not dictate choice. Most patients with exon 51 skip-amenable mutations should be offered eteplirsen, before or with a corticosteroid.

Discussion: The options available for medical management of the motor symptoms of DMD are expanding rapidly. The choice of medical therapies should balance expected benefit with side effects.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Child
  • Drug Therapy, Combination
  • Humans
  • Morpholinos / therapeutic use*
  • Muscle Weakness / drug therapy*
  • Muscular Dystrophy, Duchenne / drug therapy*
  • Surveys and Questionnaires

Substances

  • Adrenal Cortex Hormones
  • Morpholinos
  • eteplirsen

Grants and funding

Sarepta funded this study. The funder Optum provided support in the form of salaries for authors SRR and SKJ but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.