A Canadian Adult Spinal Muscular Atrophy Outcome Measures Toolkit: Results of a National Consensus using a Modified Delphi Method

Author:

Slayter Jeremy12,Hodgkinson Victoria3,Lounsberry Josh3,Brais Bernard45,Chapman Kristine6,Genge Angela45,Izenberg Aaron7,Johnston Wendy8,Lochmüller Hanns910,O’Ferrall Erin4,Pfeffer Gerald311,Plamondon Stephanie3,Rodrigue Xavier12,Schellenberg Kerri13,Shoesmith Christen14,Stables Christine6,Taillon Monique12,Warman-Chardon Jodi910,Korngut Lawrence3,O’Connell Colleen12

Affiliation:

1. Dalhousie University, Faculty of Medicine, Halifax, NS, Canada

2. Stan Cassidy Centre for Rehabilitation, Fredericton, NB, Canada

3. Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada

4. Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montréal, QC, Canada

5. Neuromuscular Clinic, Centre de Réadaptation Lucie-Bruneau, CIUSSS-CSMTL, Montreal, QC, Canada

6. Division of Neurology, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada

7. Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada

8. Division of Neurology, University of Alberta, Edmonton, AB, Canada

9. Division of Genetics, Department of Pediatrics, Children’s Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada

10. Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada

11. Department of Medical Genetics, Alberta Child Health Research Institute, University of Calgary, Calgary, AB, Canada

12. Department of Medicine, Laval University, Québec City, QC, Canada

13. Division of Neurology, Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada

14. Division of Neurology, Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON, Canada

Abstract

Background: Spinal Muscular Atrophy (SMA) is a rare disease that affects 1 in 11 000 live births. Recent developments in SMA treatments have included new disease-modifying therapies that require high quality data to inform decisions around initiation and continuation of therapy. In Canada, there are no nationally agreed upon outcome measures (OM) used in adult SMA. Standardization of OM is essential to obtain high quality data that is comparable among neuromuscular clinics. Objective: To develop a recommended toolkit and timing of OM for assessment of adults with SMA. Methods: A modified delphi method consisting of 2 virtual voting rounds followed by a virtual conference was utilized with a panel of expert clinicians treating adult SMA across Canada. Results: A consensus-derived toolkit of 8 OM was developed across three domains of function, with an additional 3 optional measures. Optimal assessment frequency is 12 months for most patients regardless of therapeutic access, while patients in their first year of receiving disease-modifying therapy should be assessed more frequently. Conclusions: The implementation of the consensus-derived OM toolkit will improve monitoring and assessment of adult SMA patients, and enrich the quality of real-world evidence. Regular updates to the toolkit must be considered as new evidence becomes available.

Publisher

IOS Press

Subject

Clinical Neurology,Neurology

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