BACKGROUND: Patients with Duchenne muscular dystrophy (DMD) are at high risk of endocrine and bone health complications resulting from the high glucocorticoid (GC) doses used to treat this condition. There are limited data characterizing the clinical management of these complications. OBJECTIVE: To determine the frequency of bone health screening, endocrinologist evaluation, and use of endocrine and bone health pharmacotherapy in the clinical care of males with DMD. METHODS: A population based cohort study using data from the Muscular Dystrophy Surveillance, Tracking, and Research Network (MD STARnet) was conducted. Clinical data was abstracted from the medical records of 683 males with DMD at five surveillance sites across the US. RESULTS: A DXA scan had been documented in 24% of cases; the percentage of cases with DXA varied across surveillance sites from 13% to 43%, p < 0.001. History of fracture and greater disease duration were associated with greater odds of having a DXA. Only 4.7% of cases had documentation of an endocrinologist evaluation. The frequency of documented endocrine and bone health pharmacotherapy use included calcium (42.8%), vitamin D (36.6%), bisphosphonates (13.3%), growth hormone (1.9%), testosterone (1.7%), insulin (1.2%), and metformin (0.3%)Conclusions:A low percentage of DMD males had record of DXA scan, endocrinologist evaluation, or treatment with endocrine or bone health pharmacotherapy. Endocrine and bone health care may represent an unmet need in the DMD population.
BACKGROUND:Patients with Duchenne muscular dystrophy (DMD) are at high risk of endocrine and bone health complications resulting from the high glucocorticoid (GC) doses used to treat this condition. There are limited data characterizing the clinical management of these complications. OBJECTIVE: To determine the frequency of bone health screening, endocrinologist evaluation, and use of endocrine and bone health pharmacotherapy in the clinical care of males with DMD. METHODS: A population based cohort study using data from the Muscular Dystrophy Surveillance, Tracking, and Research Network (MD STARnet) was conducted. Clinical data was abstracted from the medical records of 683 males with DMD at five surveillance sites across the US. RESULTS: A DXA scan had been documented in 24% of cases; the percentage of cases with DXA varied across surveillance sites from 13% to 43%, p < 0.001. History of fracture and greater disease duration were associated with greater odds of having a DXA. Only 4.7% of cases had documentation of an endocrinologist evaluation. The frequency of documented endocrine and bone health pharmacotherapy use included calcium (42.8%), vitamin D (36.6%), bisphosphonates (13.3%), growth hormone (1.9%), testosterone (1.7%), insulin (1.2%), and metformin (0.3%)Conclusions:A low percentage of DMD males had record of DXA scan, endocrinologist evaluation, or treatment with endocrine or bone health pharmacotherapy. Endocrine and bone health care may represent an unmet need in the DMD population.
Authors: Lisa A Miller; Paul A Romitti; Christopher Cunniff; Charlotte Druschel; Katherine D Mathews; F John Meaney; Dennis Matthews; Jiji Kantamneni; Zhen-Fang Feng; Nancy Zemblidge; Timothy M Miller; Jennifer Andrews; Deborah Fox; Emma Ciafaloni; Shree Pandya; April Montgomery; Aileen Kenneson Journal: Birth Defects Res A Clin Mol Teratol Date: 2006-11
Authors: Katharine Bushby; Richard Finkel; David J Birnkrant; Laura E Case; Paula R Clemens; Linda Cripe; Ajay Kaul; Kathi Kinnett; Craig McDonald; Shree Pandya; James Poysky; Frederic Shapiro; Jean Tomezsko; Carolyn Constantin Journal: Lancet Neurol Date: 2009-11-27 Impact factor: 44.182
Authors: Katharine Bushby; Richard Finkel; David J Birnkrant; Laura E Case; Paula R Clemens; Linda Cripe; Ajay Kaul; Kathi Kinnett; Craig McDonald; Shree Pandya; James Poysky; Frederic Shapiro; Jean Tomezsko; Carolyn Constantin Journal: Lancet Neurol Date: 2009-11-27 Impact factor: 44.182
Authors: W M King; R Ruttencutter; H N Nagaraja; V Matkovic; J Landoll; C Hoyle; J R Mendell; J T Kissel Journal: Neurology Date: 2007-05-08 Impact factor: 9.910
Authors: Nancy A West; Michele L Yang; David A Weitzenkamp; Jennifer Andrews; F John Meaney; Joyce Oleszek; Lisa A Miller; Dennis Matthews; Carolyn DiGuiseppi Journal: J Pediatr Date: 2013-10-06 Impact factor: 4.406