Evidence map›Paper›PMID 33755338›Full record

ArticleMolecular genetics & genomic medicine2021

Patients' and caregivers' maximum acceptable risk of death for non-curative gene therapy to treat Duchenne muscular dystrophy.

Holly L Peay, Ryan Fischer, Brennan Mange, Ryan S Paquin, Edward C Smith, Alesia Sadosky, Leo Russo, Valeria Ricotti, Colin Rensch, Carl Morris and 4 more

Open access · goldAbstract read
In one paragraph

Article in Molecular genetics & genomic medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
0.8field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 13 citations in OpenAlex.

  1. Article
  2. Perspectives of the Friedreich ataxia community on gene therapy clinical trials.Molecular therapy. Methods & clinical development · 2024
    Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Challenges in accelerated approvals for gene therapies.Molecular therapy : the journal of the American Society of Gene Therapy · 2023
    Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 7 institutions in 1 country.

Holly L PeayRTI International, Research Triangle Park, NC, USA.ORCID 0000-0002-3053-7453
Ryan FischerParent Project Muscular Dystrophy, Hackensack, NJ, USA.
Brennan MangeRTI Health Solutions, Research Triangle Park, NC, USA.
Ryan S PaquinRTI International, Research Triangle Park, NC, USA.
Edward C SmithDuke University, Durham, NC, USA.
Alesia SadoskyPfizer, Inc, New York, NY, USA.
Leo RussoPfizer, Inc, New York, NY, USA.
Valeria RicottiSolid Biosciences, Cambridge, MA, USA.
Colin RenschParent Project Muscular Dystrophy, Hackensack, NJ, USA.
Carl MorrisSolid Biosciences, Cambridge, MA, USA.
Amy Strong MartinUCLA, Los Angeles, CA, USA.
Annie GanotSolid Biosciences, Cambridge, MA, USA.
Katherine BeaversonPfizer, Inc, New York, NY, USA.
Carol MansfieldRTI Health Solutions, Research Triangle Park, NC, USA.
Pfizer (United States) · USSolidus Biosciences (United States) · USParent Project Muscular Dystrophy · USRTI Health Solutions · USRTI International · USDuke University · USUCLA Health · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGene therapy offers an etiologically targeted treatment for genetic disorders. Little is known about the acceptance of mortality risk among patients with progressive, fatal conditions. We assessed patients' and caregivers' maximum acceptable risk (MAR) of mortality for gene therapy when used to treat Duchenne muscular dystrophy (DMD).

methodsThe threshold technique was used to assess tolerance for mortality risks using a hypothetical vignette. Gene therapy was described as non-curative and resulting in a slowing of progression and with a 10-year benefit duration. MAR was analyzed using interval regression for gene therapy initiated "now"; in the last year of walking well; in the last year of being able to bring arms to mouth; and in newborns (for caregivers only).

resultsTwo hundred eighty-five caregivers and 35 patients reported the greatest MAR for gene therapy initiated in last year of being able to lift arms (mean MAR 6.3%), followed by last year of walking well (mean MAR 4.4%), when used "now" (mean MAR 3.5%), and when used in the newborn period (mean MAR 2.1%, caregivers only). About 35% would accept ≥200/2000 risk in the last year of being able to lift arms. Non-ambulatory status predicted accepting 1.8 additional points in MAR "now" compared with ambulatory status (p = 0.010). Respondent type (caregiver or patient) did not predict MAR.

conclusionIn this first quantitative study to assess MAR associated with first-generation DMD gene therapy, we find relatively high tolerance for mortality risk in response to a non-curative treatment scenario. Risk tolerance increased with disease progression. Patients and caregivers did not have significantly different MAR. These results have implications for protocol development and shared decision making.

Indexed as

AttitudeAdultCaregiversGenetic TherapyHumansMaleMuscular Dystrophy, DuchennePatientsRisk-TakingDuchenne muscular dystrophygene therapypatient-reported outcomesrisk

Identifiers

PMID33755338
PMCPMC8172191
OpenAlexW3138386431

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.