Evidence map›Paper›PMID 39061009›Full record

ArticleJournal of neurodevelopmental disorders2024

Characterizing the journey of Rett syndrome among females in the United States: a real-world evidence study using the Rett syndrome natural history study database.

Damian May, Kalé Kponee-Shovein, Jeffrey L Neul, Alan K Percy, Malena Mahendran, Nathaniel Downes, Grace Chen, Talissa Watson, Dominique C Pichard, Melissa Kennedy and 1 more

Abstract read
In one paragraph

Article in Journal of neurodevelopmental disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

11 authors.

Damian MayAcadia Pharmaceuticals, San Diego, CA, USA. dmay@ACADIA-Pharm.com.
Kalé Kponee-ShoveinAnalysis Group, Inc, Boston, MA, USA.
Jeffrey L NeulVanderbilt Kennedy Center, Nashville, TN, USA.
Alan K PercyHeersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA.
Malena MahendranAnalysis Group, Inc, Boston, MA, USA.
Nathaniel DownesAnalysis Group, Inc, Boston, MA, USA.
Grace ChenAnalysis Group, Inc, Boston, MA, USA.
Talissa WatsonAnalysis Group, Inc, Boston, MA, USA.
Dominique C PichardInternational Rett Syndrome Foundation, Cincinnati, OH, USA.
Melissa KennedyInternational Rett Syndrome Foundation, Cincinnati, OH, USA.
Patrick LefebvreAnalysis Group, Inc, Boston, MA, USA.

Funding

Overall: Eunice Kennedy Shriver Intellectual and Developmental Disabilities Research Center at VanderbiltP50HD103537 · NICHD · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Jeffrey L Neul · 2020 to 2026
$10.3M
ACADIA Pharmaceuticals ACADIA PharmaceuticalsNICHD NIH HHS P50 HD103537
6 · The paper itself

Abstract

backgroundWith the advent of the first targeted therapy for Rett Syndrome (RTT), a comprehensive assessment of the journey of RTT is needed to elucidate on present unmet needs in this population. This study characterized females with RTT in the United States and their disease journey with respect to longitudinal treatment patterns, RTT-related outcomes, and changes in disease severity.

methodsThis retrospective cohort study used registry data of females with RTT from the 5211 RTT Natural History Study (RNHS) (November 2015-July 2021). Pharmacological and supportive therapy use, RTT-related outcomes, and RTT severity, as measured by the Clinical Severity Scale and Motor Behavioral Assessment scale, were evaluated following the first RNHS visit. Analyses were conducted overall and in subgroups by RTT type (classic and atypical RTT) and age at first visit (pediatric and adult).

resultsA total of 455 females with RTT were included in the study, of whom 90.5% had classic RTT and 79.8% were pediatric individuals. Over a median follow-up of 4 years, use of pharmacological therapies, including prokinetic agents (42.7% vs. 28.3%), and supportive therapies, including physical therapy (87.3% vs. 40.2%) and speech-language therapy (86.8% vs. 23.9%), were more common in pediatric than adult individuals (all p < 0.05). Nearly half (44.6%) of all individuals had a hospital or emergency room visit, with a higher proportion of visits in individuals with classic RTT than atypical RTT and pediatric than adult individuals (both p = 0.001). An increasing trend in clinical severity was observed in pediatric individuals (mean change per year: 0.24; 95% confidence interval [CI]: 0.03, 0.44), while an increasing trend in motor-behavioral dysfunction was observed in pediatric individuals (mean change per year: 1.12; 95% CI: 0.63, 1.60) and those with classic RTT (mean change per year: 0.97; 95% CI: 0.53, 1.41).

conclusionsFindings from this study highlight the considerable burden of RTT across disease subtype and age. Despite reliance on supportive therapies and healthcare encounters, individuals with RTT experience increasing disease severity and motor-behavioral dysfunction in childhood and adolescence, underscoring the unmet needs of this population and the value of early intervention to manage RTT in the long-term.

Indexed as

Rett SyndromeAdolescentAdultChildChild, PreschoolDatabases, FactualFemaleHumansInfantRegistriesRetrospective StudiesSeverity of Illness IndexUnited StatesYoung AdultClinical manifestationsDisease progressionNatural historyRegistryRett syndromeTreatment patterns

Identifiers

PMID39061009
PMCPMC11282812

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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.