👤 Natalie F Reash

The Patient-Reported Outcomes Measurement Information System (PROMIS) is a collection of generic patient-reported outcome instruments used to quantify disease impact on a variety of functional subdomains, including physical, cognitive, emotional, and other domains. The reliability and validity of the PROMIS Parent Proxy (PP) Physical Function-Upper Extremity (UE) item bank is not established in children with Duchenne muscular dystrophy (DMD). This study evaluated the psychometric properties and measurement quality of the PROMIS PP UE item bank v1.0 (29 items) in DMD using a Rasch psychometric analysis. The PROMIS PP UE item bank was completed by caregivers of children with DMD aged at least 8 years, under care at Nationwide Children's Hospital (Columbus, OH, United States). Rasch analysis was used to evaluate the psychometric performance of the measure and its items in DMD, based on several criteria, including item-trait interaction, individual items fit, Person Separation Index (PSI), individual persons fit, and response dependency. Rasch analysis was conducted on 206 observations. Several items had weak clinical utility in measuring upper extremity functioning in DMD. Additionally, the analysis identified specific response options that could be restructured to improve the reliability and precision of the items in evaluating upper extremity function in DMD. A new customized 21-item measure demonstrated overall good fit to Rasch model expectations ( The customized PROMIS PP UE measure conformed to Rasch assumptions, indicating that it can serve as a reliable option for caregiver-reported upper extremity assessment in DMD. Show less

Single exon duplications account for disease in a minority of Duchenne muscular dystrophy patients. Exon skipping in these patients has the potential to be highly therapeutic through restoration of full-length dystrophin expression. We conducted a 48-week open label study of casimersen and golodirsen in 3 subjects with an exon 45 or 53 duplication. Two subjects (aged 18 and 23 years) were non-ambulatory at baseline. Upper limb, pulmonary, and cardiac function appeared stable in the 2 subjects in whom they could be evaluated. Dystrophin expression increased from 0.94 % ±0.59% (mean±SD) of normal to 5.1% ±2.9% by western blot. Percent dystrophin positive fibers also rose from 14% ±17% at baseline to 50% ±42% . Our results provide initial evidence that the use of exon-skipping drugs may increase dystrophin levels in patients with single-exon duplications. Show less