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Natural History, Trial Readiness and Gene Discovery: Advances in Patient Registries for Neuromuscular Disease

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Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1031))

Abstract

Inherited neuromuscular diseases (NMDs) are genetic disorders that affect the skeletal muscles or the nerves controlling muscle function. With a new generation of diagnostic options and recent advances in translational research improving the opportunities for therapy development for these rare conditions, capturing patient information in databases collecting a range of clinical and genetic data together with contact details has assumed an increasingly important role in trial planning and recruitment as well as natural history data collection. Here we provide an overview of a decade of patient registration activities in the NMD field, with a particular focus on patient registries set up with trial readiness in mind. A summary is provided of databases collecting precise genetic information focused on confirming the causative mutation and their evolution into registries that combine genetic data with additional clinical information useful for trial feasibility and recruitment. Use of these systems for a range of purposes beyond trial recruitment, including natural history assessment, care standards monitoring, genotype-phenotype correlation and disease burden evaluation is also described within the context of research networks (TREAT-NMD) and European Reference Networks (ERN-EURO-NMD). New initiatives including registries using controlled vocabularies for computational accessibility that focus on phenotypic data capture for gene discovery are analysed, and examples of the lessons learned at every stage are provided in order to allow new patient registration initiatives to benefit from the extensive experience gained.

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References

  1. Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation) (Text with EEA relevance), (2016)

    Google Scholar 

  2. Aartsma-Rus A, Fokkema I, Verschuuren J, Ginjaar I, van Deutekom J, van Ommen GJ et al (2009) Theoretic applicability of antisense-mediated exon skipping for Duchenne muscular dystrophy mutations. Hum Mutat 30(3):293–299

    Article  PubMed  Google Scholar 

  3. Beroud C, Collod-Beroud G, Boileau C, Soussi T, Junien C (2000) UMD (Universal mutation database): a generic software to build and analyze locus-specific databases. Hum Mutat 15(1):86–94

    Article  CAS  PubMed  Google Scholar 

  4. Bladen CL, Rafferty K, Straub V, Monges S, Moresco A, Dawkins H et al (2013) The TREAT-NMD Duchenne muscular dystrophy registries: conception, design, and utilization by industry and academia. Hum Mutat 34(11):1449–1457

    Article  PubMed  Google Scholar 

  5. Bladen CL, Salgado D, Monges S, Foncuberta ME, Kekou K, Kosma K et al (2015) The TREAT-NMD DMD Global Database: analysis of more than 7,000 Duchenne muscular dystrophy mutations. Hum Mutat 36(4):395–402

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Bladen CL, Thompson R, Jackson JM, Garland C, Wegel C, Ambrosini A et al (2014) Mapping the differences in care for 5,000 spinal muscular atrophy patients, a survey of 24 national registries in North America, Australasia and Europe. J Neurol 261(1):152–163

    Article  PubMed  Google Scholar 

  7. Brabec P, Vondracek P, Klimes D, Baumeister S, Lochmuller H, Pavlik T et al (2009) Characterization of the DMD/BMD patient population in Czech Republic and Slovakia using an innovative registry approach. Neuromuscul Disord 19(4):250–254

    Article  PubMed  Google Scholar 

  8. Bushby K, Connor E (2011) Clinical outcome measures for trials in Duchenne muscular dystrophy: report from International Working Group meetings. Clin Investig 1(9):1217–1235

    Article  Google Scholar 

  9. Bushby K, Finkel R, Birnkrant DJ, Case LE, Clemens PR, Cripe L et al (2010) Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and pharmacological and psychosocial management. Lancet Neurol 9(1):77–93

    Article  PubMed  Google Scholar 

  10. Bushby K, Finkel R, Birnkrant DJ, Case LE, Clemens PR, Cripe L et al (2010) Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. Lancet Neurol 9(2):177–189

    Article  CAS  PubMed  Google Scholar 

  11. Bushby K, Lynn S, Straub V (2009) Collaborating to bring new therapies to the patient--the TREAT-NMD model. Acta Myol 28(1):12–15

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Coorevits P, Sundgren M, Klein GO, Bahr A, Claerhout B, Daniel C et al (2013) Electronic health records: new opportunities for clinical research. J Intern Med 274(6):547–560

    Article  CAS  PubMed  Google Scholar 

  13. DeMuro C, Clark M, Doward L, Evans E, Mordin M, Gnanasakthy A (2013) Assessment of PRO label claims granted by the FDA as compared to the EMA (2006–2010). Value in Health, J Int Soc Pharmacoecon Outcomes Res 16(8):1150–1155

    Article  Google Scholar 

  14. Dogan C, Puymirat J, Bassez G (2015) DM-SCOPE, an intermediary appraisal report and benefits of databases in neuromuscular disorders. Med Sci, M/S. 31 Spec No 3:18–9

    Google Scholar 

  15. Dutch Techcentre for Life Sciences. The Personal Health Train initiative. http://www.dtls.nl/fair-data/personal-health-train/. Accessed 1 July 2016

  16. Eagle M, Bourke J, Bullock R, Gibson M, Mehta J, Giddings D et al (2007) Managing Duchenne muscular dystrophy--the additive effect of spinal surgery and home nocturnal ventilation in improving survival. Neuromuscul Disord 17(6):470–475

    Article  PubMed  Google Scholar 

  17. European Union Committee of Experts on Rare Diseases. EUCERD Recommendations on Quality Criteria for Centres of Expertise for Rare Diseases in Member States. http://www.EUCERD.eu/upload/file/EUCERDRecommendationCE.pdf. 2011 Accessed 1 July 2016

  18. European Union Committee of Experts on Rare Diseases. EUCERD Core Recommendations on Rare Disease Patient Registration and Data Collection. http://www.eucerd.eu/wp-content/uploads/2013/06/EUCERD_Recommendations_RDRegistryDataCollection_adopted.pdf. 2013 Accessed 1 July 2016

  19. Evangelista T, Hedley V, Atalaia A, Johnson M, Lynn S, Le Cam Y et al (2016) The context for the thematic grouping of rare diseases to facilitate the establishment of European Reference Networks. Orphanet J Rare Dis 11:17

    Article  PubMed  PubMed Central  Google Scholar 

  20. Evangelista T, Wood L, Fernandez-Torron R, Williams M, Smith D, Lunt P et al (2016) Design, set-up and utility of the UK facioscapulohumeral muscular dystrophy patient registry. J Neurol 263(7):1401–1408

    Article  PubMed  PubMed Central  Google Scholar 

  21. Fokkema IF, Taschner PE, Schaafsma GC, Celli J, Laros JF, den Dunnen JTLOVD (2011) v.2.0: the next generation in gene variant databases. Hum Mutat 32(5):557–563

    Article  CAS  PubMed  Google Scholar 

  22. Gainotti S, Turner C, Woods S, Kole A, McCormack P, Lochmuller H et al (2016) Improving the informed consent process in international collaborative rare disease research: effective consent for effective research. Eur J Hum Genet 24(9):1248–1254

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. GNEM-DMP consortium The GNE myopathy disease monitoring program (GNEM-DMP). www.gnem-dmp.com/. Accessed 1 July 2016

  24. Gonzalez M, Falk MJ, Gai X, Postrel R, Schule R, Zuchner S (2015 Oct) Innovative genomic collaboration using the GENESIS (GEM.app) platform. Hum Mutat 36(10):950–956

    Article  PubMed  PubMed Central  Google Scholar 

  25. Hall A, Sireau N (eds) (2016) The patient group handbook: a practical guide for research and drug development. Create Space Independent Publishing Platform, North Charleston

    Google Scholar 

  26. Hansson MG, van Ommen GJ, Chadwick R, Dillner J (2013) Patients would benefit from simplified ethical review and consent procedure. Lancet Oncol 14(6):451–453

    Article  PubMed  Google Scholar 

  27. Heslop E, Csimma C, Straub V, McCall J, Nagaraju K, Wagner KR et al (2015) The TREAT-NMD advisory committee for therapeutics (TACT): an innovative de-risking model to foster orphan drug development. Orphanet J Rare Dis 10(1):49

    Article  PubMed  PubMed Central  Google Scholar 

  28. Kaplan J-C, Hamroun D (2015) The 2016 version of the gene table of monogenic neuromuscular disorders (nuclear genome). Neuromuscul Disord 25(12):991–1020

    Article  PubMed  Google Scholar 

  29. Kirschner J, Schessl J, Schara U, Reitter B, Stettner GM, Hobbiebrunken E et al (2010) Treatment of Duchenne muscular dystrophy with ciclosporin A: a randomised, double-blind, placebo-controlled multicentre trial. Lancet Neurol 9(11):1053–1059

    Article  CAS  PubMed  Google Scholar 

  30. Köhler S, Vasilevsky NA, Engelstad M, Foster E, McMurry J, Aymé S et al (2017) The Human Phenotype Ontology in 2017. Nucleic Acids Res 4;45(D1):D865–D876

    Google Scholar 

  31. Korngut L, Campbell C, Johnston M, Benstead T, Genge A, Mackenzie A et al (2013) The CNDR: collaborating to translate new therapies for Canadians. Can J Neurol Sci 40(5):698–704

    Google Scholar 

  32. Landfeldt E, Alfredsson L, Straub V, Lochmuller H, Bushby K, Lindgren P (2017) Economic evaluation in Duchenne muscular dystrophy: model frameworks for cost-effectiveness analysis. Pharmacoeconomics 35(2):249–258

    Google Scholar 

  33. Landfeldt E, Lindgren P, Bell CF, Schmitt C, Guglieri M, Straub V et al (2014) The burden of Duchenne muscular dystrophy: an international, cross-sectional study. Neurology 83(6):529–536

    Article  PubMed  PubMed Central  Google Scholar 

  34. Landfeldt E, Lindgren P, Bell CF, Schmitt C, Guglieri M, Straub V et al (2015) Compliance to care guidelines for Duchenne muscular dystrophy. J Neuromuscul Dis 2(1):63–72

    PubMed  PubMed Central  Google Scholar 

  35. Lochmuller H, Le Cam Y, Jonker AH, Lau LP, Baynam G, Kaufmann P et al (2017) ‘IRDiRC Recognized Resources’: a new mechanism to support scientists to conduct efficient, high-quality research for rare diseases. Eur J Hum Genet 25(2):162–165

    Google Scholar 

  36. Mascalzoni D, Dove ES, Rubinstein Y, Dawkins HJS, Kole A, McCormack P et al (2014) International Charter of principles for sharing bio-specimens and data. Eur J Hum Genet 23(6):721–728

    Article  PubMed  PubMed Central  Google Scholar 

  37. McCormack P, Kole A, Gainotti S, Mascalzoni D, Molster C, Lochmuller H et al (2016) ‘You should at least ask’. The expectations, hopes and fears of rare disease patients on large-scale data and biomaterial sharing for genomics research. Eur J Hum Genet 24(10):1403–1408

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. McCormack P, Woods S, Aartsma-Rus A, Hagger L, Herczegfalvi A, Heslop E, et al (2013) Guidance in social and ethical issues related to clinical, diagnostic care and novel therapies for hereditary neuromuscular rare diseases: “translating” the translational. PLoS Curr 10(5)

    Google Scholar 

  39. Mercuri E, Mayhew A, Muntoni F, Messina S, Straub V, Van Ommen GJ et al (2008) Towards harmonisation of outcome measures for DMD and SMA within TREAT-NMD; report of three expert workshops: TREAT-NMD/ENMC workshop on outcome measures, 12th--13th May 2007, Naarden, The Netherlands; TREAT-NMD workshop on outcome measures in experimental trials for DMD, 30th June--1st July 2007, Naarden, The Netherlands; conjoint Institute of Myology TREAT-NMD meeting on physical activity monitoring in neuromuscular disorders, 11th July 2007, Paris, France. Neuromuscul Disord 18(11):894–903

    Article  CAS  PubMed  Google Scholar 

  40. Mora M, Angelini C, Bignami F, Bodin A-M, Crimi M, Di Donato J-H, et al (2015) The EuroBioBank Network: 10 years of hands-on experience of collaborative, transnational biobanking for rare diseases. Eur J Hum Genet 23(9):1116–1123

    Google Scholar 

  41. NeurOmics Project Consortium. NeurOmics website. http://rd-neuromics.eu/. Accessed 1 July 2016

  42. Norwood FL, Harling C, Chinnery PF, Eagle M, Bushby K, Straub V (2009) Prevalence of genetic muscle disease in Northern England: in-depth analysis of a muscle clinic population. Brain 132(Pt 11):3175–3186

    Article  PubMed  PubMed Central  Google Scholar 

  43. Philippakis AA, Azzariti DR, Beltran S, Brookes AJ, Brownstein CA, Brudno M et al (2015) The Matchmaker Exchange: a platform for rare disease gene discovery. Hum Mutat 36(10):915–921

    Article  PubMed  PubMed Central  Google Scholar 

  44. Rahbek J, Werge B, Madsen A, Marquardt J, Steffensen BF, Jeppesen J (2005) Adult life with Duchenne muscular dystrophy: observations among an emerging and unforeseen patient population. Pediatr Rehabil 8(1):17–28

    Article  PubMed  Google Scholar 

  45. Rashbass J, Peake M (2014) The evolution of cancer registration. Eur J Cancer Care 23(6):757–759

    Article  CAS  Google Scholar 

  46. Ricotti V, Ridout DA, Pane M, Main M, Mayhew A, Mercuri E et al (2016) The NorthStar Ambulatory Assessment in Duchenne muscular dystrophy: considerations for the design of clinical trials. J Neurol Neurosurg Psychiatry 87(2):149–155

    PubMed  Google Scholar 

  47. Rodger S, Lochmuller H, Tassoni A, Gramsch K, Konig K, Bushby K et al (2013) The TREAT-NMD care and trial site registry: an online registry to facilitate clinical research for neuromuscular diseases. Orphanet J Rare Dis 8:171

    Article  PubMed  PubMed Central  Google Scholar 

  48. Rodger S, Woods KL, Bladen CL, Stringer A, Vry J, Gramsch K et al (2015) Adult care for Duchenne muscular dystrophy in the UK. J Neurol 262(3):629–641

    Article  PubMed  Google Scholar 

  49. Rodrigues M, Hammond-Tooke G, Kidd A, Love D, Patel R, Dawkins H et al (2012) The New Zealand neuromuscular disease registry. J Clin Neurosci, Off J Neurosurg Soc Australasia 19(12):1749–1750

    Google Scholar 

  50. Rodwell C, Ayme S (2015) Rare disease policies to improve care for patients in Europe. Biochim Biophys Acta 1852(10 Pt B):2329–2335

    Article  CAS  PubMed  Google Scholar 

  51. Sarkozy A, Bushby K, Beroud C, Lochmuller H (2008) 157th ENMC International Workshop: patient registries for rare, inherited muscular disorders 25-27 January 2008 Naarden, The Netherlands. Neuromuscul Disord 18(12):997–1001

    Article  PubMed  Google Scholar 

  52. Sawyer SL, Hartley T, Dyment DA, Beaulieu CL, Schwartzentruber J, Smith A et al (2016) Utility of whole-exome sequencing for those near the end of the diagnostic odyssey: time to address gaps in care. Clin Genet 89(3):275–284

    Article  CAS  PubMed  Google Scholar 

  53. Scott E, Eagle M, Mayhew A, Freeman J, Main M, Sheehan J et al (2012) Development of a functional assessment scale for ambulatory boys with Duchenne muscular dystrophy. Physiother Res Int, J Research Clin Phys Ther 17(2):101–109

    Article  Google Scholar 

  54. Sparks S, Quijano-Roy S, Harper A, Rutkowski A, Gordon E, Hoffman EP et al (1993) In: Pagon RA, Adam MP, Ardinger HH, Wallace SE, Amemiya A, LJH B et al (eds) Congenital muscular dystrophy overview. GeneReviews(R), Seattle

    Google Scholar 

  55. Taruscio D, Gainotti S, Mollo E, Vittozzi L, Bianchi F, Ensini M et al (2013) The current situation and needs of rare disease registries in Europe. Public Health Genomics 16(6):288–298

    Article  CAS  PubMed  Google Scholar 

  56. Thompson R, Johnston L, Taruscio D, Monaco L, Beroud C, Gut IG et al (2014) RD-Connect: an integrated platform connecting databases, registries, biobanks and clinical bioinformatics for rare disease research. J Gen Intern Med 29(Suppl 3):S780–S787

    Article  PubMed  Google Scholar 

  57. Thompson R, Schoser B, Monckton DG, Blonsky K, Lochmuller H (2009) Patient registries and trial readiness in myotonic dystrophy--TREAT-NMD/Marigold International workshop report. Neuromuscul Disord 19(12):860–866

    Article  PubMed  Google Scholar 

  58. Thompson R, Straub V (2016) Limb-girdle muscular dystrophies – international collaborations for translational research. Nat Rev Neurol 12(5):294–309

    Article  CAS  PubMed  Google Scholar 

  59. TREAT-NMD Neuromuscular Network. Charter for the TREAT-NMD database/registry. http://www.treat-nmd.eu/downloads/file/TGDOC_Charter_2016.pdf. Accessed 1 July 2016

  60. TREAT-NMD Neuromuscular Network. TREAT-NMD Global Database Oversight Committee (TGDOC). http://www.treat-nmd.eu/resources/patient-registries/global-registries/governance/. Accessed 1 July 2016

  61. TREAT-NMD Neuromuscular Network. TREAT-NMD Registries Toolkit. http://www.treatnmd.eu/resources/patient-registries/tookit/. Accessed 1 July 2016

  62. TREAT-NMD Neuromuscular Network. TREAT-NMD: advancing diagnosis, care and treatment for people with neuromuscular diseases around the world. www.treat-nmd.eu. Accessed 1 July 2016

  63. van Deutekom JC, Bremmer-Bout M, Janson AA, Ginjaar IB, Baas F, den Dunnen JT et al (2001) Antisense-induced exon skipping restores dystrophin expression in DMD patient derived muscle cells. Hum Mol Genet 10(15):1547–1554

    Article  PubMed  Google Scholar 

  64. Vry J, Gramsch K, Rodger S, Thompson R, Steffensen BF, Rahbek J et al (2016) European cross-sectional survey of current care practices for Duchenne muscular dystrophy reveals regional and age-dependent differences. J Neuromuscul Dis 3(4):517–527

    Article  PubMed  PubMed Central  Google Scholar 

  65. Wang RT, Nelson SF (2015) What can Duchenne connect teach us about treating Duchenne muscular dystrophy? Curr Opin Neurol 28(5):535–541

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Wang RT, Silverstein Fadlon CA, Ulm JW, Jankovic I, Eskin A, Lu A, et al (2014) Online self-report data for Duchenne muscular dystrophy confirms natural history and can be used to assess for therapeutic benefits. PLoS Curr 17(6)

    Google Scholar 

  67. Wilkinson MD, Dumontier M, Aalbersberg IJ, Appleton G, Axton M, Baak A et al (2016) The FAIR guiding principles for scientific data management and stewardship. Sci Data 3:160018

    Article  PubMed  PubMed Central  Google Scholar 

  68. Willmann R, De Luca A, Benatar M, Grounds M, Dubach J, Raymackers JM et al (2012) Enhancing translation: guidelines for standard pre-clinical experiments in mdx mice. Neuromuscul Disord 22(1):43–49

    Article  PubMed  Google Scholar 

  69. Verhaart IEC, Robertson A, Leary R, McMacken G, König K, Kirschner J et al (2017) A multi-source approach to determine SMA incidence and research ready population. J Neurol 264 (7):1465–1473

    Google Scholar 

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Acknowledgments

This work was funded by the UK Medical Research Council (MRC) Centre for Neuromuscular Diseases (reference G1002274, grant ID 98482) and by MRC grant number G0900872. HL receives funding from the European Commission through the projects NeurOmics (Grant No. 305121) and RD-Connect (Grant No. 305444). AR receives funding from SMA Support UK and the LGMD2I Research Fund. RT is funded by the European Commission through RD-Connect (No. 305444). The authors wish to acknowledge Rebecca Leary, Anne Oyewole, Oksana Pogoryelova and Elizabeth Wood for insight and information on individual registry initiatives related to TREAT-NMD, as well as the members of the TREAT-NMD executive committee and global database oversight committee (TGDOC).

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Correspondence to Hanns Lochmüller .

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Thompson, R., Robertson, A., Lochmüller, H. (2017). Natural History, Trial Readiness and Gene Discovery: Advances in Patient Registries for Neuromuscular Disease. In: Posada de la Paz, M., Taruscio, D., Groft, S. (eds) Rare Diseases Epidemiology: Update and Overview. Advances in Experimental Medicine and Biology, vol 1031. Springer, Cham. https://doi.org/10.1007/978-3-319-67144-4_5

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