Publications by authors named "Kirschner J"

In a longitudinal clinical registry, different measurement instruments might have been used for assessing individuals at different time points. To combine them, we investigate deep learning techniques for obtaining a joint latent representation, to which the items of different measurement instruments are mapped. This corresponds to domain adaptation, an established concept in computer science for image data.

View Article and Find Full Text PDF

Background: Real-world data on gene addition therapy (GAT) with onasemnogene abeparvovec (OA), including all age groups and with or without symptoms of the disease before treatment are needed to provide families with evidence-based advice and realistic therapeutic goals. Aim of this study is therefore a population-based analysis of all patients with SMA treated with OA across Germany, Austria and Switzerland (D-A-CH).

Methods: This observational study included individuals with Spinal Muscular Atrophy (SMA) treated with OA in 29 specialized neuromuscular centers in the D-A-CH-region.

View Article and Find Full Text PDF

Background: Overdose is a leading cause of maternal mortality; in response, maternal mortality review committees have recommended expanding substance use disorder (SUD) screening, improving collaboration between obstetric and SUD treatment providers, and reducing fragmentation in systems of care. We undertook an analysis of the perinatal SUD treatment landscape in Baltimore, Maryland in order to identify barriers to treatment engagement during pregnancy and the postpartum period and guide system improvement efforts.

Methods: We conducted a survey of seven birthing hospitals, 31 prenatal care practices, and 108 SUD treatment providers in Baltimore from April-June 2023.

View Article and Find Full Text PDF
Article Synopsis
  • The study focuses on the safety and effectiveness of a new anticoagulant reversal agent in patients experiencing major bleeding while on anticoagulation therapy.
  • It compares the outcomes of patients treated with this agent against those receiving standard care.
  • Results show that the new agent significantly reduced bleeding and improved hemostasis, suggesting it could be a valuable option in emergency settings.
View Article and Find Full Text PDF
Article Synopsis
  • * One key treatment is the gene therapy called onasemnogene abeparvovec (Zolgensma®), which is effective for patients with specific genetic profiles, although its broad usage raises concerns about safety for less clear cases.
  • * A European expert group has investigated the use of Zolgensma® for older and heavier SMA patients, resulting in 12 consensus statements that reflect the evolving understanding of its effectiveness based on new clinical and real-world evidence.
View Article and Find Full Text PDF
Article Synopsis
  • The study revisits a decade-old cohort of patients with mitochondrial disorders who previously had a 40% undiagnosed rate using whole exome sequencing (WES), aiming to improve genetic diagnoses through reanalysis of existing data.
  • Using a standardized analysis platform, they reexamined WES data from 14 individuals and identified potential genetic diagnoses in 57% of the cases, specifically in mitochondrial and nuclear genes.
  • The findings emphasize the importance of reanalyzing existing genetic data to increase diagnostic yield, as advancements in bioinformatics and variant interpretation can lead to new insights over time.
View Article and Find Full Text PDF

Risdiplam is a once-daily oral, survival of motor neuron 2 (SMN2) splicing modifier approved for the treatment of spinal muscular atrophy (SMA). JEWELFISH (NCT03032172) investigated the safety, tolerability, pharmacokinetics (PK), and PK/pharmacodynamic (PD) relationship of risdiplam in non-treatment-naïve patients with SMA. JEWELFISH enrolled adult and pediatric patients (N = 174) with confirmed diagnosis of 5q-autosomal recessive SMA who had previously received treatment with nusinersen (n = 76), onasemnogene abeparvovec (n = 14), olesoxime (n = 71), or were enrolled in the MOONFISH study (NCT02240355) of the splicing modifier RG7800 (n = 13).

View Article and Find Full Text PDF

Objective: The objective of this study was to describe predictors of loss of ambulation in Duchenne muscular dystrophy (DMD).

Methods: This systematic review and meta-analysis included searches of MEDLINE ALL, Embase, and the Cochrane Database of Systematic Reviews from January 1, 2000, to December 31, 2022, for predictors of loss of ambulation in DMD. Search terms included "Duchenne muscular dystrophy" as a Medical Subject Heading or free text term, in combination with variations of the term "predictor".

View Article and Find Full Text PDF

Introduction: Rare diseases (RDs) collectively impact over 30 million people in Europe. Most individual conditions have a low prevalence which has resulted in a lack of research and expertise in this field, especially regarding genetic newborn screening (gNBS). There is increasing recognition of the importance of incorporating patients' needs and general public perspectives into the shared decision-making process regarding gNBS.

View Article and Find Full Text PDF
Article Synopsis
  • Early diagnosis and treatment are crucial for improving outcomes in infants with spinal muscular atrophy (SMA), leading to the implementation of newborn screening programs, but there is a lack of robust data confirming their benefits.* -
  • This study compared SMA patients diagnosed through newborn screening to those diagnosed after symptoms appeared, using data from 234 children across Germany, Austria, and Switzerland from the SMARTCARE registry.* -
  • Results showed that infants identified through newborn screening started treatment significantly earlier (average 1.3 months) than those diagnosed by symptoms (average 10.7 months), leading to better motor milestones, such as higher rates of independent sitting and walking.*
View Article and Find Full Text PDF

Genomic sequencing is poised to expand newborn screening for treatable childhood-onset disorders. Over 30 international research studies and companies are exploring its use, collectively aiming to screen more than 500,000 infants. A key challenge is determining which genes to include in screening.

View Article and Find Full Text PDF
Article Synopsis
  • Collagen VI-related dystrophies (COL6-RDs) include a range of conditions such as Ullrich congenital muscular dystrophy (UCMD), which features severe muscle weakness and respiratory issues, and Bethlem muscular dystrophy, which has milder and later-presenting symptoms.
  • Some patients with symptoms typical of COL6-RDs were previously undiagnosed until a deep intronic variant in COL6A1 was identified, leading to a severe form of UCMD in a cohort of 44 patients, except for one with a milder phenotype.
  • The study suggests that a new pseudoexon skipping therapy could effectively reduce the severity of UCMD symptoms by targeting the abnormal transcripts
View Article and Find Full Text PDF

Introduction: Tobacco and nicotine use are prevalent in residential substance use disorder (SUD) treatment programs that serve pregnant and parenting women. This study evaluated a group intervention that integrates knitting instruction, psychoeducation, and social support to improve readiness to quit and reduce tobacco and nicotine use among this population.

Methods: Clients and staff in four residential SUD treatment programs were assigned to a six-week group intervention or a wait-list control group.

View Article and Find Full Text PDF

Newborn screening for 5qSMA offers the potential for early, ideally pre-symptomatic, therapeutic intervention. However, limited data exist on the outcomes of individuals with 4 copies of SMN2, and there is no consensus within the SMA treatment community regarding early treatment initiation in this subgroup. To provide evidence-based insights into disease progression, we performed a retrospective analysis of 268 patients with 4 copies of SMN2 from the SMArtCARE registry in Germany, Austria and Switzerland.

View Article and Find Full Text PDF
Article Synopsis
  • The study examined the long-term efficacy and safety of nusinersen in adults with 5q-associated spinal muscular atrophy (SMA) over a period of 38 months, utilizing a large cohort from Germany, Switzerland, and Austria.
  • Overall, significant improvements were noted in various motor performance measures (HFMSE, RULM, and 6MWT) at multiple time points compared to baseline, indicating ongoing benefits from the treatment.
  • No new safety concerns were found, reinforcing the idea that nusinersen remains a viable therapy for adults with SMA over extended periods.
View Article and Find Full Text PDF

Background: The EURO-NMD Registry collects data from all neuromuscular patients seen at EURO-NMD's expert centres. In-kind contributions from three patient organisations have ensured that the registry is patient-centred, meaningful, and impactful. The consenting process covers other uses, such as research, cohort finding and trial readiness.

View Article and Find Full Text PDF
Article Synopsis
  • Long-term real-world data on the effectiveness and safety of onasemnogene abeparvovec for spinal muscular atrophy (SMA) is crucial for understanding outcomes outside clinical trials.
  • The RESTORE registry tracked 168 patients treated with this therapy, revealing a median age of 3 months at treatment and a majority identified through newborn screening.
  • Results showed all patients maintained or achieved motor milestones, but nearly half experienced at least one adverse event, reinforcing the treatment's safety profile.
View Article and Find Full Text PDF
Article Synopsis
  • The 270th ENMC workshop focused on improving the methods for accurately determining SMN2 gene copy number, which is vital for making treatment decisions in SMA (Spinal Muscular Atrophy) patients.
  • It brought together experts from neuromuscular medicine, clinical practice, patient advocacy, and industry to discuss the challenges faced by laboratories in this testing process.
  • Participants concluded with a set of recommendations for enhancing molecular prognosis, newborn screening, treatment approaches, and guidelines for laboratory kit manufacturers to reduce errors in testing.
View Article and Find Full Text PDF

Background: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease of the upper and lower motor neurons with varying ages of onset, progression and pathomechanisms. Monogenic childhood-onset ALS, although rare, forms an important subgroup of ALS. We recently reported specific variants resulting in sphingolipid overproduction as a cause for juvenile ALS.

View Article and Find Full Text PDF
Article Synopsis
  • Spinal muscular atrophy (SMA) is a genetic disease causing muscle weakness; gene replacement therapy (GRT) is one treatment but can affect the heart, making cardiac monitoring essential.
  • This study collected high-sensitive cardiac troponin I (hs-cTnI) levels from 30 newborns with SMA and compared them to 16 without SMA to establish baseline values.
  • Results showed neonates with SMA had higher hs-cTnI levels than adult reference values, indicating the need for careful monitoring of these levels before and after GRT treatment.
View Article and Find Full Text PDF

Since 72% of rare diseases are genetic in origin and mostly paediatrics, genetic newborn screening represents a diagnostic "window of opportunity". Therefore, many gNBS initiatives started in different European countries. Screen4Care is a research project, which resulted of a joint effort between the European Union Commission and the European Federation of Pharmaceutical Industries and Associations.

View Article and Find Full Text PDF