Publications by authors named "Mazen Dimachkie"

Article Synopsis
  • - The PROPEL trial studied the effects of cipaglucosidase alfa plus miglustat (cipa+mig) versus alglucosidase alfa plus placebo (alg+pbo) on adults with late-onset Pompe disease (LOPD) over 52 weeks, finding improvements in motor and respiratory function for those switching to cipa+mig.
  • - Patient-reported outcomes (PROs) evaluated included various measures of physical function, fatigue, and overall quality of life, with statistical analyses comparing responses between the two treatment groups.
  • - Results showed that cipa+mig significantly improved patient-reported impressions of change in ability to move around and generally outperformed alg+pbo in most PRO measures, indicating enhanced
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Introduction: Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disease with no known cure, limited treatment options with minimal benefits, and significant unmet need for disease modifying therapies.

Aims: This study investigated memantine's impact on ALS progression, with an additional focus on the effects of memantine on cognitive and behavioral changes associated with the disease.

Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted from December 2018 to September 2020.

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Amyotrophic lateral sclerosis (ALS) patients lack effective treatments to maintain motor and neuromuscular function. This study aimed to evaluate the effect of a home-based exercise program on muscle strength, ALS scores, and transcriptome in ALS patients, Clinical Trials.gov #NCT03201991 (28/06/2017).

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Article Synopsis
  • * The review aims to gather and assess existing MRI scoring systems to create an evidence-based foundation for a universal standardized system that can be used in both research and clinical settings.
  • * A systematic search of electronic databases will be conducted to consolidate information on MRI scanning protocols for evaluating muscle involvement in IIMs, with the goal of producing guidelines for consistent clinical and research practices.
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Background And Purpose: Various electrodiagnostic criteria have been developed in Guillain-Barré syndrome (GBS). Their performance in a broad representation of GBS patients has not been evaluated. Motor conduction data from the International GBS Outcome Study (IGOS) cohort were used to compare two widely used criterion sets and relate these to diagnostic amyotrophic lateral sclerosis criteria.

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  • The study assessed the effectiveness of the Inclusion Body Myositis Functional Rating Scale (IBMFRS) in measuring physical function in patients with IBM, focusing on its validity, reliability, responsiveness, and meaningful change threshold.
  • Data were collected from a 20-month multi-center clinical trial, employing various statistical methods to test the scale’s performance, revealing strong correlations with other health outcomes and reliability in its administration formats.
  • Results indicated that IBMFRS is a dependable tool for evaluating the impact of IBM on patients, with a score drop of 2 points considered a significant decline in function.
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Myositis International Health and Research Collaborative Alliance (MIHRA) is a newly formed purpose-built non-profit charitable research organization dedicated to accelerating international clinical trial readiness, global professional and lay education, career development and rare disease advocacy in IIM-related disorders. In its long form, the name expresses the community's scope of engagement and intent. In its abbreviation, MIHRA, conveys linguistic roots across many languages, that reflects the IIM community's spirit with meanings such as kindness, community, goodness, and peace.

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Inclusion body myositis (IBM) is a progressive, debilitating muscle disease commonly encountered in patients over the age of 50. IBM typically presents with asymmetric, painless, progressive weakness and atrophy of deep finger flexors and/or quadriceps muscle. Many patients with IBM develop dysphagia.

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The 2017 EULAR/ACR classification criteria for adult/juvenile idiopathic inflammatory myopathies (IIM) were established using a data-driven approach by an international group of myositis experts to allow classification of IIM and its major subtypes. Since their publication, the performance of the criteria has been tested in multiple cohorts worldwide and significant limitations have been identified. Moreover, the understanding and classification of IIM have evolved since 2017.

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Article Synopsis
  • Sporadic inclusion body myositis (IBM) primarily affects individuals over 40 and leads to progressive muscle weakness, with no effective treatments available, particularly for associated swallowing difficulties.
  • Up to 80% of IBM patients experience dysphagia, increasing their risk of severe complications like aspiration pneumonia, although the exact causes of this impairment remain unclear.
  • Current assessment methods for dysphagia in IBM, such as video fluoroscopic swallowing studies (VFSS), are limited by radiation exposure and a lack of validated tools, prompting a need for further development of alternative imaging techniques and approaches for evaluating swallowing difficulties.
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  • Dermatomyositis is an inflammatory muscle disease characterized by rashes and muscle weakness, with recent research (ProDERM study) focused on the effectiveness of intravenous immunoglobulin (IVIg) as treatment.
  • This study involved 95 adult patients, comparing the effects of IVIg to a placebo over 16 weeks, followed by an extension period where all patients received IVIg.
  • Findings indicated that while some patients experienced treatment-related adverse events (TEAEs), IVIg showed a generally favorable safety profile, with adjustments in dosage reducing certain risks without causing severe complications.
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Background: Clinical trials for rare diseases often include multiple endpoints that capture the effects of treatment on different disease domains. In many rare diseases, the primary endpoint is not standardized across trials. The win ratio approach was designed to analyze multiple endpoints of interest in clinical trials and has mostly been applied in cardiovascular trials.

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Background: The Phase 3 COMET trial (NCT02782741) comparing avalglucosidase alfa and alglucosidase alfa included health-related quality of life (HRQoL) assessments in treatment-naïve patients with late-onset Pompe disease (LOPD). Here, we further characterize results from disease-specific and general patient-reported outcome (PRO) measures.

Methods: Adults who participated in the COMET trial receiving avalglucosidase alfa or alglucosidase alfa (both 20 mg/kg biweekly) during the 49-week double-blind treatment period were included in the analysis.

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In the COMET trial of patients with late-onset Pompe disease, greater improvement in upright forced vital capacity (FVC) % predicted was observed with avalglucosidase alfa (AVA) vs alglucosidase alfa (ALGLU) (estimated treatment difference: 2.43%). The pre-specified mixed model repeated measures (MMRM) analysis demonstrated non-inferiority of AVA (P = 0.

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  • A study aimed to understand why only some patients with idiopathic peripheral neuropathy (IPN) experience neuropathic pain by analyzing proteins in their blood.
  • Researchers compared blood plasma from 31 painful IPN patients with 29 non-painful ones using mass-spectrometry to identify potential protein biomarkers.
  • The findings highlight a possible connection between the complement system and neuropathic pain, identifying specific proteins that could serve as indicators for pain severity in IPN patients.
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Background: Response adaptive randomization is popular in adaptive trial designs, but the literature detailing its execution is lacking. These designs are desirable for patients/stakeholders, particularly in comparative effectiveness research, due to the potential benefits including improving participant buy-in by providing more participants with better treatment during the trial. Frequentist approaches have often been used, but adaptive designs naturally fit the Bayesian methodology; it was developed to deal with data as they come in by updating prior information.

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Article Synopsis
  • Inclusion body myositis is a common muscle-wasting disease in people over 50, and no effective drug treatment currently exists, prompting research into the oral drug arimoclomol.
  • A double-blind, placebo-controlled study was conducted on 152 adults in specialist centers across the USA and the UK, randomly assigning them to receive either arimoclomol or a placebo for 20 months.
  • The primary goal was to measure changes in muscle function using the Inclusion Body Myositis Functional Rating Scale, with safety evaluations including all participants who received at least one dose of the medication.
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Purpose Of Review: Dysphagia is a common symptom of sporadic inclusion body myositis (IBM), affecting disease trajectory and patient quality-of-life. Despite this, it is considerably understudied. The purpose of this review is to summarize current evidence related to the evaluation and management of dysphagia in IBM.

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Background And Objectives: The Pompe Disease Symptom Scale (PDSS) and Impact Scale (PDIS) were created to measure the severity of symptoms and functional limitations experienced by patients with late-onset Pompe disease (LOPD). The objectives of this analysis were to establish a scoring algorithm and to examine the reliability, validity, and responsiveness of the measures using data from the COMET clinical trial.

Methods: The COMET trial was a randomized, double-blind study comparing the efficacy and safety of avalglucosidase alfa and alglucosidase alfa in patients with LOPD aged 16-78 years at baseline.

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Background And Objectives: Sporadic inclusion body myositis (IBM) is a rare, muscle-wasting disease that negatively affects health-related quality of life. Although a measure that has been developed to assess the impact of IBM, the IBM Functional Rating Scale (IBMFRS) has limited evidence of content validity or reliability, and what constitutes a meaningful change threshold; this study was conducted to address these gaps.

Methods: Adult patients with a clinical diagnosis of IBM from the United Kingdom and disease area expert health care professionals from the United States and United Kingdom took part in this study.

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ALSUntangled reviews alternative and off-label treatments for people living with amyotrophic lateral sclerosis (PALS). Here, we review caffeine which has plausible mechanisms for slowing ALS progression. However, pre-clinical studies are contradictory, and a large case series showed no relationship between caffeine intake and ALS progression rate.

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Idiopathic inflammatory myopathies (IIMs) are a group of acquired muscle diseases with muscle inflammation, weakness, and other extra-muscular manifestations. IIMs can significantly impact the quality of life, and management of IIMs often requires a multi-disciplinary approach. Imaging biomarkers have become an integral part of the management of IIMs.

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Article Synopsis
  • * Experts summarized essential MG outcome measures and convened a symposium to address variability, resulting in updated instructions and modifications for key measures like the MG-Activities of Daily Living and QMG score.
  • * Upcoming training materials and revised documents will be freely accessible on the MGNet website, with future studies planned to validate the updates made to the QMG-Revised.
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