Publications by authors named "Mozaffar T"

Objective: Limb-girdle muscular dystrophy R9 (LGMDR9, formerly known as LGMD2I), caused by variants in the fukutin-related protein (FKRP) gene leads to progressive muscle weakness of the shoulder and pelvic limb-girdles and loss of motor function over time. Clinical management and future trial design are improved by determining which standardized clinical outcome assessments (COA) of function are most appropriate to capture disease presentation and progression, informing endpoint selection and enrollment criteria. The purpose of our study was to evaluate the cross-sectional validity and reliability of clinical outcome assessments in patients with FKRP-related LGMDR9 participating in the Genetic Resolution and Assessments Solving Phenotypes in LGMD (GRASP) natural history study.

View Article and Find Full Text PDF
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
View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to assess the safety and effectiveness of caprylate/chromatography-purified intravenous immunoglobulin (IGIV-C) in patients with generalized myasthenia gravis (MG) compared to a placebo.
  • A total of 62 patients participated in a randomized trial, where IGIV-C showed a numerical improvement in certain outcomes like activities of daily living, although most primary and secondary outcomes did not reach statistical significance.
  • While IGIV-C was generally well-tolerated, the small size of the study suggests the need for further research to better understand its potential as a maintenance therapy for MG.
View Article and Find Full Text PDF

Enzyme replacement therapy (ERT) is the only approved disease-modifying treatment modality for Pompe disease, a rare, inherited metabolic disorder caused by a deficiency in the acid -glucosidase (GAA) enzyme that catabolizes lysosomal glycogen. First-generation recombinant human GAA (rhGAA) ERT (alglucosidase alfa) can slow the progressive muscle degeneration characteristic of the disease. Still, most patients experience diminished efficacy over time, possibly because of poor uptake into target tissues.

View Article and Find Full Text PDF
Article Synopsis
  • Late-onset Pompe disease leads to worsening muscle and respiratory function, traditionally treated with enzyme replacement therapy (ERT) using alglucosidase alfa, but newer options like avalglucosidase alfa and cipaglucosidase alfa with miglustat are now available.
  • Researchers conducted a systematic review and multi-level meta-regression to compare the effectiveness of these treatments on 6-minute walk distance (6MWD) and forced vital capacity (FVC).
  • Results indicated that cipaglucoside alfa with miglustat improved both 6MWD and FVC relative to alglucosidase alfa when assessing all available evidence, especially for patients with longer prior ERT duration.
View Article and Find Full Text PDF
Article Synopsis
  • * After the infusion, the patient showed improvements such as decreased creatine kinase levels and enhanced muscle strength, with no significant adverse effects like cytokine release syndrome.
  • * The therapy led to a rapid depletion of peripheral B cells within 15 days, and although B cells returned by two months, autoantibodies decreased significantly, indicating a positive immune response.
View Article and Find Full Text PDF

Objective: Dermatomyositis (DM) symptoms negatively affect the quality of life of individuals living with the disease. Disease-specific, patient-reported outcome (PRO) instruments are needed to assess symptoms important to individuals with DM. This study aimed to conceptualize patient DM experience and disease activity definition to refine the development of the Dermatomyositis Disease Symptom Questionnaire (DM-DSQ), a novel PRO instrument capturing patient-reported symptoms.

View Article and Find Full Text PDF

Background: The efficacy of avalglucosidase alfa (AVA) versus alglucosidase alfa (ALG) on forced vital capacity percent predicted (FVCpp) in patients with late-onset Pompe disease (LOPD) has been assessed in the Phase 3 COMET trial (NCT02782741). Due to the rarity of LOPD and thus small sample size in COMET, additional data were analyzed to gain further insights into the efficacy of AVA versus ALG.

Methods: Data from treatment-naive patients with LOPD were pooled from COMET and Phase 1/2 NEO1/NEO-EXT (NCT01898364/NCT02032524) trials for patients treated with AVA, and Phase 3 LOTS trial (NCT00158600) for patients treated with ALG.

View Article and Find Full Text PDF
Article Synopsis
  • This study looked at how a treatment called debamestrocel affects special substances in the body (biomarkers) in people with ALS, a disease that affects muscles.
  • They tested 196 people, some got the treatment while others got a fake treatment (placebo) and checked their cerebrospinal fluid (CSF) for 45 different biomarkers.
  • Results showed that debamestrocel improved many of these biomarkers, which could mean it's helping to protect nerves and reduce inflammation, especially in patients with more advanced ALS.
View Article and Find Full Text PDF
Article Synopsis
  • * Conducted over 12 months involving 188 LGMD patients from multiple sites in the U.S. and Europe, the research aims to evaluate the effectiveness of similar outcome measures in individuals with varying degrees of the disorder.
  • * This is projected to be the largest effort to validate clinical outcome assessments in LGMD, aiming to enhance clinical trial design and decision-making for future treatments, with data shared with relevant stakeholders post-study.
View Article and Find Full Text PDF
Article Synopsis
  • The PROPEL study compared a new therapy, cipaglucosidase alfa + miglustat (cipa + mig), to the standard treatment, alglucosidase alfa + placebo (alg + pbo), for adults with late-onset Pompe disease (LOPD).
  • An ongoing open-label extension study is assessing the long-term safety and effectiveness of cipa + mig, focusing on various outcome measures like walking distance and lung function.
  • After 104 weeks, patients on cipa + mig showed maintained improvements in walking distance and biomarkers with minimal safety concerns, indicating potential long-term benefits for those with LOPD.
View Article and Find Full Text PDF

Objective: ACTN2, encoding alpha-actinin-2, is essential for cardiac and skeletal muscle sarcomeric function. ACTN2 variants are a known cause of cardiomyopathy without skeletal muscle involvement. Recently, specific dominant monoallelic variants were reported as a rare cause of core myopathy of variable clinical onset, although the pathomechanism remains to be elucidated.

View Article and Find Full Text PDF
Article Synopsis
  • Cipaglucosidase alfa plus miglustat (cipa + mig) is a new two-part treatment for Pompe disease, assessed in the Phase I/II ATB200-02 study over 48 months.
  • The study involved four adult groups, including both ambulating and non-ambulating patients, who received specific doses of cipa and mig biweekly.
  • Results showed improvements in walking distances and respiratory capacity, especially in ERT-naïve patients, with the treatment generally well tolerated and a safety profile similar to existing therapies.
View Article and Find Full Text PDF

Background: The Limb Girdle Muscular Dystrophies (LGMDs) are characterized by progressive weakness of the shoulder and hip girdle muscles as a result of over 30 different genetic mutations. This study is designed to develop clinical outcome assessments across the group of disorders.

Methods/design: The primary goal of this study is to evaluate the utility of a set of outcome measures on a wide range of LGMD phenotypes and ability levels to determine if it would be possible to use similar outcomes between individuals with different phenotypes.

View Article and Find Full Text PDF
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.
View Article and Find Full Text PDF

Introduction/aims: Multiple novel therapies have been approved for patients with myasthenia gravis. Our aim is to describe the early experience of efgartigimod use in acetylcholine receptor antibody-positive generalized myasthenia gravis (AChR+ve gMG).

Methods: This multicenter retrospective study included AChR+ve gMG patients from five major neuromuscular centers who were treated with efgartigimod and had both pre- and post-efgartigimod myasthenia gravis activities of daily living (MG-ADL) scores.

View Article and Find Full Text PDF

Pompe disease is an autosomal recessive disorder caused by a deficiency of α-glucosidase, resulting in the accumulation of glycogen in smooth, cardiac, and skeletal muscles, leading to skeletal muscle dysfunction, proximal muscle weakness, and early respiratory insufficiency. Although many patients exhibit decreased bone mineral density (BMD) and increased fractures, there is currently no official protocol for surveillance and management of osteoporosis and osteopenia in late onset Pompe disease (LOPD). Enzyme replacement therapy (ERT) has therapeutic effects on muscle function; however, very few studies report on the effect of ERT on bone mineralization in LOPD patients.

View Article and Find Full Text PDF

Macrophages are essential for skeletal muscle homeostasis, but how their dysregulation contributes to the development of fibrosis in muscle disease remains unclear. Here, we used single-cell transcriptomics to determine the molecular attributes of dystrophic and healthy muscle macrophages. We identified six clusters and unexpectedly found that none corresponded to traditional definitions of M1 or M2 macrophages.

View Article and Find Full Text PDF

Background: Chimeric antigen receptor (CAR) T cells are highly effective in treating haematological malignancies, but associated toxicities and the need for lymphodepletion limit their use in people with autoimmune disease. To explore the use of CAR T cells for the treatment of people with autoimmune disease, and to improve their safety, we engineered them with RNA (rCAR-T)-rather than the conventional DNA approach-to target B-cell maturation antigen (BCMA) expressed on plasma cells. To test the suitability of our approach, we used rCAR-T to treat individuals with myasthenia gravis, a prototypical autoantibody disease mediated partly by pathogenic plasma cells.

View Article and Find Full Text PDF

The monocytic/macrophage system is essential for skeletal muscle homeostasis, but its dysregulation contributes to the pathogenesis of muscle degenerative disorders. Despite our increasing knowledge of the role of macrophages in degenerative disease, it still remains unclear how macrophages contribute to muscle fibrosis. Here, we used single-cell transcriptomics to determine the molecular attributes of dystrophic and healthy muscle macrophages.

View Article and Find Full Text PDF

Importance: In the previously reported Comparative Enzyme Replacement Trial With neoGAA Versus rhGAA (COMET) trial, avalglucosidase alfa treatment for 49 weeks showed clinically meaningful improvements in upright forced vital capacity (FVC) percent predicted and 6-minute walk test (6MWT) compared with alglucosidase alfa.

Objective: To report avalglucosidase alfa treatment outcomes during the COMET trial extension.

Design, Setting, And Participants: This phase 3 double-blind randomized clinical trial with crossover in the extension period enrolled patients 3 years and older with previously untreated late-onset Pompe disease (LOPD) between November 2, 2016, and February 10, 2021, with primary analysis after 49 weeks.

View Article and Find Full Text PDF