Clinical trials in skeletal dysplasia: a paradigm for treating rare diseases.

IF 6.7 2区 医学 Q1 Medicine
Ataf Sabir, Melita Irving
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引用次数: 2

Abstract

Background: Genetic skeletal dysplasia conditions (GSDs) account for 5% of all birth defects. Until recently, targeted treatments were only available for select few conditions; 1 however, opportunities arising from developments in molecular diagnostic technologies are now leading to unparalleled therapeutic advances. This review explores current GSD clinical trials, their challenges and the hopes for the future.

Sources of data: A systematic literature search of relevant original articles, reviews and meta-analyses restricted to English was conducted using PubMed up to February 2020 regarding emerging GSD therapies.

Areas of agreement: We discuss current clinical trials for in achondroplasia, osteopetrosis, osteogenesis imperfecta, hypophosphataemic rickets, hypophosphatasia and fibrous ossificans progressiva.

Areas of controversy: We explore challenges in GSD drug development from clinician input, cost-effectiveness and evidenced-based practice.

Growing points: We explore opportunities brought by earlier diagnosis, its treatment impact and the challenges of gene editing.

Areas timely for developing research: We horizon scan for future clinical trials.

骨骼发育不良的临床试验:治疗罕见疾病的范例。
背景:遗传性骨骼发育不良(GSDs)占所有出生缺陷的5%。直到最近,靶向治疗只适用于少数几种情况;然而,分子诊断技术的发展所带来的机会正在导致前所未有的治疗进步。本文综述了目前GSD的临床试验、面临的挑战和对未来的希望。数据来源:使用PubMed对截至2020年2月的有关新兴GSD疗法的相关原创文章、综述和荟萃分析进行了系统的文献检索,仅限于英文。共识领域:我们讨论了软骨发育不全、骨质疏松、成骨不全、低磷性佝偻病、低磷性骨化症和进行性纤维性骨化症的当前临床试验。争议领域:我们从临床医生投入、成本效益和循证实践等方面探讨GSD药物开发中的挑战。成长点:探讨早期诊断带来的机遇、治疗影响和基因编辑带来的挑战。及时开展研究的领域:我们为未来的临床试验进行水平扫描。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
British medical bulletin
British medical bulletin 医学-医学:内科
CiteScore
13.10
自引率
1.50%
发文量
24
审稿时长
>12 weeks
期刊介绍: British Medical Bulletin is a multidisciplinary publication, which comprises high quality reviews aimed at generalist physicians, junior doctors, and medical students in both developed and developing countries. Its key aims are to provide interpretations of growing points in medicine by trusted experts in the field, and to assist practitioners in incorporating not just evidence but new conceptual ways of thinking into their practice.
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