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Duchenne expert physician perspectives on Duchenne newborn screening and early Duchenne care
Niki Armstrong1, Rachel Schrader1, Ryan Fischer1
1Parent Project Muscular Dystrophy, Washington, District of Columbia, USA.
Insights
Newborn screening for Duchenne muscular dystrophy (DMD) is supported by most physicians, who are ready to implement early interventions and therapies for infants identified through screening.
Area of Science:
- Neurology
- Genetics
- Pediatrics
Background:
- Duchenne muscular dystrophy (DMD) is a fatal neuromuscular disorder.
- Recent FDA-approved therapies have increased interest in newborn screening (NBS) for DMD.
- Early diagnosis and intervention are crucial for managing DMD.
Purpose of the Study:
- To explore physician perspectives on the benefits and readiness for DMD NBS.
- To understand recommended follow-up care and therapy initiation for infants identified via NBS.
- To assess the preparedness of the DMD care community for widespread NBS.
Main Methods:
- A survey was distributed to physicians at Certified Duchenne Care Centers in the USA.
- Twenty-seven physicians responded to statements regarding NBS benefits, readiness, and care recommendations.
- Physicians provided input on initial infant visit recommendations and therapy initiation timing.
Main Results:
- 82% of physicians see a benefit in DMD NBS.
- 74% believe the DMD care community is ready for dystrophinopathy NBS.
- Physicians recommended comprehensive early interventions, including genetic counseling, early intervention services, and developmental assessments.
Conclusions:
- Physicians largely support DMD NBS and feel the care community is prepared.
- Early interventions and therapies are recommended for infants identified through NBS.
- There is a consensus to initiate approved therapies much earlier than the typical diagnosis age.
Abstract:
Duchenne muscular dystrophy (DMD) is a progressive, fatal neuromuscular disorder typically diagnosed between 4 and 5 years of age. DMD currently has five FDA approved therapies, which has led to increased interest in newborn screening (NBS) for DMD. Our objective was to explore the perspectives and predicted practices of physicians (primarily neurologists) who will likely be responsible for the follow-up of infants identified with DMD through NBS. A short survey was developed and distributed to physicians who are responsible for providing care for patients with Duchenne at Certified Duchenne Care Centers across the USA. Twenty-seven physicians responded to statements about benefit and readiness for dystrophinopathy NBS, which care recommendations they would make at initial infant visits, and when they would recommend initiating approved therapies. Most DMD physicians indicated they see benefit in NBS (82%) and believe the DMD care community is ready for NBS in dystrophinopathies (74%). The majority of physicians would recommend multiple interventions, including genetic counseling, maternal carrier testing, referral to early intervention services, screening siblings, discussion of clinical trials, exon skipping therapies, and assessment of social and language development at initial visits. The majority of physicians also indicated they would recommend initiating approved therapies much earlier than the typical age of diagnosis.
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