The cooperative international neuromuscular research group Duchenne natural history study: Glucocorticoid treatment preserves clinically meaningful functional milestones and reduces rate of disease progression as measured by manual muscle testing and other commonly used clinical trial outcome measures

Erik K. Henricson, R. Ted Abresch, Avital Cnaan, Fengming Hu, Tina Duong, Adrienne Arrieta, Jay Han, Diana M. Escolar, Julaine M. Florence, Paula R. Clemens, Eric P. Hoffman, Craig M. McDonald, the Cooperative International Neuromuscular Research Group (CINRG) Investigators

Research output: Contribution to journalArticleResearchpeer-review

109 Citations (Scopus)


Introduction: Glucocorticoid (GC) therapy in Duchenne muscular dystrophy (DMD) has altered disease progression, necessitating contemporary natural history studies. Methods: The Cooperative Neuromuscular Research Group (CINRG) DMD Natural History Study (DMD-NHS) enrolled 340 DMD males, ages 2-28 years. A comprehensive battery of measures was obtained. Results: A novel composite functional "milestone" scale scale showed clinically meaningful mobility and upper limb abilities were significantly preserved in GC-treated adolescents/young adults. Manual muscle test (MMT)-based calculations of global strength showed that those patients <10 years of age treated with steroids declined by 0.4±0.39 MMT unit/year, compared with -0.4±0.39 MMT unit/year in historical steroid-naive subjects. Pulmonary function tests (PFTs) were relatively preserved in steroid-treated adolescents. The linearity and magnitude of decline in measures were affected by maturational changes and functional status. Conclusions: In DMD, long-term use of GCs showed reduced strength loss and preserved functional capabilities and PFTs compared with previous natural history studies performed prior to the widespread use of GC therapy.

Original languageEnglish
Pages (from-to)55-67
Number of pages13
JournalMuscle & Nerve
Issue number1
Publication statusPublished - Jul 2013
Externally publishedYes


  • Adolescent
  • Adult
  • Child/preschool
  • Follow-up studies
  • Health status
  • Humans
  • Locomotion
  • Male
  • Muscle strength/physiology
  • Muscular dystrophies/classification
  • Muscular dystrophies/Duchenne/physiopathology
  • Muscular dystrophies/therapy
  • Phenotype
  • Quality of life/psychology
  • Respiratory function tests

Cite this