Trends in Corticosteroid Use Among Males With Duchenne Muscular Dystrophy (DMD) During 2000-2015: Data From the MD STAR net

Abstract

This study updates previous reports by the population-based Muscular Dystrophy Surveillance, Tracking and Research Network on associations between increased corticosteroid use over time, and delayed use of corticosteroids among non-Hispanic Black males and those having a positive family history of Duchenne muscular dystrophy. Data for 373 males from six sites born and followed during 2000-2015 were analyzed using Kaplan-Meier curve estimation and Cox proportional hazards modeling. Corticosteroids were offered to 75.6% of all males; 68.9% initiated use at median ages of 6.8 (offered) and 7.2 (used). The previously observed associations persisted. Further examination of these associations suggest diagnosis timing may partially account for the observed delays due to later diagnosis among non-Hispanic Black males and early diagnosis among those with a positive Duchenne muscular dystrophy family history. Further research into health inequities underlying diagnostic delays among non-Hispanic Black males and the safety profile of early corticosteroid use will further inform on variability in corticosteroid treatment.

Keywords: Children; Duchenne Muscular Dystrophy; Treatment.