Therapeutic Biomarkers in Friedreich ’s Ataxia: a Systematic Review and Meta-analysis

AbstractAlthough a large array of biomarkers have been investigated in Friedreich ’s ataxia (FRDA) trials, the optimal biomarker for assessing disease progression or therapeutic benefit has yet to be identified. We searched PubMed, MEDLINE, and EMBASE databases up to June 2023 for any original study (with ≥ 5 participants and ≥ 2 months’ follow-up) reporting the e ffect of therapeutic interventions on any clinical, cardiac, biochemical, patient-reported outcome measures, imaging, or neurophysiologic biomarker. We also explored the biomarkers’ ability to detect subtle disease progression in untreated patients. The pooled standardized mean difference (SMD) wa s calculated using a random-effects model. The study’s protocol was registered in PROSPERO (CRD42022319196). In total, 43 studies with 1409 FRDA patients were included in the qualitative synthesis. A statistically significant improvement was observed in Friedreich Ataxia Rating Scale scores [combi ning Friedreich Ataxia Rating Scale (FARS) and modified FARS (mFARS): SMD =  − 0.32 (− 0.62 to − 0.02)] following drugs that augment mitochondrial function in a sensitivity analysis. Left ventricular mass index (LVMI) was improved significantly [SMD =  − 0.34 (− 0.5 to − 0.18)] after 28.5 months of treatment with drugs that augment mitochondrial function. However, LVMI remained stable [SMD = 0.05 (− 0.3 to 0.41)] in untreated patients after 6-month follow-up. Non...
Source: The Cerebellum - Category: Neurology Source Type: research