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- W2560846519 abstract "Objective: To examine the association of survival with clinical sub-groups of C9orf72 expanded ALS patients Background: The C9orf72 expansion is considered to be a negative prognostic factor in ALS survival. Due to the rarity of the expansion, previous studies have not been large enough to investigate interactions between C9orf72 expansion, clinical/demographic factors and survival. Methods: C9orf72 status and demographic/clinical data were gathered from ALS patients from three prospective ALS registers (Ireland, Italy and The Netherlands), and MND DNA banks in the UK and Belgium. Royston-Parmar survival models were built including known prognostic factors (age, diagnostic delay and site of onset), gender and C9orf72 status (normal or expanded). Stratified and interaction models, with variance-covariance clustered by country, were built to explore the effects of C9orf72 on survival by gender and site of onset. Individual patient data (IPD) meta-analysis was used to estimate hazard ratios for selected models. Results: In total, 4854 ALS cases were included, of which 445 (9.2[percnt]) carried the C9orf72 expansion. An IPD meta-analysis of C9orf72 in the base model estimated a hazard ratio of survival of 1.34 (1.17 - 1.53) for those carrying the expansion. Models allowing interaction between gender and C9orf72 repeat expansions suggested an interaction between male gender and reduced survival. IPD meta-analysis of this result calculated a hazard ratio of 1.46 (95[percnt] CI: 1.25 - 1.71) in males carrying the expansion. Models exploring interactions between site of onset and C9orf72 status did not did not account for the gender specific findings. Conclusions: The C9orf72 expansion is associated with poorer prognosis in males only across multiple European cohorts. These results are the first to identify gender specific effects of a known pathogenic gene in ALS. This carries implications for prognostic prediction and modeling, and also for the structure of clinical trials. Disclosure: Dr. Rooney has nothing to disclose. Dr. McLaughlin has nothing to disclose. Dr. Vajda has nothing to disclose. Dr. Fogh has nothing to disclose. Dr. Jones has nothing to disclose. Dr. Westeneng has nothing to disclose. Dr. Heverin has nothing to disclose. Dr. van Eijk has nothing to disclose. Dr. Robberecht has received personal compensation for activities with Neuronova Ltd. Dr. Van Damme has nothing to disclose. Dr. Van den Berg has received personal compensation for activities with Baxter, Biogen Idec, and Cytokinetics as a consultant. Dr. Veldink has nothing to disclose. Dr. Al-Chalabi has received personal compensation for activities with Biogen Idec ad Cytokinetics Inc. Dr. Al-Chalabi has received research support from MNDA, ALS Association, and ALS Therapy Alliance. Dr. Chio has received personal compensation for activities with Biogen Idec, Cytokinetics, and Italfamaco. Dr. Hardiman has received royalty payment from the Royal College of Surgeons in Ireland." @default.
- W2560846519 created "2016-12-16" @default.
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- W2560846519 date "2016-04-05" @default.
- W2560846519 modified "2023-10-02" @default.
- W2560846519 title "Novel Gender Selective Survival Effect of C9orf72 in European ALS Cohorts (P5.093)" @default.
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