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Abstract Details

Internet-supervised Home-based Spirometry Through Telemedicine in Amyotrophic Lateral Sclerosis
Neuromuscular and Clinical Neurophysiology (EMG)
P6 - Poster Session 6 (8:00 AM-9:00 AM)
11-013
NA

Pilot Implementation study of At-Home Telespirometry (AHT) measurement of Erect-seated forced vital capacity (eFVC) demonstrated excellent precision (Bland-Altman), repeatability, feasibility of longitudinal measurement, increased assessment of supine forced vital capacity (sFVC) in home situation and differential rate of loss of eFVC as function of initial eFVC at baseline [ Young 2023, Narapureddy 2023 ].

Slope measurements of eFVC change differ by stratification of initial eFVC at baseline in parallel with increased rate of eFVC loss and increased rate of number of eFVC 3 % predicted monthly drops in cohort with eFVC < 60 % predicted at baseline [ Young 2023, Brooks 2023 ].

98 ALS subjects from two ALSA-certified ALS Clinics in the US (SUNY Upstate, Atrium Health) measured erect-seated and supine slow vital capacity [ eSVC, sSVC ] from home using a portable spirometer (MIR, Italy), ZEPHYRx mobile application and ZEPHYRx Provider Dashboard over 6 months. Cohorts stratified according to <60%, 60-80% and > 80% predicted eSVC at baseline are followed longitudinally to define eSVC and sSVC changes between cannonical quarterly ( q3month ) in-clinic visits to assess whether clinically significant changes in eSVC and sSVC identify respiratory complications requiring initiation of ventilator support before the next in-clinic visit
This prospective study [NCT05106569] has nearly completed recruitment of 100 ALS subjects. Baseline characteristics of enrolled ALS subjects are similar to ALS subjects completing the pilot FVC study [ Young 2023]. An interim analysis of the first 50 subjects to complete the study will be presented.
Stratification of eSVC obtained from baseline in-clinic measurement is predictive of ALS disease trajectory. This clinical study, using AHT to measure eSVC and sSVC between canonical in-clinic visits at home, will identify clinically significant, between clinic visit eSVC and sSVC changes, that may require earlier respiratory management than would occur from quarterly in-clinic visits.
Authors/Disclosures
Eufrosina I. Young, MD (Upstate University Hospital)
PRESENTER 		The institution of Dr. Young has received research support from Mitsubishi Tanabe Pharma America.
Dongliang Wang Dongliang Wang has nothing to disclose.
Birendra Sah (Upstate Medical University) Birendra Sah has received publishing royalties from a publication relating to health care.
Dragos Manta Dragos Manta has nothing to disclose.
Urvi G. Desai, MD, FAAN (Dept of Neurology, CMC) Dr. Desai has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Desai has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Desai has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Takeda. Dr. Desai has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx. Dr. Desai has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Fulcrum. Dr. Desai has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Catalyst. Dr. Desai has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Desai has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Desai has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Argenx.
George P. Slavinski, Respiratory Therapist (SUNY Upstate Medical University) Mr. Slavinski has nothing to disclose.
Lena Deb (SUNY Upstate Medical University) Lena Deb has nothing to disclose.
Marielle Posmik Marielle Posmik has nothing to disclose.
Takuya Kudo (Mitsubishi Tanabe Pharma America, Inc.) Mr. Kudo has nothing to disclose.
Kinjal Patel Kinjal Patel has nothing to disclose.
Stephen Apple Stephen Apple has received personal compensation for serving as an employee of Mitsubishi Tanabe Pharma America, Inc.
Benjamin R. Brooks, MD, FAAN (Clinical Trials Planning LLC) Dr. Brooks has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Mitsubishi Tanabe Pharma America. Dr. Brooks has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medicinova. Dr. Brooks has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Brooks has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AB Science. Dr. Brooks has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ionis. Dr. Brooks has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Mitsubishi Tanabe Pharma America. The institution of Dr. Brooks has received research support from Mitsubishi TanabePharma America. Dr. Brooks has received personal compensation in the range of $0-$499 for serving as a Member Annual Surveillance Committee CDC National ALS Registry with Center for Disease Control Agency Toxic Substances Disease Registry. Dr. Brooks has a non-compensated relationship as a Member ALS Quality Measures Subcommittee with 好色先生 that is relevant to AAN interests or activities.