{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T23:16:28Z","timestamp":1773098188068,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100014941","name":"Cytokinetics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014941","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>Durable medical equipment (DME)\u2014wheelchairs, non\u2010invasive ventilation, gastrostomy tubes, and communication devices\u2014provides vital support for individuals with amyotrophic lateral sclerosis (ALS). Here, we describe DME use in COURAGE\u2010ALS evaluating reldesemtiv's efficacy and safety in ALS, to evaluate if DME use can be considered an endpoint of interest in ALS trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>COURAGE\u2010ALS, a multicentre, double\u2010blind, randomized, placebo\u2010controlled clinical trial was conducted at 83 sites in the United States, Canada, Europe, and Australia. Participants were randomized 2:1 to receive reldesemtiv or placebo for 24\u2009weeks, followed by 24\u2009weeks of active drug treatment. Exploratory outcomes included reasons for prescribing, extent of use, DME types, and regional differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 482 participants, 166 (34.4%) were using at least one DME item at baseline. Among 276 participants completing study visits through Week 24, 130 (47.1%) initiated use of a total of 188 new DME items post\u2010baseline through 24\u2009weeks. Manual wheelchairs were most used at baseline (89 items) and initiated (47 items) during the trial. Both baseline DME use and initiating a new item were associated with lower ALS Functional Rating Scale\u2010Revised scores and worse quality of life. The trial was terminated early due to futility. Treatment assignment did not impact DME use. Regional disparities were noted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study shows that DME is commonly prescribed to ALS trial participants. Further understanding of geographic differences in DME access and their impact on clinical outcomes is warranted prior to including DME use as an endpoint in ALS trials.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: (NCT04944784)\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.70150","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T13:19:38Z","timestamp":1768828778000},"page":"608-614","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Use of Durable Medical Equipment in\n                    <scp>COURAGE<\/scp>\n                    \u2010\n                    <scp>ALS<\/scp>\n                    , a Phase 3, Multicentre, Randomized Clinical Trial for\n                    <scp>ALS<\/scp>"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3499-5208","authenticated-orcid":false,"given":"Stacy A.","family":"Rudnicki","sequence":"first","affiliation":[{"name":"Cytokinetics Incorporated  South San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9233-235X","authenticated-orcid":false,"given":"Elisa","family":"Giacomelli","sequence":"additional","affiliation":[{"name":"Sean M. Healey and AMG Center for ALS and the Neurological Clinical Research Institute Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5699-8082","authenticated-orcid":false,"given":"Katherine","family":"Herder","sequence":"additional","affiliation":[{"name":"Cytokinetics Incorporated  South San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5327-7204","authenticated-orcid":false,"given":"Caroline","family":"Ingre","sequence":"additional","affiliation":[{"name":"Karolinska Institute  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5469-1287","authenticated-orcid":false,"given":"Stuart","family":"Kupfer","sequence":"additional","affiliation":[{"name":"Cytokinetics Incorporated  South San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5597-5759","authenticated-orcid":false,"given":"Fady I.","family":"Malik","sequence":"additional","affiliation":[{"name":"Cytokinetics Incorporated  South San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0229-1131","authenticated-orcid":false,"given":"Lisa","family":"Meng","sequence":"additional","affiliation":[{"name":"Cytokinetics Incorporated  South San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0505-1168","authenticated-orcid":false,"given":"Sabrina","family":"Paganoni","sequence":"additional","affiliation":[{"name":"Sean M. Healey and AMG Center for ALS and the Neurological Clinical Research Institute Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"},{"name":"Spaulding Rehabilitation Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5820-2428","authenticated-orcid":false,"given":"Kerri","family":"Schellenberg","sequence":"additional","affiliation":[{"name":"University of Saskatchewan  Saskatoon Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9427-1452","authenticated-orcid":false,"given":"Erica","family":"Scirocco","sequence":"additional","affiliation":[{"name":"Sean M. Healey and AMG Center for ALS and the Neurological Clinical Research Institute Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6063-174X","authenticated-orcid":false,"given":"Tyrell","family":"Simkins","sequence":"additional","affiliation":[{"name":"Cytokinetics Incorporated  South San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5828-5705","authenticated-orcid":false,"given":"Jenny","family":"Wei","sequence":"additional","affiliation":[{"name":"Cytokinetics Incorporated  South San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5067-5602","authenticated-orcid":false,"given":"Jeremy M.","family":"Shefner","sequence":"additional","affiliation":[{"name":"Barrow Neurological Institute and Creighton University  Phoenix Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"COURAGE\u2010ALS Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/17482960902835970"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/5563343"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2018.1431786"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3109\/21678421.2014.920031"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2017.1363242"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2023.2297795"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2021.1946083"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2023.2216223"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2025.0241"},{"key":"e_1_2_13_11_1","unstructured":"ALSAQ\u201040 Sample \u201cOxford Website \u201daccessed December 16 2025 https:\/\/innovationoxacuk\/wp\u2010content\/uploads\/2014\/09\/SAMPLE\u2010FINAL_ALSAQ\u201040_English_UKpdf."},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181bc0141"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.191721"},{"key":"e_1_2_13_14_1","unstructured":"NICE Guidelines \u201cMotor Neurone Disease: Assessment and Management \u201daccessed January 5 2026 https:\/\/wwwniceorguk\/guidance\/ng42\/chapter\/Recommendations."},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16264"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-018-8861-4"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2023.2260832"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2024.2351185"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2021.1946089"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2016.1270325"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-4598(200103)24:3<403::AID-MUS1013>3.0.CO;2-3"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000227785.73714.64"}],"container-title":["Muscle &amp; 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